title: Noise Exposure in TKA Surgery; Oscillating Tip Saw Systems vs Oscillating Blade Saw Systems.
abstract: 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.
authors.affiliation: Department of Rheumatology, Research School CAPHRI+NUTRIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Michiel P
authors.initials: MP
authors.lastname: Peters
authors.affiliation: Department Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Peter Z
authors.initials: PZ
authors.lastname: Feczko
authors.affiliation: Department Orthopaedic Biomechanics, Faculty Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Karel
authors.initials: K
authors.lastname: Tsang
authors.affiliation: Department Orthopaedic Biomechanics, Faculty Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Bert
authors.initials: B
authors.lastname: van Rietbergen
authors.affiliation: Department Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands; Department Orthopaedic Biomechanics, Faculty Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Jacobus J
authors.initials: JJ
authors.lastname: Arts
authors.affiliation: Department Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Emans
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D001842:Bone and Bones / Q000601:surgery*; D006317:Hearing Loss, Noise-Induced / Q000209:etiology; D006801:Humans; D009622:Noise / Q000009:adverse effects; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D009985:Orthopedics / Q000706:statistics & numerical data*; D013525:Surgical Instruments
keywords: TKA surgery; hearing loss; noise-induced hearing loss; orthopedic theater; saw blade