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Updated: Feb 3, 2026

Emergency Undocking in Robotic Surgery: A Simulation Curriculum

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Inverted C-arm Orientation During Simulated Hip Arthroscopic Surgery.

Nischal Nadig¹, Kenneth Aaron Shaw¹, Edward Mottern¹

¹Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia, USA.

Orthopaedic Journal of Sports Medicine

|October 24, 2018

Summary

Using an inverted C-arm during hip arthroscopic surgery significantly reduces patient radiation exposure and cancer risk. This method offers a safer approach for patients undergoing these procedures.

Keywords:

cam/pincer carcinogenesis femoroacetabular impingement radiation risk scatter radiation

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Area of Science:

Orthopaedic Surgery
Medical Imaging
Radiation Safety

Background:

Fluoroscopic guidance is standard in hip arthroscopic surgery.
C-arm orientation impacts radiation exposure for patients and surgeons.
Previous research has not assessed this impact specifically for hip arthroscopy.

Purpose of the Study:

To evaluate the effect of an inverted C-arm orientation on radiation exposure during hip arthroscopic surgery.
To compare radiation doses to the patient and surgical team between standard and inverted C-arm positions.

Main Methods:

A descriptive laboratory study using an anthropomorphic pelvic phantom.
Simulated hip arthroscopic surgery with standard and inverted C-arm orientations.
Measured scatter radiation at six key locations and analyzed radiation dosages.

Main Results:

The inverted C-arm orientation decreased patient radiation exposure by 2.48-fold.
Patient carcinogenesis risk was reduced by 2.64-fold with the inverted orientation.
A slight increase in surgeon radiation exposure was observed with the inverted C-arm.

Conclusions:

The inverted C-arm orientation is effective in minimizing patient radiation exposure and associated cancer risk during hip arthroscopy.
This orientation also provides an increased working area for the surgeon.
Clinical adoption of the inverted C-arm is supported to enhance patient safety.