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Background:The frequency of hip arthroscopy for the treatment of acute and chronic chondrolabral pathology and femoroacetabular impingement (FAI) has increased exponentially over the past decade. While surgeon and patient radiation exposure has been well documented in other areas of the orthopaedic literature, little is known about the procedure-specific and cumulative doses affecting the hip arthroscopist.Purpose:To determine the mean annual radiation exposure to the hip arthroscopist and the mean surgeon exposure per case.Study Design:Case series; Level of evidence, 4.Methods:A total of 210 consecutive hip arthroscopies performed in 209 patients by a single surgeon at a single ambulatory surgical center in a cohort consisting of approximately 50% bony (cam and pincer) pathology were prospectively reviewed, documenting the specific procedures performed in each case and the readings from a radiation dosimeter worn by the surgeon during positioning and while performing the procedures. Radiation readings for deep dose–equivalent (DDE), lens dose–equivalent (LDE), and shallow dose–equivalent (SDE) were measured. These readings were compared with the annual radiation dose limit recommendations established by the International Commission on Radiological Protection (ICRP).Results:The total radiation doses for the operative surgeon during all 210 cases were 183 mrem (1.83 mSv) DDE, 183 mrem (1.83 mSv) LDE, and 176 mrem (1.76 mSv) SDE. The mean exposure per case was 0.871 mrem (0.00871 mSv) DDE, 0.871 mrem (0.00871 mSv) LDE, and 0.838 mrem (0.00838 mSv) SDE. The operative surgeon’s mean annual exposure, performing 70 hip arthroscopies per year with 55% involving bony work, was 61.0 mrem (0.610 mSv) DDE, 61.0 mrem (0.610 mSv) LDE, and 58.7 mrem (0.587 mSv) SDE. These results are well below the ICRP annual limits of 50,000 mrem (500 mSv) DDE, 2000 mrem (20 mSv) LDE, and 50,000 mrem (500 mSv) SDE.Conclusion:For an experienced hip arthroscopist utilizing fluoroscopy during setup and bony resection, the annual and per-patient exposure to radiation remains well below the recommended ICRP limits.Clinical Relevance:Considering the increasing annual frequency of hip arthroscopies being performed, information regarding procedure-specific and cumulative doses of radiation exposure affecting the hip arthroscopist may provide valuable safety information for the orthopaedic community.

Objectives:Hip arthroscopy is an established field within orthopaedic surgery. The majority of the procedures involve repairs of the acetabular labrum and arthroscopic treatment of femoroacetabular impingement (FAI). The procedures are being performed with increasing frequency annually. Fluoroscopic guidance is recommended during these procedures, and radiation exposure to the surgeon, staff, and patient remains a valid concern. The purpose of this study is to measure radiation exposure to the surgeon during hip arthroscopy and determine if this exposure remains below recommended annual occupational radiation exposure thresholds recommended by the International Committee on Radiological Protection (IRCP).Methods:Prospectively, radiation exposure was measured for a single surgeon at a single outpatient facility for all hip arthroscopic procedures over a three-year period. A radiation dosimeter was worn outside of the surgeon's chest on the lead apron. Standard pre-operative and intra-operative imaging was used for all patients. Radiation readings were prospectively measured for deep dose equivalent (DDE), lens dose equivalent (LDE), and shallow dose equivalent (SDE). The cumulative radiation exposure was tabulated in millirem (mrem), converted to milli-Sieverts (mSv) (standard measurement used by the IRCP) and then the per-patient exposure calculated as well as annual exposure for 100 hip arthroscopies per year.Results:Between July 2011 and July 2014, 209 patients underwent a total of 280 hip arthroscopy procedures at a single facility by a single surgeon. There were 90 labral repairs, 83 femoroplasties, 26 acetabuloplasties, 66 labral debridements, 8 trochanteric bursectomies, and 7 iliopsoas releases. The cumulative DDE was 183 mrem (1.83 mSv), LDE 183 mrem (1.83 mSv), and SDE 176 mrem (1.76 mSv). The calculated per patient exposure for the surgeon was DDE 0.875 mrem (0.00875 mSv), LDE 0.875 mrem (0.00875 mSv), and SDE 0.842 mrem (0.00843 mSv). Calculated annual exposure for a surgeon performing 100 hip arthroscopies per year are DDE 8.75 mrem (0.0875 mSv), LDE 8.75 mrem (0.0875 mSv), and SDE 8.43 mrem (0.0842 mSv).Conclusion:Hip arthroscopy & hip preservation procedures are being performed with increasing frequency annually. Fluoroscopic guidance is recommended for safe entrance into the central compartment and during various parts of the procedures. Radiation exposure to the surgeon, staff, and patient is a valid concern. The IRCP sets recommended annual safety thresholds for occupational radiation exposure. Current annual safety thresholds are 50,000 mrem (500 mSv) to the hands, 50,000 mrem (500 mSv) to the skin, hands & feet, 15,000 mrem (150 mSv) to the eye, and 30,000 mrem (300 mSv) to the thyroid of healthcare workers. Our study shows surgeon radiation exposure below the annual safety thresholds recommended by the IRCP for 100 cases per year. For surgeons performing more than 100 hip arthroscopic procedures annually, the exposure will be higher. Appropriate safety equipment such as lead aprons, thyroid sh...