Imaging in peri-prosthetic assessment: an orthopaedic perspective

Abstract

As imaging techniques are ever-evolving, this article aims to provide a brief overview of the various modalities including their limitations. The ability of imaging for evaluation of implant osseo-integration will be addressed and also the role of imaging in assessing septic and aseptic loosening, with a particular focus on adverse tissue reactions, will be discussed. Specific features when imaging the big joints such as shoulder, hip, knee and ankle joint will also be outlined.Overall, a lack of standardisation and validity was noted and despite the gross variety of imaging modalities, there is no technique covering all aspects required for evaluation of implant fixation and septic and aseptic loosening. Each imaging modality has a role, depending on the information required and anticipated. The choice of imaging technique should not be primarily based on medical considerations but also on availability, accessibility, expertise and costs. Plain radiographs alone have been recommended in cases of suspected peri-prosthetic joint infections, given the lack of evidence for additional imaging techniques in this context. For aseptic loosening, ultrasound and plain radiographs may serve as initial screening tools. Metal artefact reducing sequences (MARS) MRI are advancing cross-sectional imaging and are likely to promote their role in patient evaluation.We conclude that imaging is one essential part in the work-up of patients with total joint replacements, within a specific clinical context. Close teamwork between experienced radiologists and orthopaedic surgeons is required for optimal patient care.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160058. Originally published online at www.efortopenreviews.org

Osteo-Compatibility of 3D Titanium Porous Coating Applied by Direct Energy Deposition (DED) for a Cementless Total Knee Arthroplasty Implant: In Vitro and In Vivo Study

“…However, due to the metal interference effect of CoCr alloy and titanium, an accurate image of the bone-implant contact surface could not be obtained. Definite osteolysis can be confirmed in CT in actual clinical practice, but fine osteolysis of the surface is often difficult to identify due to interference effects [37]. This is a limitation in this study.…”

Antiseptic sealant and a nanocoated implant‐abutment interface improve the results of dental implantation

“…Osseointegration monitoring methods included X‐ray diffraction techniques, including orthopantomography (OPTG), periapical radiography (Orthophos XG 3 DS apparatus, Sirona Dental Systems, Germany), and three‐dimensional dental computed tomography (Hyperion X9, MyRay, France). Using local densitometry, a bone density distribution was obtained in a vertical section, in alveolar and deep intraosseous horizontal sections, and in the gap between the tooth and the implant …”

“…Using local densitometry, a bone density distribution was obtained in a vertical section, in alveolar and deep intraosseous horizontal sections, and in the gap between the tooth and the implant. 22 Treponema denticola, and Prevotella intermedia) were detected in one sample per patient per time point by the multiplex real-time polymerase chain reaction method. Negative and positive control samples were used, and the amplification was performed according to the kit instructions.…”

Imaging of Total Ankle Arthroplasty: Normal Imaging Findings and Hardware Complications

“…The rate of component migration can also be helpful because rapid changes in position are more commonly associated with infection. 100 Zonal systems used radiographically have been described to help localize abnormalities. One commonly used system divides the tibial component on the AP image into five or six equal-size segments and numbers the segments from 1 to 5 (or 6) labeled medial to lateral.…”