Advanced Imaging of Total Knee Arthroplasty

Area of Science:

• Radiology
• Medical Imaging
• Orthopedic Surgery

Background:

• Total knee arthroplasty (TKA) prevalence is rising due to an aging population.
• Postoperative complications following TKA often necessitate imaging in the presence of metallic implants.
• Accurate imaging is crucial for diagnosing complications and ensuring patient outcomes.

Purpose of the Study:

• To review recent advancements in medical imaging for evaluating tissues adjacent to total knee arthroplasty implants.
• To highlight the impact of new computed tomography (CT) and magnetic resonance imaging (MRI) techniques on artifact reduction.
• To assess the utility of these improved imaging modalities in diagnosing TKA complications.

Main Methods:

• Computed Tomography (CT) advancements: tin prefiltration, metal artifact reduction algorithms, dual-energy CT with virtual monoenergetic imaging, cone-beam CT, and photon-counting detector CT.
• Magnetic Resonance Imaging (MRI) advancements: high bandwidth optimization, view angle tilting, multispectral imaging techniques (e.g., multiacquisition variable-resonance image combination, slice encoding metal artifact correction).

Main Results:

• CT techniques significantly reduce metal artifacts, improving visualization of periprosthetic tissues.
• MRI techniques, particularly those combining high bandwidth and artifact correction, enhance imaging quality around metallic TKA components.
• These technological improvements are transforming MRI into a valuable tool for assessing TKA complications.

Conclusions:

• Modern CT and MRI technologies offer substantial improvements in imaging patients with total knee arthroplasty.
• These advancements enable better detection and characterization of complications around TKA implants.
• Improved imaging facilitates more accurate diagnosis and management of postoperative TKA issues.