Radiation exposure during fluoroarthroscopically assisted anterior cruciate reconstruction

We prospectively evaluated the radiation exposure during 50 consecutive fluoroscopically assisted anterior cruciate ligament reconstructions. Three different methods of anterior cruciate ligament reconstruction were performed using either rolled fascia lata allograft or bone-tendon-bone autograft. For the 50 procedures, total time using the fluoroscope was 119.61 minutes, or 2.38 minutes per procedure. The 16 primary fascia lata allograft reconstructions averaged 1.38 minutes of fluoroscope use per procedure compared with 4.69 minutes for the two revision allograft fascia lata surgeries, 3.14 minutes per procedure for the 30 primary bone-tendon-bone reconstructions, and 4.18 minutes per procedure for the two surgeries performed with an allograft meniscal transplant. The difference in exposure time between the 16 primary allograft fascia lata surgeries and the 30 primary allograft or autograft bone-tendon-bone surgeries was statistically significant. The average radiation exposure to the surgeon was 0.67 mrem per minute of fluoroscope use. It would take 7463.08 minutes of fluoroscope time, or 11,139 primary fascia lata allograft reconstructions, to exceed the recommended occupational exposure limit of 5000 mrem per year. It appears that the orthopaedic surgeon receives minimal radiation when using the fluoroscope to assist in anterior cruciate ligament reconstruction, especially when doing a primary fascia lata allograft procedure.