Sidharthan Sujith, Maliyappa Chandrashekara, Bhinda Hans
Department of Trauma and Orthopaedics, Southend University Hospital, Mid and South Essex NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, United Kingdom.
Arch Bone Jt Surg. 2023;11(9):577-581. doi: 10.22038/ABJS.2023.65653.3152.
Intra-articular hip injections (IHI) are routinely performed for both diagnostic and therapeutic purposes. The procedure can be performed via either an anterior or a lateral approach with fluoroscopic guidance being widely practised. There is a risk of radiation exposure associated with fluoroscopy assisted IHI. This may be influenced either by the surgical approach or the patient's body mass index (BMI) or both. This study was undertaken to compare the relationships of the respective approaches to BMI, fluoroscopic exposure time (FET) and radiation dose (RD).
A retrospective study was conducted comprising 74 patients who underwent IHI with 37 patients in each group (anterior and lateral). Patients were assessed pre-operatively and post operatively for any complications. The intra-operative radiation dose, fluoroscopic exposure time and BMI data were collected and analyzed.
The mean age of the patients in anterior and lateral groups was 61.18±14.08 and 67.21±14.39 years respectively. No complications were noted in either group. However, there was a significant increase in FET (P=0.002) and RD (P<0.001) in patients with BMI ≥ 30. In the lateral group, this trend was markedly noted with increase in FET (P<0.001) and RD (P<0.001) in patients with BMI ≥ 30. On the other hand, in the anterior group there was no statistically significant increase in FET (P=0.155) and only a moderate increase in RD (P=0.020) in patients with BMI ≥ 30.
Both anterior and lateral approaches to fluoroscopic guided IHI are equally safe in terms of complications involved. There is statistically significant increase in both radiation dose and fluoroscopic exposure time in patients with BMI ≥ 30. This is more pronounced in lateral approach. The anterior approach is most effective in reducing both radiation dose and fluoroscopic exposure time, more so in patients with BMI of 30 and above.
髋关节腔内注射（IHI）常用于诊断和治疗目的。该操作可通过前路或侧路进行，广泛采用透视引导。透视辅助的IHI存在辐射暴露风险。这可能受手术入路或患者体重指数（BMI）或两者影响。本研究旨在比较各入路与BMI、透视暴露时间（FET）和辐射剂量（RD）之间的关系。
进行一项回顾性研究，纳入74例行IHI的患者，每组37例（前路和侧路）。术前和术后评估患者有无并发症。收集并分析术中辐射剂量、透视暴露时间和BMI数据。
前路组和侧路组患者的平均年龄分别为61.18±14.08岁和67.21±14.39岁。两组均未发现并发症。然而，BMI≥30的患者FET（P=0.002）和RD（P<0.001）显著增加。在侧路组，BMI≥30的患者FET（P<0.001）和RD（P<0.001）增加明显。另一方面，在前路组，BMI≥30的患者FET无统计学显著增加（P=0.155），RD仅中度增加（P=0.020）。
就所涉及的并发症而言，透视引导下IHI的前路和侧路入路同样安全。BMI≥30的患者辐射剂量和透视暴露时间均有统计学显著增加。这在侧路入路中更为明显。前路入路在降低辐射剂量和透视暴露时间方面最有效，在BMI为30及以上的患者中更是如此。
