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Incidental findings detected on preoperative CT imaging obtained for robotic-assisted joint replacements: clinical importance and the effect on the scheduled arthroplasty

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Abstract

Objective

To determine the type and frequency of incidental findings detected on preoperative computed tomography (CT) imaging obtained for robotic-assisted joint replacements and their effect on the planned arthroplasty.

Materials and methods

All preoperative CT examinations performed for a robotic-assisted knee or total hip arthroplasty were obtained. This resulted in 1432 examinations performed between September 2016 and February 2020 at our institution. These examinations were initially interpreted by 1 of 9 fellowship-trained musculoskeletal radiologists. Using a diagnosis search, the examination reports were then reviewed to catalog all incidental findings and further classify as significant or non-significant findings. Demographic information was obtained. In those with significant findings, a chart review was performed to record the relevant workup, outcomes, and if the planned arthroplasty was affected.

Results

Incidental findings were diagnosed in 740 (51.7%) patients. Of those with incidental findings, 41 (5.5%) were considered significant. A significant finding was more likely to be detected in males (P = 0.007) and on the hip protocol CT (P = 0.014). In 8 patients, these diagnoses resulted in either delay or cancelation of the arthroplasty. A planned total hip arthroplasty was more likely to be altered as compared to a knee arthroplasty (P = 0.018).

Conclusion

Incidental findings are commonly detected by radiologists on preoperative CT imaging obtained for robotic-assisted joint replacement. Several were valuable findings and resulted in a delay or even cancelation of the planned arthroplasty after the detection of critical diagnoses, which if not identified may have resulted in devastating outcomes.

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Abbreviations

CT:

computed tomography

THA:

total hip arthroplasty

TJA:

total joint arthroplasty

TKA:

total knee arthroplasty

UKA:

unicompartmental knee arthroplasty

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Acknowledgments

We thank Gordon Jacobsen, MS, Henry Ford Hospital, for his help with the statistics used in this manuscript. We also thank Stephanie Stebens, MLIS, AHIP, Henry Ford Hospital, for her editorial assistance in the preparation of this manuscript.

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Authors and Affiliations

  1. Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital, Detroit, MI, USA

    Gary Tran, Allen Wrubel, Chad L. Klochko & Steven B. Soliman

  2. Division of Orthopedic Surgery, Department of Orthopedics, Henry Ford Hospital, Detroit, MI, USA

    Lafi S. Khalil & Jason J. Davis

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  1. Gary Tran
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Correspondence to Steven B. Soliman.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was waived.

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Tran, G., Khalil, L.S., Wrubel, A. et al. Incidental findings detected on preoperative CT imaging obtained for robotic-assisted joint replacements: clinical importance and the effect on the scheduled arthroplasty. Skeletal Radiol 50, 1151–1161 (2021). https://doi.org/10.1007/s00256-020-03660-0

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