Radiation exposure in fluoroscopy-guided anterior total hip arthroplasty: a systematic review

Purpose To investigate the average fluoroscopy time, as well as the patient and surgical staff average radiation exposure in the context of intraoperative fluoroscopy use during anterior total hip arthroplasty (THA). Methods PubMed, Cochrane, Embase, Web of Science and Scopus were systematically searched for studies pertaining to intraoperative anterior THA fluoroscopy (PROSPERO ID 258049). The comprehensive literary search was conducted using “THA,” “fluoroscopy” and “radiation exposure” as the search criteria, which resulted in 187 total papers. Of these 187 papers, 11 studies were included in this systematic review as they involved anterior THA and specifically contained data regarding radiation exposure dose and/or time. Results Eleven studies were included, enrolling 1839 patients. The average fluoroscopy time was 21.4 (95% confidence interval [CI] 16.6–26.1) seconds, whereas the average patient radiation dose was 1.8 × 10 –3 (95% CI 7.4 × 10 –4 –2.9 × 10 –3 ) Gy. Conclusions Although several studies fail to report fluoroscopy time and radiation dose in THA patients, fluoroscopy-guided THA has emerged as a safe procedure. Additional studies may analyze if radiation exposure during the surgeon’s THA learning curve is significantly higher, as well as what protocols may potentially reduce radiation exposure even further.