Intraoperative Radiation Exposure of Orthopaedic Surgeons-Mismatch Between Concerns and Protection

Objective: Although orthopaedic surgeons frequently utilize intraoperative imaging, there is a lack of knowledge about their patterns of radiation protection. The goal of this study was thus to fill this gap by evaluating the use of protection against radiation in relation to concerns, safety guidelines and instructions. Methods: A survey addressing the issue was performed in 531 orthopaedic and trauma surgeons. The questionnaire comprised 26 questions concerning the use of intraoperative radiation in clinical practice, concerns about it and protection against. Results: Over 31% of the surgeons are very concerned about their radiation exposure in their job and about 48% are slightly to moderately concerned. Surgeons from Asia-Pacific, Latin America, and Middle East are significantly more concerned about radiation in their job compared to European surgeons (p<0.002). However, only one fifth of the surgeons wear a dosimeter and half of them never use it. Nearly 65% of the surgeons always wear a lead apron, but only 30.8% wear a thyroid protection. Lead gloves and lead glasses were always worn by only 2.5 % (13/531) and 3.1% (16/531) respectively. Half of the respondents are aware of the radiation protection officer in their clinic, but 38.8% stated the issue has never been the subject of training at their institution. Internal training significantly affects the usage of dosimeters (odds ratio=2.97, 95% confidence interval: 2.00 – 4.39; p<0.001). Conclusion: Although most operating surgeons worry about their exposure, the knowledge and the practical implementation of radiological protection measures in clinical practice is still insufficient. Education is key for better radiation protection in orthopaedic practice.