Computed tomography for preoperative planning in minimal-invasive total hip arthroplasty: radiation exposure and cost analysis.
Computed tomography (CT) was used for preoperative planning of minimal-invasive total hip arthroplasty (THA). 92 patients (50 males, 42 females, mean age 59.5 years) with a mean body-mass-index (BMI) of 26.5 kg/m(2) underwent 64-slice CT to depict the pelvis, the knee and the ankle in three independent acquisitions using combined x-, y-, and z-axis tube current modulation. Arthroplasty planning was performed using 3D-Hip Plan(®) (Symbios, Switzerland) and patient radiation dose exposure was determined. The effects of BMI, gender, and contralateral THA on the effective dose were evaluated by an analysis-of-variance. A process-cost-analysis from the hospital perspective was done. All CT examinations were of sufficient image quality for 3D-THA planning. A mean effective dose of 4.0 mSv (SD 0.9 mSv) modeled by the BMI (p<0.0001) was calculated. The presence of a contralateral THA (9/92 patients; p=0.15) and the difference between males and females were not significant (p=0.08). Personnel involved were the radiologist (4 min), the surgeon (16 min), the radiographer (12 min), and administrative personnel (4 min). A CT operation time of 11 min and direct per-patient costs of 52.80 € were recorded. Preoperative CT for THA was associated with a slight and justifiable increase of radiation exposure in comparison to conventional radiographs and low per-patient costs.
Huppertz
Alexander
A
Imaging Science Institute Charité Berlin, Robert-Koch-Platz 7, D-10115 Berlin, Germany. Alexander.Huppertz@charite.de
Radmer
Sebastian
S
Asbach
Patrick
P
Juran
Ralf
R
Schwenke
Carsten
C
Diederichs
Gerd
G
Hamm
Bernd
B
Sparmann
Martin
M
D019644:Arthroplasty, Replacement, Hip / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000191:economics / Q000706:statistics & numerical data; D015995:Prevalence; D011829:Radiation Dosage; D011874:Radiometry / Q000191:economics / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000191:economics* / Q000706:statistics & numerical data