The advantages of cone-beam computerised tomography (CT) in pain management following total knee arthroplasty, in comparison with conventional multi-detector CT.

摘要: Abstract Background Revision of total knee arthroplasty (TKA) requires preoperative assessment to identify the causes failure. Multidetector computerised tomography (MDCT) is a commonly used imaging technique, but sensitive certain artifacts, such as metal implants, limiting its use. Cone-beam CT (CBCT) new technique dedicated musculoskeletal that less artifacts and could be utilised in implantation surgery. CBCT has not yet been validated for this indication, we therefore undertook retrospective MDCT versus CBCT, comparing: 1) image quality; 2) reproducibility angle measurements; 3) effectiveness screening periprosthetic radiolucency implant loosening; 4) radiation dose. Hypothesis This study hypothesised provides better quality, measurement reproducibility, loosening at lower doses than MDCT. Patients method Between October 2017 March 2018, 28 patients, with mean age 61 ± 11.6 years [range, 45–85 years] underwent both pain following TKA. Two radiologists performed measurements on devices: patellofemoral tilt (PFT), rotation femoral component (RAFC) tibial (RATC). They also screened pathological and/or loosening, assessed quality at various bone/implant interfaces. The dose index per examination was recorded. Results Intraclass correlation coefficients angles were respectively good (0.73) excellent (0.82) PFT, borderline (0.28) moderate (0.44) RAFC, (0.96) RATC, (0.45) (0.84) screening. inter-observer kappa diagnosis (0.93) low (0.19) (0.38) loosening. interfaces 2.2/3 2.75/3 tibia/tibial interface, 1/3 2.3/3 trochlear region/femoral 0.9/3 2/3 condyle/femoral 1.25/3 2.1/3 patella/patellar medallion interface. significantly lower, by factor 1.24, (4.138 mGy) (5.125 (p  Conclusion results present revealed added value etiological work-up It reliable reproducible due enhanced despite lower conventional Level evidence III; comparative study.