Orthopaedic surgeons' use and knowledge of ionizing radiation during surgical treatment for femoroacetabular impingement.

PURPOSE: To better understand how radiograph imaging is currently used throughout perioperative care for femoroacetabular impingement (FAI) and to define surgeon knowledge and perspective on radiation safety when treating FAI.
METHODS: An online questionnaire was designed to be completed by hip arthroscopists on the imaging modalities and projections they use during evaluation and treatment of FAI and the associated radiation exposures and safety. A sample of practicing attending orthopaedic surgeons was surveyed via an anonymous survey link emailed to corresponding authors on publications related to FAI. The anonymous survey link was also provided to orthopaedic surgeons at the 2014 Vail Hip Symposium.
RESULTS: Ninety-one surgeons completed the survey. Of these participants, 72 surgeons (79.1 %) indicated they use pre-operative radiographs and intra-operative spot fluoroscopic images during FAI treatment. Thirty-three surgeons (36.3 %) use pre-operative computed tomography (CT). Twenty-three surgeons (25.3 %) use real-time moving fluoroscopy. A majority of surgeons incorrectly answered multiple-choice questions about which C-arm positions and settings result in the lowest doses of radiation to the surgeon or patient. Eighty-three surgeons (91.2 %) indicated they believe most orthopaedic surgeons need to be more informed about radiation safety.
CONCLUSIONS: This study gives a quantitative representation of the imaging modalities and projections utilized during perioperative treatment for FAI. This study also identified a lack of knowledge of radiation safety among orthopaedic surgeons treating patients with FAI and demonstrates the need for greater education. LEVEL OF EVIDENCE: IV.