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Feb 08, 2021

Photon counting CT detects early stage knee arthroplasty implant failure

- By Jacqueline Wheeler

Multi‑energy spectral photon counting computed tomography accurately reveals polyethylene wear without any significant artefact characteristic of standard MRI20, concludes a study from the Chinese University of Hong Kong1.

At present, early stages of wear and tear in total knee anthroplasty (TKA) can only be detected with limited success using existing modalities of radiography, fluoroscopy, ultrasound, computed tomography, and magnetic resonance imaging. However, when the Hong Kong group used multi-energy spectral photon counting CT to examine the TKA of an elderly patient that had been in place for twelve years, the technology “could clearly demonstrate polyethylene inset wear and metallic tibia tray wear not demonstrable by other imaging techniques”.

This is the first study to show how photon counting CT can detect orthopaedic implant failure that is not detected by standard current imaging modalities. As such, it is a promising illustration of how it can identify problems in TKA far earlier than alternatives, potentially avoiding major revision surgery which incurs significant bone and soft tissue loss.

The positive impact photon counting CT could have on patient care and medical cost is significant. Further evidence that our future technology is making medical challenges of today a thing of the past.

Read the report in full at

1Lau, L.C.M., Lee, W.Y.W., Butler, A.P.H. et al. Multi-energy spectral photon-counting computed tomography (MARS) for detection of arthroplasty implant failure. Sci Rep 11, 1554 (2021).