Ipsilateral reference may reduce THA fluoroscopy
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By
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Andrea Surnit
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September 15, 2026
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4 min
Ipsilateral Reference May Reduce THA Fluoroscopy
Overview
Using the ipsilateral hip as a radiographic reference during total hip arthroplasty (THA) may reduce fluoroscopy use relative to operative duration compared to the contralateral hip. However, both techniques showed similar absolute fluoroscopy times and radiation doses.
Background
Fluoroscopy is commonly utilized during direct anterior approach total hip arthroplasty to ensure accurate component positioning and leg length restoration. Understanding the impact of different radiographic references on fluoroscopy use and radiation exposure is crucial for optimizing surgical safety and minimizing patient radiation exposure.
Data Highlights
| Technique | Mean Fluoroscopy Time (seconds) | Mean Radiation Dose (mGy) | Mean Operative Time (minutes) |
|---|---|---|---|
| Contralateral | 60.4 | 15.4 | 154.3 |
| Ipsilateral | 55.9 | 13.0 | 164.6 |
Key Findings
- Mean fluoroscopy time was 60.4 seconds for the contralateral technique and 55.9 seconds for the ipsilateral technique.
- Mean radiation dose was 15.4 mGy for the contralateral technique and 13.0 mGy for the ipsilateral technique.
- Mean operative time was longer with the ipsilateral technique (164.6 minutes) compared to the contralateral technique (154.3 minutes).
- Normalized fluoroscopy time was lower with the ipsilateral technique (0.34 arbitrary units) compared to the contralateral technique (0.39 arbitrary units).
- Normalized radiation dose was also lower with the ipsilateral technique (0.08 arbitrary units) compared to the contralateral technique (0.10 arbitrary units).
- Statistically significant interactions were observed between BMI and reference technique on radiation dose and operative time.
Clinical Implications
The choice of radiographic reference in DAA-THA may influence fluoroscopy use relative to operative duration.
Conclusion
Both ipsilateral and contralateral reference techniques resulted in similar absolute fluoroscopy use.
Related Resources & Content
- Knee Surgery, Sports Traumatology, Arthroscopy, 2012 -- Fluoroscopy Utilization During Surgery Enhances Accuracy in Traditional Total Knee Arthroplasty
- European Radiology, 2022 -- Integrating 3-D and 2-D Templating Techniques for Total Hip Arthroplasty Utilizing a Novel Tin-Filtered Ultra-Low-Dose CT with Radiation Levels Comparable to Standard Radiographs
- European Radiology, 2023 -- Alterations in Femoral Anteversion Linked to Ischiofemoral Impingement Following Total Hip Arthroplasty: A Retrospective CT Analysis
- Frontiers in Surgery — Robotic-assisted vs. fluoroscopy-assisted MIS-TLIF: improved screw accuracy and reduced early opioid use with comparable long-term outcomes
- Does intraoperative fluoroscopy improve acetabular component positioning and limb-length discrepancy during direct anterior total hip arthroplasty? A meta-analysis
- Recommendations From the Blue Ribbon Panel on Fluoroscopy Safety
- Reliability of a simple fluoroscopic image to assess leg length discrepancy during direct anterior approach total hip arthroplasty
- NCRP commentary no. 33-recommendations for stratification of equipment use and radiation safety training for fluoroscopy - PubMed
- https://cs.acr.org/-/media/ACR/Files/Practice-Parameters/MgmtFluoroProc.pdf
- Robotic-Assisted Direct Anterior Approach Total Hip Arthroplasty: A 6.5-fold Reduction in Fluoroscopic Radiation Exposure - PubMed
- Robotic Assistance is Associated With No Intraoperative Fluoroscopy or Radiation Exposure During Direct Anterior Total Hip Arthroplasty.
- Fluoroscopy use and radiation safety in orthopedic surgery: a cross-sectional survey of knowledge and protective behaviors - PMC
Based on findings from:
Ipsilateral reference may reduce THA fluoroscopy
Andrea Surnit. MDSpire News, 2026.
https://news.mdspire.com/orthopedic-medicine/articles/ipsilateral-reference-may-reduce-tha-fluoroscopy/
This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.
