Document Type : RESEARCH PAPER
Department of Trauma and Orthopaedics, Southend University Hospital, Mid and South Essex NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, United Kingdom
Objectives: Intra-articular hip injections (IHI) are routinely performed for both diagnostic and
therapeutic purposes. The procedure can be performed via either an anterior or a lateral approach
with fluoroscopic guidance being widely practised. There is a risk of radiation exposure associated
with fluoroscopy assisted IHI. This may be influenced either by the surgical approach or the patient ’s
body mass index (BMI) or both. This study was undertaken to compare the relationships of the
respective approaches to BMI, fluoroscopic exposure time (FET) and radiation dose (RD).
Methods: A retrospective study was conducted comprising 74 patients who underwent IHI with 37
patients in each group (anterior and lateral). Patients were assessed pre -operatively and post
operatively for any complications. The intra-operative radiation dose, fluoroscopic exposure time and
BMI data were collected and analyzed.
Results: The mean age of the patients in anterior and lateral groups was 61.18 ±14.08 and
67.21±14.39 years respectively. No complications were noted in either group. However, there was a
significant increase in FET (P=0.002) and RD (P<0.001) in patients with BMI ≥ 30. In the lateral
group, this trend was markedly noted with increase in FET (P<0.001) and RD (P<0.001) in patients
with BMI ≥ 30. On the other hand, in the anterior group there was no statistically significant increase
in FET (P=0.155) and only a moderate increase in RD (P=0.020) in patients with BMI ≥ 30.
Conclusion: Both anterior and lateral approaches to fluoroscopic guided IHI are equally safe in terms
of complications involved. There is statistically significant increase in both radiation dose and
fluoroscopic exposure time in patients with BMI ≥ 30. This is more pronounced in lateral approach. The
anterior approach is most effective in reducing both radiation dose and fluoroscopic exposure time,
more so in patients with BMI of 30 and above.
Level of evidence: III