title: Computed tomography for preoperative planning in minimal-invasive total hip arthroplasty: radiation exposure and cost analysis.
abstract: 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.
authors.affiliation: Imaging Science Institute Charité Berlin, Robert-Koch-Platz 7, D-10115 Berlin, Germany. Alexander.Huppertz@charite.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Huppertz
authors.forename: Sebastian
authors.initials: S
authors.lastname: Radmer
authors.forename: Patrick
authors.initials: P
authors.lastname: Asbach
authors.forename: Ralf
authors.initials: R
authors.lastname: Juran
authors.forename: Carsten
authors.initials: C
authors.lastname: Schwenke
authors.forename: Gerd
authors.initials: G
authors.lastname: Diederichs
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Martin
authors.initials: M
authors.lastname: Sparmann
mesh_terms: 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