Knee arthroplasty loosening Movement matters

Knee arthroplasty is a crucial aspect of orthopedic surgery, providing patients with advanced osteoarthritis an effective solution for pain relief and mobility restoration. However, the need for revision surgeries remains a concern, with 13% of patients requiring a revision within ten years. The primary causes include aseptic loosening, periprosthetic infections, and mechanical instability. This dissertation focuses on improving diagnostic methods for aseptic loosening of knee prostheses to prevent unnecessary revisions and promote timely and accurate treatments.
The first part of this dissertation evaluates current diagnostic methods for aseptic loosening. A systematic review and meta-analysis reveal that MRI and SPECT/CT offer the highest diagnostic accuracy, although methodological limitations persist. Additionally, variability in diagnostic criteria and intraoperative assessment is examined, emphasizing the need for standardized diagnostic protocols.
The second part introduces and evaluates a new diagnostic method: the AtMoves Knee System. This system applies standardized loading during a CT scan to measure micromovement of the tibial component. Research demonstrates that the method is reproducible, reliable, and clinically safe, with high diagnostic accuracy. Findings suggest that the AtMoves Knee System could serve as a valuable addition to existing diagnostic tools. This dissertation highlights the potential of this technique and advocates for further validation in larger patient cohorts to optimize the diagnosis of aseptic loosening.