Stories March 26, 2025

New study could increase access and enhance care for patients requiring knee replacement surgery

Stories March 26, 2025

Brittany Sinclair, CenTRI Facility Manager, showing weight-bearing computed tomography (CT) images of a patient’s knee to Matthew Teeter, PhD, Scientist at LHSCRI, Interim Director of the Western Bone and Joint Institute, and Associate Professor at the Schulich School of Medicine & Dentistry at Western University.
Brittany Sinclair, CenTRI Facility Manager, showing weight-bearing computed tomography (CT) images of a patient’s knee to Matthew Teeter, PhD, Scientist at LHSCRI, Interim Director of the Western Bone and Joint Institute, and Associate Professor at the Schulich School of Medicine & Dentistry at Western University.

Scientists at London Health Sciences Centre Research Institute (LHSCRI) and Western University have discovered that —weight-bearing computed tomography (CT) could help patients who require knee replacements receive faster, less invasive diagnoses and better care.

The study, published in the Journal of Orthopaedic Research, uncovered that weight-bearing CT scans can provide the same accurate results as a specialized X-ray technique called radiostereometric analysis (RSA). RSA uses X-rays and tiny marker beads placed in bones and joints to track how they move and change over time. However, RSA is only available in about a dozen health-care organizations worldwide, while weight-bearing CT machines are more common, with over 175 health-care organizations using them worldwide, which could allow more patients access and help improve the standard of care.

Matthew Teeter, PhD, in weight-bearing CT room
Above: Matthew Teeter, PhD, in weight-bearing CT room

The study showed weight-bearing CTs are reliable for evaluating implant loosening in patients after knee replacement surgery. It found that this more accessible technology can offer precise imaging, improving the detection of knee implant failures that might require additional surgeries.

“Weight-bearing CTs are more accessible than RSA, and our research shows they produce the same reliable results,” says Matthew Teeter, PhD, Scientist at LHSCRI, Associate Professor at the Schulich School of Medicine & Dentistry at Western University and lead researcher for the study. “This could enhance care before and after knee replacement surgery without the need to surgically insert marker beads to monitor knee implant movement.”

“Without access to highly specialized RSA, surgeons rely on standard X-rays to monitor knee implants, but these may not catch the subtle bone changes indicating an implant is becoming loose,” says Teeter. “If loosening is not caught early, then surgery becomes more complicated because it requires larger metal implants to replace the bone that re-absorbs around the loose implant. Weight-bearing CTs may help us catch it earlier, have more successful surgeries and have better outcomes for patients.”

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