Intraoperative Radiation Exposure During Revision Total Ankle Replacement.
Intraoperative C-arm image intensification is required for primary total ankle replacement implantation. Significant radiation exposure has been linked to these procedures; however, the radiation exposure during revision total ankle replacement remains unknown. Therefore, we sought to evaluate the radiation exposure encountered during revision total ankle replacement. The data from 41 patients were retrospectively analyzed from a prospective database: 19 Agility(™) to Agility(™); 4 Agility(™) to Custom Agility(™); 9 Agility(™) to INBONE(®) II; 5 Agility(™) to Salto Talaris(®) XT; 2 Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT; and 2 INBONE(®) I to INBONE(®) II revision total ankle replacements were performed. Two broad categories were identified: partial revision (Agility(™) to Agility(™), Agility(™) to Custom Agility(™), INBONE(®) I to INBONE(®) II) and complete conversion (Agility(™) to INBONE(®) II, Agility(™) to Salto Talaris(®) XT, Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT). The mean radiation exposure per case was significant at 3.49 ± 2.21 mGy. Complete conversions, specifically Agility(™) to INBONE(®) II, exhibited the greatest radiation exposure and C-arm time. Revision implant selection and revision type (complete or partial) directly contributed to radiation exposure. Accordingly, revision systems requiring less radiation exposure are preferable. Surgeons should strive to minimize intraoperative complications and limit additional procedures to those necessary, because both lead to additional radiation exposure.
Attending Staff, Orthopaedic Center, Gundersen Health System, La Crosse, WI. Electronic address: tsroukis@gundersenhealth.org.
Thomas S
TS
Roukis
Rosalind Franklin University of Medicine and Science, North Chicago, IL.
Kelli
K
Iceman
Postgraduate Year III Podiatric Medicine and Surgery Resident, Gundersen Medical Foundation, La Crosse, WI.
Andrew D
AD
Elliott
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058737:Arthroplasty, Replacement, Ankle; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007432:Intraoperative Period; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D000069079:Radiation Exposure; D011839:Radiation, Ionizing; D012086:Reoperation; D012189:Retrospective Studies
ankle arthroplasty; complications; primary total ankle replacement; prosthetic failure