https://www.scirp.org/journal/jbise J. Biomedical Science and Engineering, 2021, Vol. 14, (No. 10), pp: 339-345 https://doi.org/10.4236/jbise.2021.1410029 339 J. Biomedical Science and Engineering Investigation of Hammering Sound Frequency to Prevent Intraoperative Fracture during Total Hip Arthroplasty Rina Sakai 1,2 , Tatsuki Kitazato 2 , Katsufumi Uchiyama 2,3 , Kazuhiro Yoshida 1,2 , Takeaki Yamamoto 4 , Naonobu Takahira 1,2 , Masanobu Ujihira 1,2 1 Department of Medical Engineering and Technology, School of Allied Health Sciences, Kitasato University, Sagamihara City, Japan; 2 Kitasato University Graduate School of Medical Sciences, Sagamihara City, Kanagawa, Japan; 3 Department of Orthopedic Surgery, School of Medicine, Kitasato University, Sagamihara City, Japan; 4 Department of Orthopedic Surgery, School of Medicine, St. Marianna University, Kawasaki City, Kanagawa, Japan Correspondence to: Rina Sakai, Keywords: Total Hip Arthroplasty, Periprosthetic Fracture, Cementless Stem, Hammering Sound, Peak Frequency Received: September 8, 2021 Accepted: October 26, 2021 Published: October 29, 2021 Copyright © 2021 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ ABSTRACT 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 be- comes 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 fre- quency 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 meas- ured. 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 arth- roplasty was 2.98 ± 0.73 kHz and that in healthy individuals was 2.15 ± 0.32 kHz. This sug- gested 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 sys- Open Access