Surgeons Experience More Physiologic Stress and Strain During Revision Than Primary Total Joint Arthroplasty |
| |
| Institution: | 1. Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio;2. Department of Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina;3. Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina;4. Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland;1. Hospital for Special Surgery, Adult Reconstruction and Joint Replacement, New York, New York;2. Hospital for Special Surgery, Department of Biomechanics, New York, New York;1. Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York;2. Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania;3. Biostatistics Core, Research Administration, Hospital for Special Surgery, New York, New York;4. Division of Infectious Diseases, Department of Medicine, Hospital for Special Surgery, New York, New York |
| |
| Abstract: | BackgroundRevision total knee arthroplasty (rTKA) and total hip arthroplasty (rTHA) procedures are more complex than primary TKA and THA, but their physiologic burden to the surgeon has not been quantified. While rTKA and rTHA have longer operative times, it is unknown whether differences exist in stress and strain compared to primary TKA and primary THA. The study was conducted to elicit whether differences exist in surgeon physiological response while performing rTKA and rTKA compared to primary TKA and primary THA.MethodsWe evaluated a prospective cohort study of 70 consecutive cases (23 primary TKAs, 12 primary THAs, 16 rTKAs, and 19 rTHAs). Two high-volume fellowship-trained arthroplasty surgeons wore a smart vest that recorded cardiorespiratory data while performing primary THA, primary TKA, rTHA, and rTKA. Heart rate (beats/minute), stress index (correlates with sympathetic activation), respiratory rate (respirations/minute), minute ventilation (L/min), and energy expenditure (Calories) were collected for every case, along with patient body mass index (kilograms/meter2) and working operative time (minutes). T-tests were used to assess for differences between the two groups.ResultsCompared to primary TKA, performing rTKAs had a significantly higher surgeon stress index (17 versus 15; P = .035), heart rate (104 versus 99; P = .007), energy expenditure per case (409 versus 297; P = .002), and a significantly lower heart rate variability (11 versus 12; P = .006). Compared to primary THA, performing rTHA had a significantly higher energy expenditure per case (431 versus 307; P = .007) and trended towards having a higher surgeon stress index (16 versus 14; P = .272) and a lower heart rate variability (11 versus 12; P = .185), although it did not reach statistical significance.ConclusionSurgeons experience higher physiological stress and strain when performing rTKA and rTHA compared to primary TKA and primary THA. This study provides objective data on what many surgeons feel and should promote further research on the specific stress and strain felt by surgeons who perform revision arthroplasty procedures. |
| |
| Keywords: | revision TJA primary TJA stress strain energy expenditure smart vest |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
