Active Noise-Cancelling Headphones Reduce Operative Time and Improve Procedural Consistency in ACL Reconstruction l

Overview

High noise levels generated by arthroscopic equipment may impair intraoperative communication and increase cognitive workload, potentially affecting surgical efficiency. Active noise-cancelling (ANC) systems combined with closed-loop communication may enhance team interaction; however, their clinical impact remains unclear. Purpose of this study is To evaluate the effect of ANC headphones and a closed-loop communication system on operative time and intraoperative team performance during arthroscopic anterior cruciate ligament (ACL) reconstruction.

This prospective, two-arm pilot randomized controlled trial included patients aged 18-50 years undergoing primary arthroscopic ACL reconstruction. Participants were randomized (1:1) into: * Control group: standard operating room conditions without headphones * ANC group: surgeon, assistant, and scrub nurse using ANC headphones with a closed-loop communication system The anesthesia team did not use headphones to ensure continuous monitoring of patient safety. The primary outcome was operative time (skin incision to closure). Secondary outcomes included communication quality, number of repeated or misunderstood commands, NASA-TLX workload scores, and intraoperative noise levels.

Conditions