Table 2.

Study characteristics for ergonomics descriptive synthesis

Author	Aim	Measured parameters	Assessment timeframe	Setting	Procedure(s) performed	Surgeon age in years	% men	Number, training status
Bergovec et al. [14]	To investigate surgeon energy requirements and cardiovascular response at seven key points during THA; to investigate the effect of age and experience on cardiovascular response	BP, HR, EE	Intraoperative	Surgery	THA	28-65	100	26 attendings
Ferrari et al. [26]	To compare surgeon performance during conventional broaching and using an automated impaction device	sEMG muscle activation (brachioradialis, biceps brachii, trapezius), fatigue	Intraoperative, perioperative	Synthetic composite femur	Automated and conventional broaching	NR	NR	7 attendings
Gupta et al. [29]	To investigate the cardiovascular response of surgeons and trainees during hallux valgus surgery, TKA, and THA; to compare the response between trainers and trainees	BP, HR, MAP, exercise stress test	Intraoperative	Surgery	Hallux valgus correction, TKA, THA	NR	100	3 attendings, 3 residents
Haffar et al. [30]	To investigate the impact of operative laterality and surgeon limb dominance on surgeon physiologic stress and energy expenditure during TJA	HR, HRV, RR, MV, EE	Intraoperative	Surgery	TJA	NR	NR	3 attendings
Haffar et al. [31]	To compare surgeon stress and strain during robotic-assisted TKA and conventional TKA	HR, HRV, RR MV, EE, posture	Intraoperative	Surgery	Unilateral TKA	57-72	NR	NR
Hsiao et al. [34]	To measure the muscle strength and fatigability of the forearm in orthopaedic surgeons performing bone screw fixations	Gripping force, driving torque, push force, sEMG	Intraoperative, perioperative	Porcine femur	Fixation (8 bone screw insertion)	33.8 ± 3.9	100	2 attendings, 6 residents
Jevsevar et al. [38]	To measure physiologic strain in orthopaedic residents and faculty surgeons and identify daily stressors	HRV, RHR, RR, sleep quality	Intraoperative, perioperative	Surgery, clinic	NR	25-41	NR	9 attendings, 12 residents
Kothari and Urakov [43]	To assess the posture of a spine surgeon in various spine surgery cases	Time in nonneutral spine position (slouched)	Intraoperative	Surgery	Spine surgeries	NR	NR	1 attending
Kwon et al. [44]	To measure the intraoperative stress of spine surgeons	HR, HRV, EEG	Intraoperative	Surgery	Elective lumbar spine surgeries	34-65	NR	2 attendings, 3 fellows
Kwon et al. [45]	To analyze intraoperative stress with EEG signals and HRV during spine surgery	HRV, BP, EEG signals	Intraoperative	Surgery	Elective lumbar spine surgeries	34-63	NR	2 attendings, 3 fellows
Lorenz et al. [48]	To measure torques generated by acetabular reamers in THA	Forces and torque along reamer axis	Intraoperative	Fresh frozen cadaver	THA	NR	NR	NR
Mahmood et al. [50]	To evaluate the magnitude of hand-arm vibration exposure in orthopaedic surgeons using a battery-operated saw	Triaxial acceleration	Intraoperative	Fresh frozen cadaver	Tibial bone cut	NR	NR	3 attendings
Park et al. [58]	To assess differences in surgeon whole spine angles according to operating table height and visual aids during discectomy	Whole spine angles	Intraoperative	Simulator	Discectomy	NR	NR	12 attendings
Scheidt et al. [59]	To investigate the impact of front protection X-ray aprons on the posture of orthopaedic and trauma surgeons	Posture	Intraoperative	Surgery	Various	31.07 ± 4.98	65	24 specialist registrars, 2 specialists, 5 senior specialists
Scholl et al. [60]	To compare surgeon cervical spine postures and repetitive motions when performing manual TKA versus robotic-assisted TKA	Cervical spine postures and repetitive motions	Intraoperative	Fresh frozen cadaver	TKA	NR	NR	2 attendings
Sochacki et al. [64]	To determine orthopaedic surgery residents’ and attending surgeons’ resting HR and HRV and correlated factors	Resting HR, HRV	Intraoperative, perioperative	Surgery, clinic	NR	Resident: 29.8 ± 2.6; attending: 47.2 ± 9.5	Resident: 58; attending: 89	12 residents, 9 attendings
Sochacki et al. [65]	To measure the quantity and quality of sleep in orthopaedic surgeons and correlated factors	Sleep quantity and quality	Intraoperative, perioperative	Surgery, clinic	NR	37.2 ± 10.9	71%	12 residents, 9 attendings
Whitney et al. [73]	To measure EE during simulated orthopaedic spine surgery	VO2, EE, fat and carbohydrate utilization	Intraoperative	Fresh frozen cadaver	One-level lumbar laminectomy and fusion	32 ± 2	NR	1 attending, 7 residents

Data presented as range or mean ± SD. BP = blood pressure; HR = heart rate; EE = energy expenditure; sEMG = surface electromyography; NR = not reported; MAP = mean arterial pressure; HRV = heart rate variability; RR = respiratory rate; RHR = resting heart rate; MV = minute ventilation; TJA = total joint arthroplasty; EEG = electroencephalography.