Surgery should not hurt: A look into the ergonomics of orthopedics

Orthopedic surgery is among the most physically demanding medical specialties, exposing surgeons to prolonged static postures, repetitive high-force movements, and heavy equipment that significantly increase the risk of musculoskeletal injury. Historical perspectives reveal that ergonomic principles have been recognized since antiquity, yet modern surgical practice continues to neglect them, resulting in high rates of pain, disability, and even premature retirement among orthopedic surgeons. Recent survey data demonstrate that musculoskeletal disorders affect surgeons across all subspecialties, with the lumbar spine, neck, and shoulders most frequently involved, and that these injuries directly influence surgical performance, career longevity, and workforce sustainability. Evidence-based strategies-including intraoperative postural awareness, optimized table and monitor positioning, ergonomic instrument design, microbreaks, targeted physical conditioning, and adoption of assistive technologies-have been shown to mitigate injury risk without compromising operative efficiency. Reframing ergonomics as a cornerstone of operative excellence is essential not only for surgeon well-being but also for ensuring high-quality, sustainable patient care in the future.