Detection of Total Hip Prostheses at Airport Security Checkpoints: How Has Heightened Security Affected Patients?

Johnson, Aaron J.; Naziri, Qais; Hooper, Hasan A; Mont, Michael A.

doi:10.2106/jbjs.k.00864

Cited by 12 publications

(30 citation statements)

References 9 publications

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“…Furthermore, the five additional patients who did not trigger an airport metal detector but did trigger a handheld metal detector at another location all had stainless steel instrumentation. This is most probably due to the ferromagnetic (attracted to a magnetic field) properties of stainless steel versus the diamagnetic (not attracted to a magnetic field) nature of titanium [12], and confirms previous orthopaedic research indicating that titanium implants have the lowest rates of metal detector triggering [4][5][6][7][8][9][10]. We did not show that an increased implant density was associated with more frequent airport metal detector triggering events, which is likely due to the rarity in metal detector triggering coupled with the small variation in the range of implant density in this cohort.…”

Section: Discussionsupporting

confidence: 84%

“…This has led to several reports in the orthopaedic literature discussing the implication of these heightened security measures on orthopaedic patients. While pre-9/11 series have shown that orthopaedic implants infrequently triggered metal detectors [1][2][3], many post-9/11 reports of increased screening procedures on travellers with orthopaedic instrumentation are available and have indicated increased detection frequency (of up to 88 %) and burden of security checkpoint stress on patients with orthopaedic implants [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Airport metal detector activation is rare after posterior spinal fusion in children with scoliosis

Fabricant

Robles

Blanco

2013

Journal of Children's Orthopaedics

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Purpose Since the September 11, 2001 terrorist attacks on the World Trade Center in New York City, travel security has become an ever-increasing priority in the United States. Frequent parent and patient inquiry and recent literature reports have generated interest in the impact of heightened security measures on patients with orthopaedic implants, and have indicated increasing rates of metal detector triggering. There are no reports to date, however, evaluating children and adolescents who have undergone posterior spinal fusion for scoliosis, so responses to patient and parent inquiries are not data-driven. The purpose of this study is to determine the frequency of airport metal detector triggering by patients who have had posterior-only spinal fusion and to characterise any potential predictors of metal detector activation. Methods A cross-sectional study was performed by interviewing 90 patients who underwent posterior-only spinal fusion for a diagnosis of juvenile or adolescent idiopathic scoliosis and have travelled by air in the past year. Demographic, clinical and surgical instrumentation data were collected and evaluated, along with patients' reports of airport metal detector triggering and subsequent screening procedures. Results Five patients with stainless steel instrumentation (5.6 % of the cohort) triggered an airport walkthrough metal detector, and an additional five patients who did not trigger an airport detector triggered a handheld detector at a different venue. All patients who triggered an airport metal detector had stainless steel instrumentation implanted prior to 2008, and no patient with titanium instrumentation triggered any detector in any venue. All trigger events required subsequent screening procedures, even when an implant card was presented. Conclusions In this cohort of children and adolescents with posterior spinal instrumentation, airport walkthrough metal detector triggering was a rare event. Therefore, we advise patients and families with planned posterior scoliosis fusions using titanium instrumentation that airport detection risk is essentially non-existent, and only rare for those with planned stainless steel instrumentation. We no longer issue implant cards postoperatively, as these did not prevent further screening procedures in this cohort. Level of evidence Prognostic level 2. Study design: crosssectional.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Airport metal detector activation is rare after posterior spinal fusion in children with scoliosis

Fabricant

Robles

Blanco

2013

Journal of Children's Orthopaedics

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“…5,6 The questionnaire administered, which was used in two previously published studies, consisted of several questions which assessed the patients' experiences during airport travel. 5,6 Patients provided information regarding included questions about which joint(s) had been replaced, the number of encounters with airport security, the frequency of body scanner activation, geographic location of body scanner activation, and any additional screening procedures that were utilized, whether security officials requested documentation regarding the prosthesis and the degree of inconvenience. In addition, patients were asked to detail their experiences with scanners and metal detectors in locations aside from airports.…”

Section: Methodsmentioning

confidence: 99%

“…1,4 Before their introduction, many patients with joint prostheses were exposed to unnecessary invasive searches that they characterized as embarrassing and an inconvenience. [5][6][7][8][9][10] There have been historical reports on the experiences of patients with joint prostheses passing through standard metal detectors at airports with 47 to 83% of patients reporting triggering the alarm with their orthopedic hardware. 6,11 However, given the updates to security measures as well as changes in implants, it is imperative that the effects on those who have undergone total knee arthroplasty (TKA) be assessed.…”

mentioning

confidence: 99%

Detection of Total Knee Arthroplasties at Airport Security Checkpoints: How Do Updated Security Measures Affect Patients?

et al. 2016

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Airport security measures continue to be updated with the incorporation of the new body scanners and automatic target recognition software. The purpose of this study was analyze the incidence of: (1) triggering the security alarm; (2) extra security searches; (3) perceived inconvenience; and (4) presence of other surgical hardware in those who underwent total knee arthroplasty (TKA) and passed through airport security. A questionnaire was given to 125 consecutive patients with a TKA. Those who passed through airport security after January 2014 were considered for inclusion. A questionnaire was administered that addressed the number of encounters with airport security, metal detector activation, additional screening procedures, and perceived inconvenience. Out of the 125 patients, 53 met inclusion criteria. Out of the 53 patients, 20 (38%) reported that their prosthesis triggered a metal detector. Out of the 20 patients, 8 (40%) who reported triggering of metal detectors also reported the presence of surgical hardware elsewhere in the body. Eighteen of the 53 patients (34%) believed having a TKA was inconvenient for airplane travel. Compared with the historical cohort, alarms were triggered in 70 of 97 patients ( = 0.0001) and 50 of 97 reported inconvenience when traveling ( = 50 of 97 patients; = 0.04). The incidences of those who underwent TKA triggering alarms and perceiving inconvenience when passing through airport security have decreased from previously published studies. This is most likely due to the recent updates and modifications to screening. As these security measures are modified and implant designs continue to evolve, this is an area of investigation that should continue.

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“…33 34 Make patients with joint replacements aware of the increased risk of activating security alarms in airports, and being searched more thoroughly by security staff. 35 …”

Section: Travelmentioning

confidence: 99%

Primary care management of postoperative shoulder, hip, and knee arthroplasty

Aresti

Kassam

Bartlett

et al. 2017

BMJ

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Detection of Total Hip Prostheses at Airport Security Checkpoints: How Has Heightened Security Affected Patients?

Cited by 12 publications

References 9 publications

Airport metal detector activation is rare after posterior spinal fusion in children with scoliosis

Airport metal detector activation is rare after posterior spinal fusion in children with scoliosis

Detection of Total Knee Arthroplasties at Airport Security Checkpoints: How Do Updated Security Measures Affect Patients?

Primary care management of postoperative shoulder, hip, and knee arthroplasty

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