Background: Most orthopedists are right-handed. However, osteoarthritis occurs with
equal frequency over both sides. Does perfect and effective arthroplasty
surgery require ambidextrous motor skills? Objectives: In this study, we
aimed to investigate the clinical features of arthroplasty for hip and knee joints
(THR and TKR) on different sides affected by orthopedist laterality. Patients
and Methods: All right-handed orthopedists performed 64 right and 52 left
primary THR among 100 patients, and 115 right and 118 left primary TKR among 192
patients. Clinical and surgical features were retrospectively reviewed and
analyzed. The body mass index (BMI), inner diameter of acetabular cup liners
(ACD), diameter of the femoral head (FHD), diameter of the femoral stem (FSD),
and the femoral neck length (FNL) were included in THR-receiving patients. The BMI,
femoral component (FC) size, tibial plate (TP) size, and thickness of articular
surface inserts (ASI) were included in TKR-receiving patients. Results: No
significant differences were observed in ACD, FHD and FSD between patients
receiving right and left THR groups (p = 0.16, 0.11, and 0.05, respectively). Similarly, there were no significant
differences in FC, TP, and ASI between patients receiving right and left TKR
groups (p = 0.06, 0.80, and 0.46, respectively).
However, FNL in left THR group was significantly longer than that in right THR group (p = 0.01). Conclusion: This study showed that dexterity or proprioception in
handedness had no affect on bone resection and thicknesses of the polyethylene
in TKR and acetabular reaming and femoral canal rasping in THR. However, it did
lead to differences in femoral neck resection. Right-handed orthopedists
significantly tend to perform excessive femoral neck cutting or prefer the
larger size of FNL when performing left side THR, while no differences occur
when performing TKR.
Pedowitz, R., Nicandri, G. and Tuchschmid, S. (2016) Asymmetry in Dominant/Non-Dominant Hand Performance Differentiates Novices from Experts on an Arthroscopy Virtual Reality Serious Game. Studies in Health Technology and Informatics, 220, 289-294.
Hanna, G.B., Drew, T., Clinch, P., Shimi, S., Dunkley, P., Hau, C. and Cuschieri, A. (1997) Psychomotor Skills for Endoscopic Manipulations: Differing Abilities between Right and Left-Handed Individuals. Annals of Surgery, 225, 333-338. https://doi.org/10.1097/00000658-199703000-00014
Lee, J.Y., Mucksavage, P. and McDougall, E.M. (2013) Surgical Skills Acquisition among Left-Handed Trainees-True Inferiority or unfair Assessment: A Preliminary Study. Journal of Surgical Education, 70, 237-242. https://doi.org/10.1016/j.jsurg.2012.09.007
Kuo, Y.W., Yen, M.K., Cheng, K.I., Tang, C.S., Chau, S.W., Hou, M.F., Wang, J.J. and Lin, S.F. (2007) Lightwand-Guided Endotracheal Intubation Performed by the Nondominant Hand Is Feasible. The Kaohsiung Journal of Medical Sciences, 23, 504-510. https://doi.org/10.1016/S1607-551X(08)70008-1
Oms, L.M. and Badia, J.M. (2003) Laparoscopic Cholecystectomy In Situs Inversus Totalis: The Importance of Being Left-Handed. Surgical Endoscopy, 17, 1859-1861. https://doi.org/10.1007/s00464-003-9051-7
Moloney, D., Bishay, M., Ivory, J. and Pozo, J. (1994) Failure of the Sliding Hip Screw in the Treatment of Femoral Neck Fractures: “Left-Handed Surgeons for Left-Sided Hips”. Injury, 25, B9-B13. https://doi.org/10.1016/0020-1383(94)90194-5
Mehta, S. and Lotke, P.A. (2007) Impact of Surgeon Handedness and Laterality on Outcomes of Total Knee Arthroplasties: Should Right-Handed Surgeons Do only Right TKAs? American Journal of Orthopedics, 36, 530-533.
Spicer, D.D., Pomeroy, D.L., Badenhausen, W.E., Schaper, L.A., Curry, J.I., Suthers, K.E. and Smith, M.W. (2001) Body Mass Index as a Predictor of Outcome in Total Knee Replacement. International Orthopaedics, 25, 246-249. https://doi.org/10.1007/s002640100255
Si, H.B., Zeng, Y., Shen, B., Yang, J., Zhou, Z.K., Kang, P.D. and Pei, F.X. (2015) The Influence of Body Mass Index on the Outcomes of Primary Total Knee Arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 23, 1824-1832.
Liabaud, B., Patrick, D.A. and Geller, J.A. (2013) Higher Body Mass Index Leads to Longer Operative Time in Total Knee Arthroplasty. The Journal of Arthroplasty, 28, 563-565. https://doi.org/10.1016/j.arth.2012.07.037
Liljensøe, A., Lauersen, J.O., Søballe, K. and Mechlenburg, I. (2013) Overweight Preoperatively Impairs Clinical Outcome after Knee Arthroplasty: A Cohort Study of 197 Patients 3-5 Years after Surgery. Acta Orthopaedica, 84, 392-397. https://doi.org/10.3109/17453674.2013.799419
Jackson, M.P., Sexton, S.A., Walter, W.L., Walter, W.K. and Zicat, B.A. (2009) The Impact of Obesity on the Mid-Term Outcome of Cementless Total Knee Replacement. The Journal of Bone and Joint Surgery. British Volume, 91, 1044-1048.
Collins, R.A., Walmsley, P.J., Amin, A.K., Brenkel, I.J. and Clayton, R.A. (2012) Does Obesity Influence Clinical Outcome at Nine Years Following Total Knee Replacement? The Journal of Bone and Joint Surgery. British Volume, 94, 1351-1355. https://doi.org/10.1302/0301-620X.94B10.28894
Davis, A.M., Wood, A.M., Keenan, A.C., Brenkel, I.J. and Ballantyne, J.A. (2011) Does Body Mass Index Affect Clinical Outcome Post-Operatively and at Five Years after Primary Uni-lateral Total Hip Replacement Performed for Osteoarthritis? A Multivariate Analysis of Prospective Data. The Journal of Bone and Joint Surgery. British Volume, 93, 1178-1182. https://doi.org/10.1302/0301-620X.93B9.26873
McLaughlin, J.R. and Lee, K.R. (2006) The Outcome of Total Hip Replacement in Obese and Non-Obese Patients at 10- to 18-Year. The Journal of Bone and Joint Surgery. British Volume, 88, 1286-1292. https://doi.org/10.1302/0301-620X.88B10.17660
Nogler, M., Hozack, W., Collopy, D., Mayr, E., Deirmengian, G. and Sekyra, K. (2012) Alignment for Total Knee Replacement: A Comparison of Kinematic Axis versus Mechanical Axis Techniques. A Cadaver Study. International Orthopaedics, 36, 2249-2253. https://doi.org/10.1007/s00264-012-1642-2
Chiu, K.Y., Yau, W.P., Ng, T.P. and Tang, W.M. (2008) The Accuracy of Extramedullary Guides for Tibial Component Placement in Total Knee Arthroplasty. International Orthopaedics, 32, 467-471. https://doi.org/10.1007/s00264-007-0354-5
Edwards, S.A., Pandit, H.G., Ramos, J.L. and Grover, M.L. (2002) Analysis of Polyethylene Thickness of Tibial Components in Total Knee Replacement. The Journal of Bone and Joint Surgery, 84, 369-371. https://doi.org/10.2106/00004623-200203000-00006
Pijls, B.G., Van der Linden-Van der Zwaag, H.M. and Nelissen, R.G. (2012) Polyethylene Thickness Is a Risk Factor for Wear Necessitating Insert Exchange. International Orthopaedics, 36, 1175-1180. https://doi.org/10.1007/s00264-011-1412-6
Yau, W.P., Leung, A., Liu, K.G., Yan, C.H., Wong, L.L. and Chiu, K.Y. (2007) Interobserver and Intra-Observer Errors in Obtaining Visually Selected Anatomical Landmarks during Registration Process in Non-Image-Based Navigation-Assisted Total Knee Arthroplasty. The Journal of Arthroplasty, 22, 1150-1161. https://doi.org/10.1016/j.arth.2006.10.010