EP9.23 Intraoperative Noise Exposure Across the Spectrum of Hip Surgery: Hip Arthroscopy, Periacetabular Osteotomy, and Total Hip Arthroplasty

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ID: 331281
2026
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Abstract
Abstract Background Orthopaedic surgeons are exposed to substantial intraoperative noise, particularly during procedures involving powered instrumentation, reaming, broaching, and implant insertion. The OSHA defined permissible exposure limit is 90 dB over an 8-hour day and although prior studies have evaluated noise exposure in arthroplasty, comparative data across hip preservation and hip reconstructive procedures remain limited. This study compared intraoperative noise exposure during hip arthroscopy, periacetabular osteotomy (PAO), and total hip arthroplasty (THA). Methods A prospective observational study was performed at a single institution between January 2024 and October 2025. Consecutive cases were included. Sound meters were placed according to operating room role. Recordings began at incision and ended at skin closure. Primary outcomes were OSHA-derived noise dose percentage (Dose %) and time-weighted average exposure (TWA, dBA). Secondary outcomes included LAeq, RMS Max, and sound exposure level (SEL). Comparisons across procedures were performed using Kruskal-Wallis tests with Bonferroni-adjusted pairwise testing. One surgeon performed all THAs while another surgeon performed all hip arthroscopies and PAOs. Results Fifty-seven cases were successfully analyzed, including 20 hip arthroscopies, 17 PAOs, and 20 THAs. Mean recorded case duration was 69.0 ± 14.0 minutes for hip arthroscopy, 170.6 ± 34.9 minutes for PAO, and 31.5 ± 8.2 minutes for THA. Surgeon noise exposure was significantly greater during PAO and THA than during hip arthroscopy. Compared with hip arthroscopy, surgeons had higher Dose % during PAO (4.57 ± 1.53% vs 1.12 ± 0.57%; p < 0.001) and THA (3.56 ± 2.29% vs 1.12 ± 0.57%; p < 0.001), and higher TWA during PAO (67.34 ± 2.51 vs 56.59 ± 4.12 dBA; p < 0.001) and THA (63.90 ± 6.39 vs 56.59 ± 4.12 dBA; p < 0.001). Conclusions Surgeon cumulative noise exposure is significantly higher during PAO and THA than during hip arthroscopy. These findings support hip surgery as a meaningful occupational noise source and reinforce the need for targeted hearing conservation strategies. These findings are indicative of single case exposures, and repeated exposure across multiple cases per day and over years of practice may contribute to cumulative noise burden.
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Authors Collin Nguyen, Jack Drake, Matthew Hoffa, Justin M. Lapow, Samuel J. Mosiman, Brian T. Nickel, Andrea M. Spiker
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.503
URL
https://doi.org/10.1093/jhps/hnag043.503
Keywords Keywords not found

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