Repetitive Musculoskeletal Injuries: A Survey of Female Adult Reconstruction Surgeons

Published:January 10, 2022DOI:



      Occupational injuries are a prevalent and costly problem for orthopaedic surgeons, especially arthroplasty surgeons performing physically demanding and repetitive tasks. The purpose of this study was to characterize musculoskeletal occupational injuries in female adult reconstruction surgeons.


      A prospective survey about workplace musculoskeletal injuries was distributed to female attending adult reconstruction surgeons in May 2020. Participants were identified using subspecialty membership data, social media, and personal contacts. Results were analyzed using descriptive statistics.


      63 female arthroplasty surgeons responded. 65.1% were 30-45 years old, and 42.9% were within 5 years of practice. 68.3% sustained a musculoskeletal occupational injury, most commonly forearm/wrist/hand (79.1%) shoulder (48.8%) and low back (44.2%). 10.0% of reported occupational injuries not related to pregnancy resulted in the surgeon requiring time off work, while 48.2% required temporary modifications of job performance, and 10.9% required surgical treatment. Of the injured surgeons who reported having been pregnant, 65.4% reported a workplace exacerbation of a pregnancy-related musculoskeletal condition, including low back pain (52.9%), pubic symphysis pain (35.3%), and carpal tunnel syndrome (29.4%).


      68.3% of female arthroplasty surgeons reported musculoskeletal occupational injuries, predominately forearm/wrist/hand, with a portion of those requiring modifications of job performance. Musculoskeletal injuries may be mitigated by performing repetitive tasks ergonomically, correcting posture, using appropriately sized instrumentation, and using automated or lighter instruments, to potentially avoid modifications to job performance, time off work or even surgical procedures. Further studies should investigate factors that contribute to injuries in arthroplasty surgeons and how they can be prevented.

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        • Davis W.T.
        • Sathiyakumar V.
        • Jahangir A.
        • Obremsky W.
        • Sethi M.
        Occupational injury among orthopaedic surgeons.
        J Bone Joint Surg Am. 2013; 95: e107
        • Alsiddiky A.M.
        • Alatassi R.
        • Altamimi S.M.
        • Alqarni M.M.
        • Alfayez S.M.
        Occupational injuries among pediatric orthopedic surgeons How serious is the problem?.
        Medicine. 2017; 96e7194
        • Auerbach J.D.
        • Weidner Z.D.
        • Milby A.H.
        • Diab M.
        • Lonner B.S.
        Musculoskeletal disorders among spine surgeons: Results of a survey of the Scoliosis Research Society membership.
        Spine. 2011; 36: 1715-1721
        • Mirbod M.S.
        • Yoshida H.
        • Miyamoto K.
        • Miyashita K.
        • Inaba R.
        • Iwata H.
        Subjective complaints in orthopedists and general surgeons.
        Int Arch Occup Environ Health. 1995; 67: 179-186
        • Alzaharani M.
        • Alqahtani S.
        • Tanzer M.
        • Hamdy R.
        Musculoskeletal disorders among orthopedic pediatric surgeons: an overlooked entity.
        J Child Orthop. 2016; 10: 461-466
        • Alqahtani S.
        • Alzahrani M.M.
        • Harvey E.
        Prevalence of musculoskeletal disorders among orthopedic trauma surgeons: an OTA survey.
        Can J Surg. 2016; 59: 42-47
        • Alqahtani S.M.
        • Alzahrani M.M.
        • Tanzer M.T.
        Adult reconstructive surgery: a high-risk profession for work-related injuries.
        J Arthroplasty. 2016; 31: 1194-1198
        • Vajapey S.P.
        • Li M.
        • Glassman A.H.
        Occupational hazards of orthopaedic surgery and adult reconstruction: A cross-sectional study.
        Journal of Orthopaedics. 2021; 25: 23-30
        • Chambers C.
        • Ihnow S.
        • Monroe E.
        • Suleiman L.
        Women in orthopaedic surgery: population trends in trainees and practicing surgeons.
        J Bone Joint Surg. 2018; 100: e116
        • Rhode R.
        • Wolf J.
        • Adams J.
        Where are the women in orthopaedic surgery?.
        Clin Orthop Relat Res. 2016; 474: 1950-1956
        • Alaqeel M.
        • Tanzer M.
        Improving ergonomics in the operating room for orthopaedic surgeons in order to reduce work-related musculoskeletal injuries.
        Ann Med Surg (London). 2020; 56: 133-138
      1. Moore SM, Steiner LJ, Torma-Krajewski J. Practical demonstrations of ergonomic principles. Department of Health and Human Services: Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health, Publication No. 2011-191.

        • Epstein S.
        • Sparer E.
        • Tran B.
        • Ruan Q.
        • Dennerlein J.
        • Singhal D.
        • et al.
        Prevalence of work-related musculoskeletal disorders among surgeons and interventionalists: A systematic review and meta-analysis.
        JAMA Surg. 2018; 153e174947
        • Berguer R.
        • Hreljac A.
        The relationship between hand size and difficulty using surgical instruments: a survey of 726 laparoscopic surgeons.
        Surg Endosc. 2004; 18: 508-512
        • Huang J.
        • McGlothlin J.
        Assessment of obstetrician-gynecologists performing laparoscopic surgery: study of hand size and surgical instruments.
        J Ergonomics. 2017; 8: 1
        • Kesikburun S.
        • Guzelkcucuk U.
        • Fidan U.
        • Demir Y.
        • Ergun A.
        • Tan A.K.
        Musculoskeletal pain and sypmptons in pregnancy: a descriptive study.
        Ther Adv Musculoskel Dis. 2018; 10: 229-234
        • Anderson M.
        • Goldman R.
        Occupational reproductive hazards for female surgeons in the operating room.
        JAMA Surg. 2020; 155: 243-249
        • Keene R.
        • Hillard-Sembell D.
        • Robinson B.
        • Novicoff W.
        • Saleh K.
        Occupational hazards to the pregnant orthopaedic surgeon.
        J Bone Joint Surg. 2011; 93: e141
        • Downes J.
        • Rauk P.
        • VanHeest A.
        Occupational hazards for pregnant or lactating women in the orthopaedic operating room.
        J Am Acad Orthop Surg. 2014; 22: 326-332