Caba Melanie, Gains Connor, Nessler Joseph, Frye Benjamin, Scholl Laura, Sequeira Sean B, Mont Michael
Stryker Orthopaedics, Mahwah, NJ, USA.
St. Cloud Orthopedics, Sartell, MN, USA.
J Orthop. 2024 Jul 14;62:126-132. doi: 10.1016/j.jor.2024.07.001. eCollection 2025 Apr.
The adoption of new techniques, such as the direct anterior (DA) approach, and technologies, such as robotic assistance, in total hip arthroplasty (THA) has the potential to alleviate the intraoperative physical and mental demand that surgeons experience. Therefore, the aim of this study is to compare the physical and mental demand of surgeons performing conventional DA THA with fluoroscopy and robotic-assisted DA THA without fluoroscopy.
Two orthopaedic surgeons completed bilateral DA THA's on six cadaveric specimens. To assess physical demand, heart rates (HR), respirations, HR variability (stress), calories burned, and sweat loss were recorded using smartwatches. Surgeons completed a modified SURG-TLX questionnaire to assess physical and mental demand. Data were pooled together and two-sample -tests were performed.
Physical and mental demand metrics such as maximum HR, maximum stress, mean caloric expenditure and sweat loss were lower in robotic-assisted DA THA without fluoroscopy. Robotic-assisted THA was associated with a decreased percentage change for both the overall procedure and all surgical steps. Robotic-assisted THA also resulted in a significant difference in percentage change for maximum HR during acetabular reaming.Via questionnaire results, surgeons reported that robotic-assisted DA THA was significantly less physically and mentally demanding compared to conventional DA THA for the overall procedure and acetabular reaming.
It is important to understand how robotic-assisted THA impacts the health of the surgeons using them. Robotic-assisted DA THA without fluoroscopy resulted in less physical and mental demand for orthopaedic surgeons for the overall procedure and individual surgical steps.
在全髋关节置换术（THA）中采用新技术，如直接前路（DA）入路，以及技术，如机器人辅助，有可能减轻外科医生在手术中所经历的身体和精神需求。因此，本研究的目的是比较进行传统透视下DA THA的外科医生与非透视下机器人辅助DA THA的外科医生的身体和精神需求。
两名骨科医生在六个尸体标本上完成了双侧DA THA。为了评估身体需求，使用智能手表记录心率（HR）、呼吸、HR变异性（压力）、卡路里消耗和出汗量。外科医生完成了一份修改后的SURG-TLX问卷，以评估身体和精神需求。数据汇总在一起并进行双样本检验。
在非透视下机器人辅助DA THA中，诸如最大HR、最大压力、平均卡路里消耗和出汗量等身体和精神需求指标较低。机器人辅助THA与整个手术过程和所有手术步骤的百分比变化降低相关。机器人辅助THA在髋臼扩孔期间最大HR的百分比变化方面也产生了显著差异。通过问卷结果，外科医生报告说，与传统DA THA相比，机器人辅助DA THA在整个手术过程和髋臼扩孔方面对身体和精神的要求明显更低。
了解机器人辅助THA如何影响使用它们的外科医生的健康很重要。非透视下机器人辅助DA THA对外科医生在整个手术过程和各个手术步骤中的身体和精神需求较低。
