Investigation of Hammering Sound Frequency to Prevent Intraoperative Fracture during Total Hip Arthroplasty

Background: The 1st peak frequency of the hammering sound in total hip arthroplasty may serve as an evaluation index to prevent intraoperative fracture. Fixation of the stem and femur cannot be acquired unless the 1st peak frequency of hammering the stem into the femur stabilizes, and fixation can be judged as acquired when the 1st peak frequency becomes constant. To investigate whether the environmental sound in the operating room can be differentiated from the hammering sound of total hip arthroplasty, the 1st peak frequency of the hammering sound when impacting the stem into the femur with a hammer was identified. Method: The hammering sound of impacting the stem into a biomechanical test material through an impactor was analyzed using a fast Fourier transform analyzer. Environmental sound in the operating room was simulated and the 1st peak frequency of the sound on collision between the operator’s voice and the surgical instrument was measured. The 1st peak frequency of hammering sound was compared between patients indicated for total hip arthroplasty and healthy individuals to investigate whether there is a difference due to bone quality. Results: The natural frequency of the impactor was 3.41 ± 0.05 kHz, and the 1st peak frequency of the femur, stem, and impactor was 2.43 ± 1.45 kHz. The 1st peak frequency of hammering sound on simulated femur in patients indicated for total hip arthroplasty was 2.98 ± 0.73 kHz and that in healthy individuals was 2.15 ± 0.32 kHz. This suggested that the hammering sound in total hip arthroplasty-indicated patients overlaps with the frequency of the collision sound of surgical instruments. Conclusion: To develop a system to prevent intraoperative fracture, countermeasures, such as noise canceling, are necessary to prevent false detection of hammering sounds.