Assessing implant position and bone properties after cementless total knee arthroplasty using weight-bearing computed tomography

Background Weight-bearing CT (WBCT) scanners are growing in availability and provide the capability of three-dimensional imaging while a joint is under load. This may be particularly useful in relation to personalized total knee arthroplasty (TKA) with cementless implants. The objective of the prese...

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Vydáno v:BMC musculoskeletal disorders Ročník 26; číslo 1; s. 477 - 7
Hlavní autoři: Lin, Jane, Zamani, Mariam, Kalia, Vishal, Vasarhelyi, Edward M., Lanting, Brent A., Teeter, Matthew G.
Médium: Journal Article
Jazyk:angličtina
Vydáno: London BioMed Central 15.05.2025
BioMed Central Ltd
Springer Nature B.V
BMC
Témata:
Aged
Aged, 80 and over
Ankle
Arthroplasty (knee)
Arthroplasty, Replacement, Knee - instrumentation
Arthroplasty, Replacement, Knee - methods
Artificial hip joints
Bone Density
Bones
Cementless total knee arthroplasty
Computed tomography
Coronal alignment
CT imaging
Density
Epidemiology
Female
Femur
Femur - diagnostic imaging
Femur - surgery
Hip-knee-ankle angle
Humans
Implant fixation
Implants, Artificial
Internal Medicine
Joint line obliquity
Joint replacement surgery
Knee
Knee Joint - diagnostic imaging
Knee Joint - surgery
Knee Prosthesis
Male
Mechanical properties
Medical imaging
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Middle Aged
Observer Variation
Orthopedics
Patients
Physiological aspects
Prosthesis
Rehabilitation
Reproducibility of Results
Rheumatology
Sports Medicine
Surgery, Experimental
Surgical research
Tibia
Tibia - diagnostic imaging
Tibia - surgery
Tomography
Tomography, X-Ray Computed - methods
Transplants & implants
Triathlon
Weight-Bearing - physiology
Canada
Coronal alignment
Bone density
Cementless total knee arthroplasty
Hip-knee-ankle angle
Joint line obliquity
Implant fixation
ISSN:1471-2474, 1471-2474
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Popis
Shrnutí:Background Weight-bearing CT (WBCT) scanners are growing in availability and provide the capability of three-dimensional imaging while a joint is under load. This may be particularly useful in relation to personalized total knee arthroplasty (TKA) with cementless implants. The objective of the present study was to evaluate the utility and inter-observer repeatability of WBCT in assessing patients with cementless TKA in a loaded position. Methods Forty patients who underwent primary TKA approximately 3 years previously and received one of two cementless implant systems were recruited, including two subjects with bilateral TKA, for a total of 42 knees. All subjects underwent examination of their knee with WBCT while standing, thereby loading the indicated knee. Lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), hip-knee-ankle angle (HKAA), and joint line obliquity (JLO) were measured on full length radiographs and the WBCT exams by two observers. Femoral and tibial component rotation was measured on WBCT. Greyscale values representing bone density were assessed in five identically sized regions of interests in both the femur and the tibia on WBCT. Results Inter-observer agreement for alignment was good (95% ICC: 0.87). Inter-observer agreement for femoral component rotation was moderate (95% ICC: 0.67) and for tibial component rotation was good (95% ICC: 0.84). Inter-observer agreement for femoral greyscale values was good (95% ICC: 0.87) and for tibial greyscale values was excellent (95% ICC: 0.97). Conclusion Cementless TKA can be assessed postoperatively using WBCT to measure implant position and bone density in a functional, loaded joint position with good inter-observer repeatability.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1471-2474
1471-2474
DOI:10.1186/s12891-025-08718-5