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Background <p>Retained foreign objects (RFOs), particularly surgical sponges, remain a serious yet preventable source of morbidity and litigation. Although radiofrequency (RF)-tagged sponges have shown 100% sensitivity and specificity in general surgery, their performance in orthopedic procedures involving metallic implants remains underexplored. This study evaluates the reliability of RF-tagged sponges in total joint arthroplasty and identifies unique limitations associated with their use in orthopedic surgery.</p> Methods <p>A retrospective review was conducted of 2,251 total knee and total hip arthroplasty cases performed at a high-volume orthopedic center from April 30, 2024 to February 28, 2025. All cases employed both standard manual sponge counts and RF detection technology. The primary outcome was the discrepancy rate between manual and RF counts, with secondary analysis of false-positive and false-negative events and contributing intraoperative factors.</p> Results <p>Three discrepancies (0.13%) were identified. One case represented a false-negative RF scan in which the tag became undetectable due to cement polymerization and proximity to a metallic femoral stem. Two cases involved false-positive detections that resolved on repeat scanning without evidence of retained items.</p> Conclusions <p>RF-tagged surgical sponges may serve as a useful adjunct for RFO prevention in orthopedic surgery but may be affected by metallic interference and tag damage during implant cementation. The technology should supplement, not replace, manual counts and intraoperative imaging. Further research is warranted to optimize RF performance in orthopedic applications.</p>

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The safety of radiofrequency surgical sponges in orthopedic surgery: a validation study in 2,251 arthroplasty procedures

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月4日

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  • Jack A. Will,
  • Lachlan F. Anderson,
  • Steven Ogden

摘要

Background

Retained foreign objects (RFOs), particularly surgical sponges, remain a serious yet preventable source of morbidity and litigation. Although radiofrequency (RF)-tagged sponges have shown 100% sensitivity and specificity in general surgery, their performance in orthopedic procedures involving metallic implants remains underexplored. This study evaluates the reliability of RF-tagged sponges in total joint arthroplasty and identifies unique limitations associated with their use in orthopedic surgery.

Methods

A retrospective review was conducted of 2,251 total knee and total hip arthroplasty cases performed at a high-volume orthopedic center from April 30, 2024 to February 28, 2025. All cases employed both standard manual sponge counts and RF detection technology. The primary outcome was the discrepancy rate between manual and RF counts, with secondary analysis of false-positive and false-negative events and contributing intraoperative factors.

Results

Three discrepancies (0.13%) were identified. One case represented a false-negative RF scan in which the tag became undetectable due to cement polymerization and proximity to a metallic femoral stem. Two cases involved false-positive detections that resolved on repeat scanning without evidence of retained items.

Conclusions

RF-tagged surgical sponges may serve as a useful adjunct for RFO prevention in orthopedic surgery but may be affected by metallic interference and tag damage during implant cementation. The technology should supplement, not replace, manual counts and intraoperative imaging. Further research is warranted to optimize RF performance in orthopedic applications.