Weeks Colleen A, Preston Stephen, Howard James L, Vasarhelyi Edward M, Matz Jacob, Lanting Brent A
Orthopedics. 2016 Sep 1;39(5):e962-6. doi: 10.3928/01477447-20160616-06. Epub 2016 Jun 24.
The direct anterior approach for total hip arthroplasty (THA) requires the use of intraoperative imaging, exposing the patient and surgical team to radiation. The authors hypothesized that calculation of the preoperative pelvic tilt angle and communication of this value with the fluoroscopy technician may result in a decrease in intraoperative fluoroscopy use. The study also examined total radiation exposure during the procedure to ensure that it was within safe limits. The pelvic tilt was calculated preoperatively for 100 consecutive patients undergoing THA by the direct anterior approach. The fluoroscopy technician was blinded to the value of pelvic tilt for the first 50 cases (control group), with the angle being communicated for the following 50 cases (test group). The total duration of fluoroscopy use for each case was recorded. The values were compared for the 2 experienced technicians involved in the study. The surgeon was blinded to the duration of fluoroscopy use in all cases. Mean fluoroscopy time was 28.65 seconds in the control group and 23.61 seconds in the test group (P=.033). No significant difference in duration of fluoroscopy use was found between the 2 fluoroscopy technicians. The control group and the test group were within safe limits of radiation exposure to both the patient and the surgical team. Preoperative pelvic tilt calculation significantly decreases the amount of imaging used during THA by the direct anterior approach. Although it was a statistically significant reduction, both groups were within safe limits for both the surgical team and the patients, and thus the clinical significance is unknown. [Orthopedics.2016; 39(5):e962-e966.].
全髋关节置换术（THA）的直接前路手术需要使用术中成像，这会使患者和手术团队暴露于辐射之下。作者推测，术前计算骨盆倾斜角度并将该值告知透视技师可能会减少术中透视的使用。该研究还检查了手术过程中的总辐射暴露，以确保其在安全范围内。对连续100例行直接前路THA的患者术前计算骨盆倾斜度。在前50例病例中（对照组），透视技师不知道骨盆倾斜度的值，而在后50例病例中（试验组）告知其角度值。记录每例病例的透视使用总时长。对参与研究的2名经验丰富的技师所得到的值进行比较。在所有病例中，外科医生对透视使用时长均不知情。对照组的平均透视时间为28.65秒，试验组为23.61秒（P = 0.033）。两名透视技师之间在透视使用时长上未发现显著差异。对照组和试验组对患者和手术团队的辐射暴露均在安全范围内。术前计算骨盆倾斜度可显著减少直接前路THA术中的成像使用量。尽管这是一个具有统计学意义的减少，但两组对手术团队和患者而言均在安全范围内，因此其临床意义尚不清楚。[《骨科》.2016; 39(5):e962 - e966.]
