Ergonomic Evaluation of Different Surgeon Positions for Total Knee Arthroplasty Surgery

Abstract

Ergonomics and risk factors for work-related musculoskeletal disorders have been studied extensively in various industry fields. However, only a few decades ago, these issues became a concern in the healthcare sector. Total knee arthroplasty (TKA) is one of the most common procedures performed by orthopaedic surgeons, and it would be desirable to perform it with an ergonomically safer technique. This study evaluated the ergonomic risk of different surgeon positions when performing contralateral TKA using the dominant hand. After the authors defined the four possible surgeon positions according to the most common positions used by surgeons in our environment (position A, on the opposite side of the knee to be operated on; position B, on the same side as the knee to be operated on; position C, with the patient’s legs separated and the surgeon standing between them; and position D, facing the knee to be operated on, at the patient’s feet), we performed an ergonomic analysis using the Rapid Entire Body Assessment (REBA) method. The overall REBA scores (lower score values indicate better ergonomics than higher) were between 7 and 6.5 for position A, between 6.17 and 5.5 for position B, between 5.92 and 5.5 for position C, and between 3.75 and 3.42 for position D. The test–retest and inter-rater reliability values ranged from substantial agreement to almost perfect agreement. Based on the results, we can conclude that the most ergonomic position for a right-handed surgeon to perform a left TKA is facing the left knee, at the patient’s feet (position D).