{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:22:00Z","timestamp":1793643720632,"version":"4.5.1"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Orthopaedic surgeons are at high risk for experiencing work-related musculoskeletal (MSK) injuries and chronic pain due to repetitive large magnitude forces, altered posture from lead vests, and prolonged irregular body positions. We sought to synthesize available evidence regarding (1) the biomechanics of orthopaedic surgery and (2) MSK injuries sustained by orthopaedic surgeons with subsequent treatment and consequences.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n To conduct this systematic review, we queried 4 databases (PubMed, Embase, MEDLINE, and Web of Science) for original research studies presenting on the biomechanics of orthopaedic surgery or MSK injuries sustained by orthopaedic surgeons. Studies were excluded if they were not original research (i.e., reviews) or reported on non-MSK injuries and injuries in patients or nonorthopaedic specialists. The literature search yielded 3,202 publications, 34 of which were included in the final analysis.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Eight studies reported on the biomechanics of orthopaedic surgery. Surgeons spent an average 41.6% of operating time slouched. Head and whole spine angles were closest to natural standing position when using a microscope for visualization and with higher surgical field heights. Use of lead aprons resulted in a shifted weight distribution on the forefoot, gain in thoracic kyphosis, and increase in lateral deviation from postural loading. Twenty-six studies reported on MSK symptoms and injuries experienced by orthopaedic surgeons, with an overall prevalence from 44% to 97%. The most common body regions involved were lower back (15.2%-89.5%), hip\/thigh (5.0%-86.6%), neck (2.4%-74%), hand\/wrist (10.5%-54%), shoulder (7.1%-48.5%), elbow (3.1%-28.3%), knee\/lower leg (7.9%-27.4%), and foot\/ankle (7%-25.7%). Of surgeons with any reported MSK symptom or injury, 27% to 65.7% required nonoperative treatment, 3.2% to 34.3% surgery, and 4.5% to 31% time off work. Up to 59.3% of surgeons reported that their injuries would negatively influence their ability to perform surgical procedures in the future.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The orthopaedic surgeon population experiences a high prevalence of MSK symptoms and injuries, likely secondary to the biomechanical burdens of tasks required of them during strenuous operations.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n Level III<\/jats:underline>\n . See Instructions for Authors for a complete description of levels of evidence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.22.00202","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T16:07:37Z","timestamp":1675267657000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["The Biomechanical Burden of Orthopaedic Procedures and Musculoskeletal Injuries Sustained by Orthopaedic Surgeons"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3651-2361","authenticated-orcid":false,"given":"Amy L.","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6382-0944","authenticated-orcid":false,"given":"Oscar G.","family":"Covarrubias","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7112-0139","authenticated-orcid":false,"given":"Ramakanth R.","family":"Yakkanti","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0880-3230","authenticated-orcid":false,"given":"Rachel B.","family":"Sotsky","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5070-2770","authenticated-orcid":false,"given":"Amiethab A.","family":"Aiyer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1]]},"reference":[{"issue":"10","key":"r2-20240731","first-page":"49","article-title":"Safety culture in healthcare: the $13 billion case","volume":"58","author":"Harris","year":"2013","journal-title":"Prof Saf"},{"key":"r3-20240731","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.amsu.2020.06.020","article-title":"Improving ergonomics in the operating room for orthopaedic surgeons in order to reduce work-related musculoskeletal injuries","volume":"56","author":"Alaqeel","year":"2020","journal-title":"Ann Med Surg (Lond)"},{"issue":"4","key":"r4-20240731","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1302\/2633-1462.14.BJO-2020-0005","article-title":"Work-related musculoskeletal disorders among Saudi orthopedic surgeons: a cross-sectional study","volume":"1","author":"Al-Mohrej","year":"2020","journal-title":"Bone Jt Open"},{"issue":"1","key":"r5-20240731","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1503\/cjs.014415","article-title":"Prevalence of musculoskeletal disorders among orthopedic trauma surgeons: an OTA survey","volume":"59","author":"AlQahtani","year":"2016","journal-title":"Can J Surg"},{"issue":"25","key":"r6-20240731","doi-asserted-by":"crossref","first-page":"e7194","DOI":"10.1097\/MD.0000000000007194","article-title":"Occupational injuries among pediatric orthopedic surgeons: how serious is the problem?","volume":"96","author":"Alsiddiky","year":"2017","journal-title":"Medicine (Baltimore)"},{"issue":"8","key":"r7-20240731","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1016\/j.arth.2022.01.001","article-title":"Repetitive musculoskeletal injuries: a survey of female adult reconstruction surgeons","volume":"37","author":"Cohen-Rosenblum","year":"2022","journal-title":"J Arthroplasty"},{"issue":"1","key":"r8-20240731","first-page":"e21","article-title":"Prevalence of back and neck pain in orthopaedic surgeons in Western New York","volume":"6","author":"Lucasti","year":"2022","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"issue":"1","key":"r9-20240731","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5704\/MOJ.2003.004","article-title":"Musculoskeletal occupational injuries in orthopaedic surgeons and residents","volume":"14","author":"Tan","year":"2020","journal-title":"Malays Orthop J"},{"issue":"3","key":"r10-20240731","first-page":"132","article-title":"Occupational hazards facing orthopedic surgeons","volume":"41","author":"Lester","year":"2012","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"r11-20240731","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.jor.2021.02.023","article-title":"Are we putting ourselves in danger? 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