M. Saddique1, M. Fatima1, F. Shahid1, E. Moazzam1, A. Sehar1, A. Ijaz1, I. Shahid1, A. Syeda2, S. Naqi3 1King Edward Medical University, Lahore, PUNJAB, Pakistan 2University of Pennsylvania, Philadelphia, PA, USA 3Allama Iqbal Medical College, Lahore, PUNJAB, Pakistan
Introduction: A concerningly high percentage (78.3%) of plastic surgeons experience work-related musculoskeletal symptoms, primarily manifesting as pain, stiffness, fatigue, and numbness. These symptoms frequently affect the neck, shoulders, and lower back. Extensive work hours, intense physical activity, and prolonged static postures contribute to a high prevalence of musculoskeletal pain (MSP) among plastic surgeons.
Methods: We conducted a comprehensive search on PubMed, Embase, Scopus, and Cochrane databases from inception until March 31, 2024. A total of 11 studies reporting MSP, musculoskeletal disorders (MSD), or injuries related to plastic surgery in plastic surgeons, plastic surgery residents: microsurgeons, and reconstructive surgeons from any subspecialty were included in this meta-analysis. The analysis was conducted in MetaXL Software (version 5.3)The pooled outcomes were presented as untransformed proportions with 95% confidence intervals (CI) using a random-effects model. The I2 test was used to evaluate interstudy heterogeneity. A p-value of less than 0.05 was considered statistically significant.
Results:
A total of 11 studies comprising 3,056 plastic surgeons were included,Out of total, 50% of the participants were from the microsurgery (n=1539) subspecialty. The pooled prevalence of 12-month work-related musculoskeletal pain (MSP) among plastic surgeons was 90% (2398 of 3056) [95% CI 78%-98%, I2=98%], with 66% in male plastic surgeons (1757 of 2473) [95% CI 52%-79%, I2=98%] and 32% in female plastic surgeons(764 of 2621) [95% CI 19%-45%, I2=99%]. The pooled prevalence of 12-month neck pain among plastic surgeons was 42% (913 of 1990) [95% CI 20%-65%, I2=99% ], back pain was 47% (1048 of 1990) [95% CI 21%-74%, I2=99%] and shoulder pain was 29% (659 of 1892) [95% CI 12%-50%, I2=99%]. Overall quality of the included studies was moderate as assessed by the NewCastle-Ottawa (NOS) Quality Assessment tool. On DOI plots, the outcome, 12-month neck pain, demonstrated minor asymmetry, while all other outcomes demonstrated major asymmetry.
Conclusion: Our study reported a high prevalence of 12-month work-related musculoskeletal pain among plastic surgeons with male surgeons than female plastic surgeons. There was a significantly high prevalence of back and neck pain among plastic surgeons. Robust interventional studies exploring the effectiveness of ergonomic interventions and the potential role of robot-assisted surgery in reducing work-related MSP are required.