Monday, May 28, 2007

Airport Metal Detectors and Orthopedic Implants

In my practice patients will ask whether their orthopedic implant will cause any trouble at an airport security checkpoint. Until now I had not been able to reference any scientific studies that have evaluated which implants would trigger the airport metal detector.

An article that recently caught my attention was titled "Detection of Orthopaedic Implants in Vivo by Enhanced-Sensitivity, Walk-Through Metal Detectors" and appeared in the April, 2007 Journal of Bone and Joint Surgery. This article will be of general interest to patients in predicting whether their implant will trigger extra scrutiny at a security checkpoint. Shown on the right is an xray of a stainless steel plate and screws at the knee joint. This is likely to be detected by the Airport Metal Detector because of the large size of the blade plate and screws.

Patients with Total Hip and Total Knee replacements are commonly given credit card sized identification cards to travel with. However, in reality these cards are not acknowledged by airport screeners. If you have an orthopedic implant in your body that is likely to trigger the Airport Metal Detector allow extra time (5-15 minutes) to pass through airport security. What my patients with Knee Replacements tell me is that their implant does trigger the detector, and they are taken to the secondary screening station. There they are "wand ed" to verify the cause of the Metal Detector alarm was in fact their artificial knee and then they are cleared through the screening area. Rarely is any other type of more prolonged and time consuming screening done.

In their study the authors looked at Hip replacements, Knee replacements, spine fusion hardware, and upper and lower extremity fracture repair rods, plates and screws and wire.


Xray of Total Hip Replacement (above). This has a 100% chance of triggering the Airport Metal Detector.

The findings are summarized here. As you read the findings keep in mind that detection rates will vary because of the following facts: 1. Different brands and models of detector machines will have variable detections rates. 2. Sensitivities of metal detectors can be influenced by local magnetic interference such as fluorescent lighting or from other medical imaging devices. Repeating this study in a different location, such as your hometown airport, may show different detection rates. However in general the following observations can guide you as to the likelihood of whether your orthopedic implant will trigger an airport metal detector.

  • Total Hip replacements were detected 100% of the time.
  • Total Knee replacements were detected 90% of the time.
  • Total Shoulder and wrist replacements were not detected.
  • Plates with screws were detected approximately 25% of the time.
  • Screws alone or wire alone or intramedullary rods alone were usually not detected.
  • Lower extremity implants were detected 66 % of the time.
  • Upper extremity implants were detected 17% of the time.
  • Spine implants were detected 14% of the time.


And the type of metal matters. Cobalt chrome and titanium were likely to be detected, while stainless steel was unlikely to be detected.




Photograph of Knee Replacement implants made of cobalt chrome (above). Total Knee Replacements are detected 90% of the time by Airport Metal Detectors.

I invited readers to submit their experiences navigating through security with orthopedic implants.

4 comments:

Andrew P. said...

I have a knee replacement joint that the articles says will have a 90% chance of going off. Can my doctor get me a letter explaining my implant? Done anyone know of patients who have tried sheilding the joint from the detector?

Stefan D. Tarlow MD said...

Good Morning Andrew,

Usually your Doctor can provide you with a credit card sized identification card from the manufacturer of your Total knee implant. Your Doctor could hand write you a note on a prescription pad or type a letter for you to carry when you travel. However, the airport screener's do not acknowledge identification cards or letters. You will most likely be taken aside for secondary screening with a wand and then passed through security. This should take 5-15 minutes.

I do not know of any patient that has tried to shield their implant.

Your question is a good one and I have edited my blog to address your question, which I anticipate others will ask.

SDT

Chris said...

Andrew,
I had my knee replaced late last year and have flown several times. Being wanded is really not that big of a deal. Much depends also on the airport you are flying out of. Flying out of Phoenix, AZ I found many of the screeners curt and very business like. Flying out of Portland, OR the screeners were friendly and curious about rehab time etc.
IMHO I think if a person tried to shield their joint and got caught your delays would be much longer and more frustrating than just taking the time to be wanded.

Anonymous said...

I have a total knee replacement and have been checked twice in the airport and once in a court building. I have never been kept longer then just for the wand. I am about to compare both procedures as I am schedule to have my other knee replaced with the minimally invasive procedure and am looking for much better results. It has been over a year and my first replacement is still hurting.