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Detection of Total Hip Prostheses at Airport Security Checkpoints: How Has Heightened Security Affected Patients?
Aaron J. Johnson, MD1; Qais Naziri, MD1; Hasan A. Hooper, CST, CSA1; Michael A. Mont, MD1
1 Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215. E-mail addresses for M.A. Mont: mmont@lifebridgehealth.org
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Apr 04;94(7):e44 1-4. doi: 10.2106/JBJS.K.00864
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Abstract

Background: 

The sensitivity of airport security screening measures has increased substantially during the past decade, but few reports have examined how this affects patients who have undergone hip arthroplasty. The purpose of this study was to determine the experiences of patients who had hip prostheses and who passed through airport security screenings.

Methods: 

A consecutive series of 250 patients who presented to the office of a high-volume surgeon were asked whether they had had a hip prosthesis for at least one year and, if so, whether they had flown on a commercial airline within the past year. Patients who responded affirmatively to both questions were asked to complete a written survey that included questions about which joint(s) had been replaced, the number of encounters with airport security, the frequency and location of metal detector activation, any additional screening procedures that were utilized, whether security officials requested documentation regarding the prosthesis, the degree of inconvenience, and other relevant information.

Results: 

Of the 143 patients with hip replacements who traveled by air, 120 (84%) reported triggering the alarm and required wanding with a handheld detector. Twenty-five of these patients reported subsequently having to undergo further inspection, including additional wanding, being patted down, and in two cases having to undress in a private room to show the incision. Ninety-nine (69%) of the 143 patients reported that the prosthetic joint caused an inconvenience while traveling.

Conclusions: 

This study provides interesting and critical information that allows physicians to understand the real-world implications of implanted orthopaedic devices for patients who are traveling where there has been heightened security since September 11, 2001. Patients should be counseled that they should expect delays and be prepared for such inconveniences, but that these are often only momentary. This information could relieve some anxiety and concerns that patients may have prior to traveling.

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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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    Marshall Ackerman, M.D.
    Posted on April 05, 2012
    Airport detection of total joint implants is hardly an ' inconvenience.'
    Shady Grove Orthopaedic Associates, P.A.

    As the orthopedic surgeon spouse of woman with a total knee replacement, I have had repetitive and consistent experiences with airport detection of her implant at domestic airports over the past 3 1/2 years and it has not been an 'inconvenience'. She is repeatedly subjected to invasive 'pat downs' both here in the Washington, DC area and elsewhere, to the point where I was threatened with arrest for protesting and trying to video the procedure. Contrast this with travel in Israel from where we just returned, where her knee replacement never set off the screening, we never took off our shoes and I did not even have to remove my belt with a large metal buckle. Even travelling in a high security area in Argentina, her knee replacement did not set off the detectors, and armed guards merely smiled and waved us through when we brought it to their attention. AAOS and AAHKS should be making a major effort with TSA to make travel in the USA more accommodating to the millions of Americans with major joint implants.

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