Peters Michiel P, Feczko Peter Z, Tsang Karel, van Rietbergen Bert, Arts Jacobus J, Emans Peter J
Department of Rheumatology, Research School CAPHRI+NUTRIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
Department Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands.
J Arthroplasty. 2016 Dec;31(12):2773-2777. doi: 10.1016/j.arth.2016.05.030. Epub 2016 May 27.
Historically it has been suggested that noise-induced hearing loss (NIHL) affects approximately 50% of the orthopedic surgery personnel. This noise may be partially caused by the use of powered saw systems that are used to make the bone cuts. The first goal was to quantify and compare the noise emission of these different saw systems during total knee arthroplasty (TKA) surgery. A second goal was to estimate the occupational NIHL risk for the orthopedic surgery personnel in TKA surgery by quantifying the total daily noise emission spectrum during TKA surgery and to compare this to the Dutch Occupational Health Organization guidelines.
A conventional sagittal oscillating blade system with a full oscillating blade and 2 newer oscillating tip saw systems (handpiece and blade) were compared. Noise level measurements during TKA surgery were performed during cutting and hammering, additionally surgery noise profiles were made.
The noise level was significantly lower for the oscillating tip saw systems compared to the conventional saw system, but all were in a range that can cause NIHL. The conventional system handpiece produced a considerable higher noise level compared to oscillating tip handpiece.
NIHL is an underestimated problem in the orthopedic surgery. Solutions for decreasing the risk of hearing loss should be considered. The use of oscillating tip saw systems have a reduced noise emission in comparison with the conventional saw system. The use of these newer systems might be a first step in decreasing hearing loss among the orthopedic surgery personnel.
历史上曾有人提出，噪声性听力损失（NIHL）影响约50%的骨科手术人员。这种噪声可能部分是由用于切割骨头的电动锯系统的使用引起的。第一个目标是量化和比较这些不同锯系统在全膝关节置换术（TKA）手术期间的噪声排放。第二个目标是通过量化TKA手术期间的每日总噪声排放频谱来估计TKA手术中骨科手术人员的职业性NIHL风险，并将其与荷兰职业健康组织的指南进行比较。
比较了一种具有全振荡刀片的传统矢状振荡刀片系统和2种较新的振荡尖端锯系统（机头和刀片）。在TKA手术期间，在切割和锤击过程中进行噪声水平测量，此外还制作了手术噪声分布图。
与传统锯系统相比，振荡尖端锯系统的噪声水平显著更低，但所有系统的噪声水平都在可能导致NIHL的范围内。与振荡尖端机头相比，传统系统机头产生的噪声水平要高得多。
NIHL在骨科手术中是一个被低估的问题。应考虑降低听力损失风险的解决方案。与传统锯系统相比，振荡尖端锯系统的噪声排放有所降低。使用这些较新的系统可能是减少骨科手术人员听力损失的第一步。
