Hackensack University Medical Center Researcher Examines Value and Risk of CT Scans in Orthopedic Surgery

Arthroplasty Today study evaluates radiation exposure impact in elective knee and hip arthroplasty

Computerized tomography (CT) scans offer insight to surgeons in elective knee and hip arthroplasty planning and implementation but expose patients to high levels of radiation compared to other imaging techniques.

Gregg Klein, M.D., one of the surgeons and investigators affiliated with Hackensack Meridian Hackensack University Medical Center, recently assessed the value versus risk of CT imaging in these particular orthopedic procedures. The study, published in Arthroplasty Today, notes that nearly 2% of all cancers in the United States may be attributable to radiation from CT scans, and calls for special consideration of CT imaging use in elective knee and hip arthroplasty.

The study calls attention to the fact that in the last 25 years, average background radiation exposure in the United States has nearly doubled, almost entirely due to medical imaging. In the United States more than 85 million CT scans are performed annually.

While CT scans provide valuable detail regarding bone structure and assist in the planning and completion of surgical procedures, the value of this insight must be weighed against the cancer risk of radiation exposure, researchers determined. Given the nondiagnostic purpose of preoperative CT for knee and hip arthroplasty, surgeons performing these procedures and their patients should give special consideration to CT employment, particularly as alternatives are available, including conventional techniques, MRI-based methods for cutting guide customization, portable handheld accelerometer-based navigation and image-free robotics. Modulating CT machine settings also can decrease radiation exposure.

The study recommends that the routine use of CT scans for preoperative planning in elective orthopedic cases must be reviewed in context of the inherent radiation risks for an individual patient.

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