An interventional study of Active Noise-Cancelling Headphones With Closed-Loop Communication and Standard Operating Room Communication in Anterior Cruciate Ligament Rupture, Anterior Cruciate Ligament (ACL) Tear and Anterior Cruciate Ligament Injury, sponsored by Fatih Sultan Mehmet Training and Research Hospital. Active, not recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-09-10.
Sponsored by Fatih Sultan Mehmet Training and Research Hospital · Not applicable, Interventional, and Other
Operating room noise may interfere with communication, concentration, and surgical workflow. Active noise-cancelling (ANC) headphones can reduce background auditory distractions; however, their potential benefit during surgery may depend on maintaining effective communication among surgical team members. This prospective randomized controlled trial evaluates the effect of ANC headphones integrated with a closed-loop communication system on operative efficiency and intraoperative workflow during arthroscopic anterior cruciate ligament (ACL) reconstruction. Participants undergoing primary arthroscopic ACL reconstruction are randomized to either an ANC group or a control group. In the ANC group, the surgeon, first assistant, and scrub nurse use ANC headphones connected through a closed-loop communication system during surgery. The control group undergoes surgery under standard operating room conditions. The primary outcome is operative time from skin incision to skin closure. Secondary outcomes include command acknowledgment time, instrument handover time, and repeated verbal requests assessed using objective video-based workflow analysis.
Operating room noise represents a potential source of distraction and may interfere with effective communication, concentration, coordination, and surgical workflow. Active noise-cancelling headphones can reduce perceived background auditory stimuli; however, conventional noise-cancelling devices may also interfere with communication when used without a dedicated communication system.
This prospective, single-center, randomized controlled trial evaluates whether active noise-cancelling headphones integrated with a closed-loop communication system improve operative efficiency and intraoperative workflow during arthroscopic anterior cruciate ligament reconstruction.
Patients undergoing primary arthroscopic ACL reconstruction for isolated ACL rupture are randomized in a 1:1 ratio to an intervention group or a control group.
In the intervention group, the surgeon, first assistant, and scrub nurse use active noise-cancelling headphones connected through a closed-loop communication system throughout the surgical procedure. This system is designed to reduce perceived background auditory distractions while maintaining continuous verbal communication among the core surgical team. The anesthesia team does not use headphones and maintains awareness of monitor alarms, ventilator alarms, and operating room announcements. When required, communication between the anesthesia and surgical teams occurs using standard verbal communication.
In the control group, arthroscopic ACL reconstruction is performed under standard operating room conditions without active noise-cancelling headphones or an additional closed-loop communication system.
All procedures are performed using a standardized single-bundle hamstring autograft ACL reconstruction technique, standardized instrumentation, fixation systems, arthroscopic equipment, and operating room setup.
The primary objective is to evaluate the effect of ANC-assisted closed-loop communication on operative time. Secondary objectives include assessment of objective communication and workflow parameters, including command acknowledgment time, instrument handover time, and repeated verbal requests.
Exclusion Criteria:
Participants undergo arthroscopic ACL reconstruction while the surgeon, first assistant, and scrub nurse use active noise-cancelling headphones connected through a closed-loop communication system. The system allows continuous verbal communication among the core surgical team while reducing perceived background auditory distractions.
Device: Active Noise-Cancelling Headphones With Closed-Loop Communication
Participants undergo the same standardized arthroscopic anterior cruciate ligament reconstruction under routine operating room conditions. The surgeon, first assistant, and scrub nurse communicate using standard verbal communication without active noise-cancelling headphones or a dedicated closed-loop communication system.
Other: Standard Operating Room Communication
Active noise-cancelling headphones connected through a closed-loop communication system are used by the surgeon, first assistant, and scrub nurse throughout arthroscopic ACL reconstruction. The system is intended to reduce perceived background auditory distractions while maintaining continuous verbal communication among the core surgical team.
The surgical team performs arthroscopic ACL reconstruction under routine operating room conditions and communicates using standard verbal communication without active noise-cancelling headphones or a dedicated closed-loop communication system.
Operation Time
Operative time is defined as the elapsed time from skin incision to completion of skin closure and is measured in minutes.
Time frame: Intraoperative, from skin incision to completion ofskin closure
Command Acknowledgment Time
Command acknowledgment time is defined as the interval between the surgeon's verbal request and the first verbal acknowledgment by the first assistant or scrub nurse. Measurements are obtained from video recordings of predefined standardized intraoperative communication events.
Time frame: Intraoperative, during predefined standardized instrument-request events
Instrument Handover Time
Instrument handover time is defined as the interval between the surgeon's verbal request for an instrument and physical delivery of the requested instrument. Measurements are obtained from video recordings of predefined standardized intraoperative instrument-request events.
Time frame: Intraoperative, during predefined standardized instrument-request events
Repeated Verbal Requests
A repeated verbal request is defined as any verbal request repeated because of an absent, delayed, or inadequate response. The number of repeated requests is determined using video recordings of predefined standardized intraoperative communication events.
Time frame: Intraoperative, during the surgical procedure
Plan to share: No — Individual participant data are not planned to be publicly shared.
This study is active, not recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Anterior Cruciate Ligament Injuries→
Fatih Sultan Mehmet Training and Research Hospital