Fluoroscopy Learning Curve in Hip Arthroscopy—A Single Surgeon's Experience

Purpose To determine if (1) absorbed radiation dose and (2) fluoroscopy time decreased with experience over the first 100 cases of a single surgeon's hip arthroscopy practice. Methods Subjects who underwent hip arthroscopy for symptomatic femoroacetabular impingement and labral injury were eligible for analysis. Inclusion criteria included the first 100 subjects who underwent hip arthroscopy by a single surgeon (December 2013 to December 2014). Subject demographics, procedure details, fluoroscopy absorbed dose (milligray [mGy]), and time were recorded. Subjects were categorized by date of surgery to one of 4 possible groups (25 per group). One-way analysis of variance was used to determine if a significant difference in dose (mGy) or time was present between groups. Simple linear regression analysis was performed to determine the relation between case number and both radiation dose and fluoroscopy time. Results Subjects underwent labral repair (n = 93), cam osteoplasty (n = 90), and pincer acetabuloplasty (n = 65). There was a significant (P <.001 for both) linear regression between case number and both radiation dose and fluoroscopy time. A significant difference in mGy was observed between groups, group 1 the highest and group 4 the lowest amounts of radiation (P =.003). Comparing individual groups, group 4 was found to have a significantly lower amount of radiation than group 1 (P =.002), though it was not significantly lower than that of group 2 (P =.09) or group 3 (P =.08). A significant difference in fluoroscopy time was observed between groups, group 1 the highest and group 4 the lowest times (P =.05). Comparing individual groups, group 4 was found to have a significantly lower fluoroscopy time than group 1 (P =.039). Correction for weight, height, and body mass index all revealed the same findings: significant (P <.05) differences in both dose and time across groups. Conclusions The absorbed dose of radiation and fluoroscopy time decreased significantly over the first 100 cases of a single surgeon's hip arthroscopy practice learning curve. Level of Evidence Level IV, therapeutic, retrospective, noncomparative case series.