The Impact of Noise Reduction Techniques on Total Knee Replacement: A Comparative Study to achieve ‘Silent TKR’

Authors: Mithin Aachi, Ayesha Baig, Ramba Govardhana Anjali

DOI: 10.18231/j.ijos.11901.1758800628

Keywords: total knee replacement,noise pollution,theater staff preference,silent TKR,decibel meter

Abstract: Background: Noise levels in the operating theatre (OT) during Total Knee Replacement (TKR) surgeries can impact surgical precision, communication, and staff well-being. This study evaluates the effects of noise-reducing interventions on surgical outcomes and staff satisfaction in TKR procedures and trying to achieve as much Silent TKR as possible Methods: A total of 104 TKR surgeries were performed, with 50 conducted using conventional OT practices and 54 using noise-reducing interventions during Jan 1st 2023 to Dec 31st 2024. The noise reducing interventions included minimal verbal exchanges, the use of noise-isolating ear pods, reduced but optimal staff presence, and minimized instrument handling. Verbal communication was observed using modified OTAS based checklist. Intraoperative noise levels were measured, and post-operative complications, surgical time, and staff-reported satisfaction were assessed. Results: The noise-reducing group demonstrated lower intraoperative noise levels (mean reduction of 27.5 dB%, p<0.05, based on subjective feedbacks). There was no significant difference in surgical time or post-operative complications between the two groups. However, staff satisfaction surveys revealed significantly higher scores in the noise-reducing group, citing improved concentration, reduced stress, and better teamwork efficiency (p<0.01). Surgeons and assisting staff reported feeling more in control and less fatigued at the end of procedures. Conclusion: Implementing noise-reducing strategies in the OT during TKR leads to a more focused surgical environment without compromising patient outcomes. Additionally, staff members experience greater job satisfaction and reduced stress levels. While observer bias and confounders exist, this study provides basis for future larger trials. Further studies are warranted to explore long-term benefits and broader applications in other surgical procedures. A goal of ‘Silent TKR’ to the best of our ability is possible with good planning and execution.