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2 result(s) for "León-Muñoz, Vicente Jesús"
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Ergonomic Risk in Total Hip Arthroplasty: Approach-Specific Postural Loads and Position-Swap Effects During Cup Preparation
Musculoskeletal disorders (MSDs) among orthopaedic surgeons are associated with sustained, constrained postures during demanding intraoperative tasks. Total hip arthroplasty (THA) comprises sequential steps that may impose different postural loads on both the surgeon and assistant, yet team-level ergonomic design interventions remain underexplored. This study compared ergonomic risk during primary THA performed through the direct lateral (modified Hardinge) and posterolateral (Moore) approaches and assessed a simple workflow redesign: swapping surgeon and assistant positions during acetabular cup preparation (bottom reaming, perimeter reaming, and cup impaction). In a controlled Sawbones-based simulation using standard THA instruments, eight standardised surgical steps were recorded with 360° photographs. Forty-two postural instances (22 for the surgeon, 20 for the assistant) were analysed. Joint angles were measured with Kinovea and converted to Rapid Entire Body Assessment (REBA) scores; intra- and inter-rater reliability (ICC) and minimum detectable change (MDC95) were calculated. Surgeon REBA scores were in the medium-risk range and slightly lower with the posterolateral approach (mean 5.5) than with the direct lateral approach (mean 5.88), whereas assistant scores were in the low-risk range (means 3.43 and 3.29, respectively). The position-swap intervention successfully lowered the surgeon’s REBA action level, most notably during cup impaction, where ergonomic risk dropped from 10 (high risk) to 4 (medium risk) in the posterolateral approach, and from 7 (medium risk) to 3 (low risk) in the direct lateral approach, without increasing assistant risk. These findings provide controlled simulation-based evidence that this simple, zero-cost positional change can reduce the surgeon’s ergonomic action level during THA, although confirmation under real operative conditions is needed before broad generalization.
The Accuracy and Absolute Reliability of a Knee Surgery Assistance System Based on ArUco-Type Sensors
Recent advances allow the use of Augmented Reality (AR) for many medical procedures. AR via optical navigators to aid various knee surgery techniques (e.g., femoral and tibial osteotomies, ligament reconstructions or menisci transplants) is becoming increasingly frequent. Accuracy in these procedures is essential, but evaluations of this technology still need to be made. Our study aimed to evaluate the system’s accuracy using an in vitro protocol. We hypothesised that the system’s accuracy was equal to or less than 1 mm and 1° for distance and angular measurements, respectively. Our research was an in vitro laboratory with a 316 L steel model. Absolute reliability was assessed according to the Hopkins criteria by seven independent evaluators. Each observer measured the thirty palpation points and the trademarks to acquire direct angular measurements on three occasions separated by at least two weeks. The system’s accuracy in assessing distances had a mean error of 1.203 mm and an uncertainty of 2.062, and for the angular values, a mean error of 0.778° and an uncertainty of 1.438. The intraclass correlation coefficient was for all intra-observer and inter-observers, almost perfect or perfect. The mean error for the distance’s determination was statistically larger than 1 mm (1.203 mm) but with a trivial effect size. The mean error assessing angular values was statistically less than 1°. Our results are similar to those published by other authors in accuracy analyses of AR systems.