Energy expenditure of femoral broaching in direct anterior total hip replacements-Comparison between manual and automated techniques

Introduction: Little information is known regarding the energy expenditure of the surgeon during total hip arthroplasty (THA). We sought to compare the energy expenditure associated with femoral broaching using two techniques: manual and automated.Methods: We recorded energy expenditure, minute ventilation, heart rate, and total broaching time of a single surgeon while broaching the femoral canal during direct anterior THA using two different techniques: Manual broaching (n = 26) and automated broaching (n = 20).Results: Manual broaching required a longer time than automated broaching (6.1 +/- 1.1 vs. 3.7 +/- 0.9 min; p < 0.001) with an increase in energy expenditure (32.6 +/- 7.0 vs. 16.0 +/- 7.1 Calories; p < 0.001). Heart rate was higher with manual broaching (99.4 +/- 9.8 vs. 90.1 +/- 9.8 beats per min; p = 0.003), along with minute ventilation (36.5 +/- 7.0 vs. 30.3 +/- 5.8 L/min; p = 0.003). There were no intraoperative complications.Conclusions: Automated femoral broaching during THA can decrease the energy expenditure of broaching by 50% and time of broaching by 40%, when compared to manual technique.