Optimizing intraoperative video for surgical training: a comparative study of three recording techniques in hip arthroplasty

High-quality intraoperative video documentation is increasingly valued in surgery for its role in surgical evaluation, procedural archiving, and education. However, the comparative advantages of different recording methods have not been thoroughly examined. In this prospective, double-blinded study, 44 experienced orthopedic surgeons evaluated posterior total hip arthroplasty videos recorded using three techniques: a head-mounted camera, a light-handle-mounted camera, and an externally operated camera. All videos were captured by the same surgeon using standardized hardware and settings. Participants assessed video quality and educational value using a structured questionnaire. Data were analyzed using ANOVA and chi-square testing. The light-handle-mounted camera received the highest mean scores across all five evaluation domains, including visual clarity, image stability, and overall quality (mean scores ranging from 6.91 to 7.98). Repeated measures ANOVA confirmed statistically significant differences among the three camera techniques for all five questions (<i>p</i> = 0.022-0.043). Post hoc analysis revealed that the light-handle-mounted camera significantly outperformed the head-mounted system (<i>p</i> < 0.05 for all comparisons), while the external camera also demonstrated superiority over the head-mounted method. Chi-square testing showed a significant difference in educational suitability ratings (Question 6), with the light-handle-mounted system receiving the highest percentage of affirmative responses (79.5%) compared to the head-mounted (50.0%) and external cameras (31.8%) (<i>p</i> < 0.001). The light-handle-mounted system offered the most balanced solution, providing stable, high-quality recordings without disrupting sterility or workflow. While head-mounted and external methods have niche applications, their practical limitations reduce their suitability for routine documentation in procedures.