Curtin Brian M, Armstrong Lucas C, Bucker Brandon T, Odum Susan M, Jiranek William A
OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.
Department of Orthopaedic Surgery, VCU/MCV West Hospital, Richmond, Virginia.
J Arthroplasty. 2016 Jun;31(6):1218-1221. doi: 10.1016/j.arth.2015.12.012. Epub 2015 Dec 17.
This study sought to quantify the total patient radiation exposure during fluoro-assisted direct anterior approach (DAA) total hip arthroplasty (THA). We hypothesized that the patient radiation exposure would fall within acceptable published limits for a 1-time patient exposure.
After institutional review board approval, we performed a retrospective chart review of consecutive unilateral primary DAA THAs at 2 institutions (N = 157) between 2012 and 2014 by a single fellowship-trained arthroplasty surgeon assisted by residents and fellows. Incomplete dose reporting information was the sole exclusion criterion. Patient electronic medical records were queried regarding exposure time (seconds), radiation emittance (mGy), and peak kilovoltage (kVp). Descriptive statistics were calculated. Pearson correlation coefficients were used to determine the correlation between variables.
Mean radiation dose for patient exposure measured 2.97 ± 1.63 mGy (range: 0.29-9.83). Positive but weak linear relationship with radiation dose and body mass index (BMI; r = 0.34; P < .0002). Average exposure time per procedure was 23.74 s (range: 11.3-61.7). Average kVp per procedure was 75.38 (range: 65-86). Average BMI was 28.32 (range: 16.6-39.8). There was a significantly strong correlation between kVp and BMI (r = 0.75; P < .0001).
Total patient radiation exposure was nearly identical with previously published values for a screening mammogram (3 mGy) and 4 times less than that of a standard chest computed tomography (13 mGy). Although it is difficult to ascertain the exact patient-absorbed radiation, our data suggest that a 1-time exposure during DAA THA is likely negligible and provides the surgeon with additional data for counseling patients preoperatively.
本研究旨在量化在荧光透视辅助下直接前路全髋关节置换术(DAA-THA)期间患者接受的总辐射剂量。我们假设患者的辐射剂量将落在已公布的单次患者暴露可接受范围内。
经机构审查委员会批准后,我们对2012年至2014年间在两家机构由一名接受过专科培训的关节置换外科医生在住院医师和专科医师协助下连续进行的单侧初次DAA-THA病例进行了回顾性图表审查。不完整的剂量报告信息是唯一的排除标准。查询患者电子病历以获取暴露时间(秒)、辐射发射量(mGy)和峰值千伏(kVp)。计算描述性统计量。使用Pearson相关系数确定变量之间的相关性。
患者暴露的平均辐射剂量为2.97±1.63 mGy(范围:0.29 - 9.83)。辐射剂量与体重指数(BMI)呈正但弱的线性关系(r = 0.34;P < 0.0002)。每次手术的平均暴露时间为23.74秒(范围:11.3 - 61.7)。每次手术的平均kVp为75.38(范围:65 - 86)。平均BMI为28.32(范围:16.6 - 39.8)。kVp与BMI之间存在显著强相关性(r = 0.75;P < 0.0001)。
患者接受的总辐射剂量与之前公布的乳腺钼靶筛查值(3 mGy)几乎相同,比标准胸部计算机断层扫描(13 mGy)少4倍。尽管难以确定患者确切吸收的辐射量,但我们的数据表明,DAA-THA期间的单次暴露可能可以忽略不计,并为外科医生在术前向患者提供咨询提供了额外的数据。