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J Knee Surg 2023; 36(09): 988-994
DOI: 10.1055/s-0042-1748899
Original Article

Metal Artifact Reduction Dual-Energy CT as an Accurate and Reliable Method for Measuring Total Knee Arthroplasty Femoral Component Rotation Compared to Conventional CT

Chankue Park
1   Department of Radiology, Pusan National University – Yangsan Hospital, Yangsan, Korea
2   Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Yangsan, Korea
,
Sang-Min Lee 
2   Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Yangsan, Korea
3   Department of Orthopaedic Surgery, Pusan National University – Yangsan Hospital, Yangsan, Korea
,
Jae Seung Seo
3   Department of Orthopaedic Surgery, Pusan National University – Yangsan Hospital, Yangsan, Korea
,
Tae Woo Kim
2   Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Yangsan, Korea
3   Department of Orthopaedic Surgery, Pusan National University – Yangsan Hospital, Yangsan, Korea
,
Seung Joon Rhee
2   Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Yangsan, Korea
4   Department of Orthopedic Surgery, Pusan National University Hospital, Busan, Korea
,
Hee Seok Jeong
1   Department of Radiology, Pusan National University – Yangsan Hospital, Yangsan, Korea
2   Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Yangsan, Korea
› Author Affiliations
Funding This study was supported by Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital (30-2021-009)
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Abstract

This article determines the accuracy and reliability of dual-energy computed tomography (DECT) with metal artifact reduction (MAR) in the evaluation of femoral component rotation after total knee arthroplasty (TKA), in comparison with conventional CT images. A total of 49 patients (mean age, 69 years; 42 women) who underwent TKA between January 2019 and March 2020 were retrospectively enrolled. Femoral component rotation, including the anatomic and surgical transepicondylar axes, was evaluated with preoperative conventional CT and postoperative conventional CT and DECT with MAR. Surgical femoral component rotation was also assessed as a reference standard. Accuracy was assessed using paired t-test, and inter- and intraobserver reliability using intraclass correlation coefficients (ICCs) based on postoperative conventional CT and DECT with MAR. Clinical outcomes were evaluated using the Knee Society objective and functional scores. Accuracy of femoral component rotation was not significantly different from that of surgical rotation with both conventional CT and DECT with MAR. However, inter- and intraobserver reliability were better for DECT with MAR (ICC: 0.953–0.966) than for conventional CT (ICC: 0.641–0.749). The Knee Society objective and functional scores improved 1 year postoperatively.

Conclusion DECT with MAR showed accurate and more reliable results than did conventional CT in the evaluation of femoral component rotation after TKA.

Keywords

total knee replacement - dual-energy scanned projection - multidetector computed tomography - reproducibility of results


Publication History

Received: 27 September 2021

Accepted: 18 March 2022

Article published online:
12 July 2022

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