To determine whether state-of-the-art multi-energy spectral photon-counting computed tomography (MARS) can detect knee arthroplasty implant failure not detected by standard pre-operative imaging techniques. A total knee arthroplasty (TKA) removed from a patient was reviewed. The extracted prosthesis [NexGen Legacy Posterior Stabilized (LPS) TKA] was analyzed as were pre-operative imaging examination and compared with a MARS-CT examination obtained of the extracted TKA prosthesis. Radiographs, fluoroscopy, ultrasound and MRI preoperatively did not reveal the cause of the implant failure. MARS CT images of the extracted prosthesis clearly showed the presence of posteromedial polyethylene and tibial tray wear which is compatible with the clinical appearance of the extracted TKA. MARS can identify polyethylene insert and metallic tibial tray wear as a cause of TKA failure, that could not be identified with on standard pre-operative imaging. Although clinical MARS CT system is still under development, this case does illustrate its potential clinical usefulness. This is the first study to document how MARS CT imaging can detect orthopedic implant failure not detected by standard current imaging techniques. This system has a potential clinical application in orthopedic patients.

确定最先进的多能光谱光子计数计算机断层扫描 (MARS) 是否可以检测标准术前成像技术未检测到的膝关节置换术植入物故障。回顾了从患者身上取出的全膝关节置换术 (TKA)。提取的假体 [NexGen Legacy 后稳定 (LPS) TKA] 与术前成像检查一样进行分析，并与提取的 TKA 假体的 MARS-CT 检查进行比较。术前的 X 光片、透视、超声和 MRI 没有揭示植入物失败的原因。提取假体的 MARS CT 图像清楚地显示了后内侧聚乙烯和胫骨托磨损的存在，这与提取的 TKA 的临床外观相符。MARS 可以将聚乙烯插入物和金属胫骨托磨损识别为 TKA 失败的原因，而标准术前成像无法识别这些原因。尽管临床 MARS CT 系统仍在开发中，但该案例确实说明了其潜在的临床用途。这是第一项记录 MARS CT 成像如何检测标准当前成像技术未检测到的骨科植入物故障的研究。该系统在骨科患者中具有潜在的临床应用。这是第一项记录 MARS CT 成像如何检测标准当前成像技术未检测到的骨科植入物故障的研究。该系统在骨科患者中具有潜在的临床应用。这是第一项记录 MARS CT 成像如何检测标准当前成像技术未检测到的骨科植入物故障的研究。该系统在骨科患者中具有潜在的临床应用。