The use of ionising radiation in orthopaedic surgery: principles, regulations and managing risk to surgeons and patients

Raza, Mohsen; Houston, James; Geleit, Ryan; Williams, R. Ryan; Trompeter, Alex

doi:10.1007/s00590-021-02955-9

Cited by 7 publications

(7 citation statements)

References 55 publications

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“…In addition, portable X-ray machines generate more radiation to many patients and medical staff around. The dose of a pelvic X-ray was approximately 0.7 mSv, which is 35 times the dose of a chest X-ray and is equivalent to 4-months of exposure to natural background radiation [ 26 ]. Nevertheless, PACU X-rays may benefit the surgeons who do not obtain intraoperative X-rays and low-volume surgeons who perform THA in low-volume hospitals.…”

Section: Discussionmentioning

confidence: 99%

Are immediate postoperative X-Rays valuable in evaluating complications of primary total hip arthroplasty?

et al. 2022

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Purpose This study aimed to investigate the complications of primary total hip arthroplasty based on immediate postoperative X-rays. The overall quality and cost of X-rays were assessed. Methods The institutional database was queried to identify all patients who underwent total hip arthroplasty in a single institution between January 1, 2018, and December 31, 2018. Immediate postoperative X-rays were reviewed to identify the complications such as periprosthetic fractures, dislocation, and fixation failure. The quality and cost of X-ray were assessed. The complications were categorized as "known" and "unknown" according to the intraoperative fluoroscopic results. Results A total of 518 total hip arthroplasties were included in this study. Based on intraoperative fluoroscopy, periprosthetic fractures were found in 10 (2%) THAs. Compared to the X-rays taken immediately after surgery, 9 periprosthetic fractures (recorded as "known") were found and 1 was not (recorded as "unknown"). There was no significant difference between intraoperative fluoroscopy and X-rays (P > 0.05). Of the 518 X-rays, 225 (43%) were of suboptimal quality. The cost of a single portable pelvic X-ray was $647. Conclusion In total hip arthroplasty, X-rays taken immediately after surgery rarely reveal unknown complications. The X-rays are often of suboptimal quality, have minimal clinical utility, and are less cost-effective.

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Section: Discussionmentioning

confidence: 99%

Are immediate postoperative X-Rays valuable in evaluating complications of primary total hip arthroplasty?

et al. 2022

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“…It is estimated that a single-limb X-ray (less than 0.01 mSv) is equivalent to 1.5 days of natural background radiation and one-fourth of the equivalent dose of flying from one coast of the USA to the other (0.035 mSv). A single-limb X-ray has the half equivalent dose of chest X-ray (0.02 mSv) and much less equivalent dose of pelvic X-ray (0.7 mSv) ( 17 ) . As stated by two professional medical societies, radiation risks below an individual dose of 50 mSv for single procedures or 100 mSv for multiple procedures are either too small to be observed or are nonexistent ( 18 ) .…”

Section: Discussionmentioning

confidence: 99%

“…In cases of non-angulated distal radius fractures in children, even though X-ray imaging is Alireza Mobasseri, Padideh Noorifard (0.035 mSv). A single-limb X-ray has the half equivalent dose of chest X-ray (0.02 mSv) and much less equivalent dose of pelvic X-ray (0.7 mSv) (17) . As stated by two professional medical societies, radiation risks below an individual dose of 50 mSv for single procedures or 100 mSv for multiple procedures are either too small to be observed or are nonexistent (18) .…”

Section: Tab 1 Characteristics Of Studies Concerning the Use Of Ultra...mentioning

confidence: 99%

Ultrasound in the diagnosis of pediatric distal radius fractures: does it really change the treatment policy? An orthopedic view

Mobasseri¹,

Noorifard²

2022

J Ultrason

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Background: Distal radius fractures are the most common pediatric fractures, increasing in number in recent decades. Although simple bi-planar radiographs are sufficient for diagnosis, wrist ultrasonography has been popularized in recent years for fracture detection, mostly because of the concern about children’s radiation exposure. Despite its availability and diagnostic accuracy, ultrasound has not gained widespread acceptance and popularity among orthopedic surgeons. We asked about the reasons for its lack of acceptance as a diagnostic tool by orthopedic surgeons, and its failure to be incorporated into diagnostic algorithms. Material and methods: We reviewed the latest articles concerning the use of ultrasound in the diagnosis of pediatric distal radius fracture. Data extraction was performed from each study with a focus on the following items: the specialty field of the authors, number of patients, number of fractures, mean age of the patients, and the gold standard method of diagnosis. Results: Nine studies concerning the diagnostic accuracy of ultrasound in detecting distal radius fractures in children were included in the review. The most common field of practice of the authors was emergency medicine. Only two studies had an orthopedic surgeon among their authors. All studies employed X-ray imaging as the gold standard method. All studies were designed as prospective trials without randomization of patients. Generally, there was no independent blinded reviewer for the interpretation of ultrasound and X-ray images. Conclusions: Most studies were completed by emergency medicine physicians, without involving an orthopedic surgeon. Ultrasound evaluation was undertaken primarily by emergency medicine physicians with little experience. These studies were not randomized controlled trials, and knowledge of the history and clinical presentation of the subjects could have led to information bias. The relatively low number of included patients and lack of follow-up examinations were other limitations. As a result, we believe that ultrasound has not proven to be a suitable substitute for conventional X-ray imaging in the detection of pediatric distal radius fractures. We propose X-ray evaluation as the clinical gold standard method for pediatric wrist fractures.

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“…La energía de la radiación está determinada por la rapidez con la que se repite la longitud de onda, dado que toda la radiación electromagnética viaja a la velocidad de la luz, esto está determinado por cuán pequeña es la longitud de onda; una longitud de onda más corta transportaría mayores cantidades de radiación. 1 is a potential risk for both patients and health professionals because it can produce an increase in free radicals that cause abnormalities in cellular DNA, which is correlated with various types of cancer. Orthopedists are five times more likely to develop cancer in their lifetime compared to other areas of healthcare personnel due to constant exposure to occupational radiation.…”

Section: Rayos Xunclassified

“…La radiación ionizante es un riesgo potencial tanto para los pacientes como para los profesionales de la salud. 1 Los cirujanos ortopedistas expuestos a radiación tienen cinco veces más probabilidades de desarrollar cáncer en el transcurso de su vida, en comparación con otros trabajadores de la salud, debido a la exposición a la radiación ocupacional, 2 la prevalencia de cáncer de mama es 2.9 veces mayor en las cirujanas ortopédicas comparado con la población general de EE. UU., aunado a que existe una escasez de investigaciones sólidas sobre la seguridad de la radiación para el personal de quirófano.…”

Section: Introductionunclassified

Principios básicos de rayos X en cirugía de columna. Revisión de la literatura. Equipo Iberolatinoamericano de Investigación SILACO

Luis Bazán,

Salcido Reyna,

Jiménez Ávila

et al. 2023

Cir Columna

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El uso de rayos X es fundamental para la práctica ortopédica, especialmente para la cirugía de columna con enfoques mínimamente invasivos. La radiación se refiere a la transmisión de energía a través de cualquier medio que puede ser transportada como onda o partícula. Los rayos X y la tomografía computarizada utilizan radiación de tipo ionizante. La radiación ionizante es un riesgo potencial tanto para los pacientes como para los profesionales de la salud debido a que puede producir un aumento de radicales libres que provocan anomalías en el ADN celular, lo cual se correlaciona con diversos tipos de cáncer. Los ortopedistas tienen cinco veces más probabilidades de desarrollar cáncer en el transcurso de su vida en comparación con otras áreas del personal de salud, debido a la constante exposición a la radiación ocupacional. La Comisión Internacional de la Protección Radiológica (ICRP) establece tres principios básicos para cumplir sus objetivos: justificación, optimización y límite de dosis. La finalidad principal de la protección radiológica es proporcionar un nivel apropiado de protección para el ser humano, sin limitar indebidamente las prácticas beneficiosas que dan lugar a la exposición de la radiación ionizante. Es muy importante seguir las recomendaciones de protección y mantenimiento de los equipos para reducir en la medida de lo posible la radiación tanto en el personal de la salud como en los pacientes.

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The use of ionising radiation in orthopaedic surgery: principles, regulations and managing risk to surgeons and patients

Cited by 7 publications

References 55 publications

Are immediate postoperative X-Rays valuable in evaluating complications of primary total hip arthroplasty?

Are immediate postoperative X-Rays valuable in evaluating complications of primary total hip arthroplasty?

Ultrasound in the diagnosis of pediatric distal radius fractures: does it really change the treatment policy? An orthopedic view

Principios básicos de rayos X en cirugía de columna. Revisión de la literatura. Equipo Iberolatinoamericano de Investigación SILACO

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