Surgical Ergonomics and Musculoskeletal Pain in Orthopaedic Surgery Residents: A Multicenter Survey Study

Abstract

Purpose: Owing to the nature of orthopaedic surgery, occupational hazards and musculoskeletal pain (MSP) are inherent. These hazards have been well-documented among practicing orthopaedic surgeons, but there remains a paucity of data regarding MSP among orthopaedic surgery residents. The purpose of this study was to identify the prevalence and quantify the extent of work-related MSP among orthopaedic surgical residents. We also sought to analyze resident attitudes, beliefs, and behaviors regarding surgical ergonomics.

Methods: An online survey was sent to 78 orthopaedic surgery resident program directors to be distributed to residents within their programs. The survey included three main sections: symptoms by body part, attitudes/beliefs/behaviors regarding surgical ergonomics, and finally demographics. Pain was reported as using the 0 to 10 Numeric Rating Scale, with 0 = no pain and 10 = maximum pain. Several questions about resident well-being were assessed using the Maslach Burnout Inventory.

Results: Seventy-six orthopaedic surgery residents completed the survey, 72% men and 28% women. Most residents (97%) experience procedural-related MSP. Average pain scores of all residents was 3.52/10. Notable levels of MSP (≥4/10) were most common in the lower back (35%), neck (29.7%), and feet (25.7%). A positive association exists between higher MSP and lower work satisfaction (P = 0.005), burnout (P = 0.04), and callousness toward others (P < 0.0001). MSP has notable impact on resident behaviors including over-the-counter medication use, stamina, concentration, and degree of irritability.

Conclusion: The prevalence of MSP among orthopaedic surgical residents is extremely high. Our study demonstrates that MSP has a notable impact on resident concentration, degree of irritability, and other burnout symptoms. The results of this study highlight the importance of limiting compromising procedural positions, ergonomic optimization, and increasing the awareness of the importance of ergonomics among residents. This could have future implications on productivity and career longevity.

Figure 1

Pie chart demonstrating severity of pain scores after a full day of operating. Notable pain was termed pain ≥ 4/10 using the numeric rating scale.

Figure 2

Pie chart demonstrating the chronicity procedural related pain among orthopaedic surgery residents. Chronic pain was termed pain lasting ≥ 30 days straight.

Figure 3

A bar graph demonstrating notable pain among orthopaedic residents stratified by anatomic location. Notable pain was termed pain ≥ 4/10 using the numeric rating scale.

Figure 4

Bar chart demonstrating how procedural-related pain affects the behavior and daily life of orthopaedic surgery residents.

Figure 5

Bar chart demonstrating the most common ergonomic approaches used by orthopaedic residents to minimize procedural-related pain.

Figure 6

Bar chart demonstrating the most common avenues of medical care sought to address procedural-related pain among orthopaedic residents.