Leaded Eyeglasses Substantially Reduce Radiation Exposure of the Surgeon’s Eyes During Acquisition of Typical Fluoroscopic Views of the Hip and Pelvis

Burns, Sean M.; Thornton, Raymond H.; Dauer, Lawrence T.; Quinn, Brian; Miodownik, Daniel; Hak, David J.

doi:10.2106/jbjs.l.00893

Cited by 59 publications

(36 citation statements)

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“…Moreover, when automatic exposure control is used and the glove is in the sensing area, radiation will be increased by the fluoroscope in order to penetrate through the glove [43]. Lead glasses are also available and may provide additional protection of the eyes [68]. There is no conflict of interest to declare.…”

Section: Discussionmentioning

confidence: 99%

The Great Unknown—A systematic literature review about risk associated with intraoperative imaging during orthopaedic surgeries

Matityahu

Duffy

Goldhahn

et al. 2017

Injury

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Section: Discussionmentioning

confidence: 99%

The Great Unknown—A systematic literature review about risk associated with intraoperative imaging during orthopaedic surgeries

Matityahu

Duffy

Goldhahn

et al. 2017

Injury

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“…Anterior knee pain is still an important complication and is causing a high percentage of unsatisfied patients after TKA [27]. The assumption that resurfacing the patella could prevent the phenomenon of anterior knee pain could not be proved [28-30].…”

Section: Discussionmentioning

confidence: 99%

Patellofemoral contact patterns before and after total knee arthroplasty: an in vitro measurement

et al. 2013

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BackgroundPatellofemoral complications are one of the main problems after Total Knee Arthroplasty (TKA). Retropatellar pressure distribution after TKA can contribute to these symptoms. Therefore we evaluated retropatellar pressure distribution subdivided on the ridge, medial and lateral surface on non-resurfaced patella before and after TKA. Additionally, we analyzed axial femorotibial rotation and quadriceps load before and after TKA.MethodsSeven fresh frozen cadaver knees were tested in a force controlled knee rig before and after TKA (Aesculap, Tuttlingen, Germany, Columbus CR) while isokinetic flexing the knee from 20° to 120° under weight bearing. Ridge, medial and lateral retropatellar surface were defined and pressure distribution was dynamically measured while quadriceps muscles and hamstring forces were applied. Aside axial femorotibial rotation and quadriceps load was recorded.ResultsThere was a significant change of patella pressure distribution before and after TKA (p = 0.004). In physiological knees pressure distribution on medial and lateral retropatellar surface was similar. After TKA the ridge of the patella was especially in higher flexion grades strongly loaded (6.09 +/−1.31 MPa) compared to the natural knee (2.92 +/−1.15 MPa, p < 0.0001). Axial femorotibial rotation showed typical internal rotation with increasing flexion both before and after TKA, but postoperatively it was significantly lower. The average amount of axial rotation was 3.5° before and after TKA 1.3° (p = 0.001). Mean quadriceps loading after implantation of knee prosthesis did not change significantly (575 N ±60 N in natural knee and after TKA 607 N ±96 N; p = 0.28).ConclusionsThe increased retropatellar pressure especially on the ridge may be one important reason for anterior knee pain after TKA. The trochlea of the femoral component might highly influence the pressure distribution of the non-resurfaced retropatellar surface. Additionally, lower axial femorotibial rotation after TKA might lead to patella maltracking. Changing the design of the prosthesis or a special way of patella shaping might increase the conformity of the patella to trochlea to maintain natural contact patterns.

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“…Leaded eyewear should include lateral protection, as the eyes are susceptible to backscatter from the head and direct scatter when the head is turned [13]. Leaded eyewear can reduce the exposure to the eyes by up to 90% in pelvic and hip surgery [14]. …”

Section: Introductionmentioning

confidence: 99%

Intraoperative radiation safety in orthopaedics: a review of the ALARA (As low as reasonably achievable) principle

et al. 2016

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The use of fluoroscopy has become commonplace in many orthopaedic surgery procedures. The benefits of fluoroscopy are not without risk of radiation to patient, surgeon, and operating room staff. There is a paucity of knowledge by the average orthopaedic resident in terms proper usage and safety. Personal protective equipment, proper positioning, effective communication with the radiology technician are just of few of the ways outlined in this article to decrease the amount of radiation exposure in the operating room. This knowledge ensures that the amount of radiation exposure is as low as reasonably achievable. Currently, in the United States, guidelines for teaching radiation safety in orthopaedic surgery residency training is non-existent. In Europe, studies have also exhibited a lack of standardized teaching on the basics of radiation safety in the operating room. This review article will outline the basics of fluoroscopy and educate the reader on how to safe fluoroscopic image utilization.

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Leaded Eyeglasses Substantially Reduce Radiation Exposure of the Surgeon’s Eyes During Acquisition of Typical Fluoroscopic Views of the Hip and Pelvis

Abstract: Leaded glasses are a powerful tool for reducing the orthopaedic surgeon's lens exposure to radiation during acquisition of common intraoperative fluoroscopic views.

Cited by 59 publications

References 1 publication

The Great Unknown—A systematic literature review about risk associated with intraoperative imaging during orthopaedic surgeries

The Great Unknown—A systematic literature review about risk associated with intraoperative imaging during orthopaedic surgeries

Patellofemoral contact patterns before and after total knee arthroplasty: an in vitro measurement

Intraoperative radiation safety in orthopaedics: a review of the ALARA (As low as reasonably achievable) principle

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