Comparative analysis of radiation doses in total hip arthroplasty: Evaluating conventional, navigation, and robotic modalities.

BACKGROUND

Total hip arthroplasty (THA) is an effective procedure for relieving the symptoms of hip arthritis, with accurate component positioning being essential for optimal outcomes. Advances in robotic and navigation-assisted THA have introduced imaging protocols that incorporate standard radiographs, functional radiographs, and CT-based imaging. While these approaches improve surgical accuracy, they may also increase radiation exposure. This study aims to evaluate and compare radiation exposure associated with imaging modalities used in conventional, navigated, and robotic THA.

METHODS

A retrospective analysis of 104 patients was performed. Of these, 50 underwent Mako robotic-assisted THA, 23 underwent Corin OPS-assisted THA, 18 underwent conventional THA with standard AP radiographs, and 13 underwent lateral radiographic imaging. Imaging data were obtained from radiology records. Dose-length product (DLP) was recorded for CT scans and dose-area product (DAP) for radiographs. Effective doses (E) were calculated using specialised software, including the ImPACT CT Dosimetry Calculator and the PCXMC Dose Calculator. Statistical comparisons between imaging modalities were conducted using ANOVA testing, with statistical significance defined as p < 0.05.

RESULTS

The Mako CT protocol demonstrated a mean effective dose (E) of 8.3 mSv, while the Corin OPS CT protocol showed a lower mean E of 6.6 mSv. Functional radiographs used in the OPS pathway contributed an additional mean E of 0.73 mSv. Conventional AP and lateral radiographs were associated with the lowest mean E at 0.174 mSv.

CONCLUSION

This study highlights the importance of monitoring and optimising radiation exposure in preoperative imaging for THA. The implementation of low-dose CT protocols and alternative imaging strategies may reduce radiation exposure while maintaining diagnostic accuracy. Further research and collaboration are required to develop standardised guidelines for radiation dose optimisation in THA.