Houston Methodist Orthopedics & Sports Medicine, Houston, Texas, U.S.A.
Houston Methodist Orthopedics & Sports Medicine, Houston, Texas, U.S.A..
Arthroscopy. 2017 Oct;33(10):1804-1809. doi: 10.1016/j.arthro.2017.03.026.
PURPOSE: To determine if (1) absorbed radiation dose and (2) fluoroscopy time decreased with experience over the first 100 cases of a single surgeon's hip arthroscopy practice. METHODS: Subjects who underwent hip arthroscopy for symptomatic femoroacetabular impingement and labral injury were eligible for analysis. Inclusion criteria included the first 100 subjects who underwent hip arthroscopy by a single surgeon (December 2013 to December 2014). Subject demographics, procedure details, fluoroscopy absorbed dose (milligray [mGy]), and time were recorded. Subjects were categorized by date of surgery to one of 4 possible groups (25 per group). One-way analysis of variance was used to determine if a significant difference in dose (mGy) or time was present between groups. Simple linear regression analysis was performed to determine the relation between case number and both radiation dose and fluoroscopy time. RESULTS: Subjects underwent labral repair (n = 93), cam osteoplasty (n = 90), and pincer acetabuloplasty (n = 65). There was a significant (P < .001 for both) linear regression between case number and both radiation dose and fluoroscopy time. A significant difference in mGy was observed between groups, group 1 the highest and group 4 the lowest amounts of radiation (P = .003). Comparing individual groups, group 4 was found to have a significantly lower amount of radiation than group 1 (P = .002), though it was not significantly lower than that of group 2 (P = .09) or group 3 (P = .08). A significant difference in fluoroscopy time was observed between groups, group 1 the highest and group 4 the lowest times (P = .05). Comparing individual groups, group 4 was found to have a significantly lower fluoroscopy time than group 1 (P = .039). Correction for weight, height, and body mass index all revealed the same findings: significant (P < .05) differences in both dose and time across groups. CONCLUSIONS: The absorbed dose of radiation and fluoroscopy time decreased significantly over the first 100 cases of a single surgeon's hip arthroscopy practice learning curve. LEVEL OF EVIDENCE: Level IV, therapeutic, retrospective, noncomparative case series.
目的：确定（1）吸收剂量和（2）透视时间是否随一名外科医生髋关节镜实践的前 100 例经验而减少。
方法：有症状性股骨髋臼撞击症和盂唇损伤而行髋关节镜检查的受试者有资格进行分析。纳入标准包括由一名外科医生（2013 年 12 月至 2014 年 12 月）进行的前 100 例髋关节镜检查的受试者。记录受试者的人口统计学数据、手术细节、透视吸收剂量（毫格雷[mgY]）和时间。根据手术日期将受试者分为四组中的一组（每组 25 例）。采用单因素方差分析确定各组之间剂量（mgY）或时间是否存在显著差异。进行简单线性回归分析，以确定病例数与辐射剂量和透视时间之间的关系。
结果：受试者行盂唇修复术（n=93）、凸轮骨切除术（n=90）和钳夹髋臼成形术（n=65）。病例数与辐射剂量和透视时间之间存在显著的线性回归关系（两者 P<.001）。组间 mGy 差异有统计学意义（P<.001），组 1 辐射剂量最高，组 4 辐射剂量最低（P=.003）。比较各组，发现组 4 的辐射量明显低于组 1（P=.002），但与组 2（P=.09）或组 3（P=.08）相比差异无统计学意义。组间透视时间差异有统计学意义，组 1 时间最长，组 4 时间最短（P=.05）。比较各组，发现组 4 的透视时间明显短于组 1（P=.039）。对体重、身高和体重指数进行校正后，均发现了相同的发现：组间剂量和时间差异均有统计学意义（P<.05）。
结论：一名外科医生髋关节镜实践学习曲线的前 100 例中，辐射吸收剂量和透视时间显著减少。
证据水平：IV 级，治疗，回顾性，非对照病例系列。
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