Current Uses for Medical Imaging With Orthopaedic Implant Technology.

Musculoskeletal applications have been at the forefront of medical imaging since the first-ever x-ray was taken of a hand. Radiography remains routine in orthopaedics for surgical planning and diagnosing implant complications. Fluoroscopy is used to guide intra-operative implant placement and to assess kinematics of different implants. Computed tomography (CT) is used to develop surgical robotics plans and patient-specific instruments, while magnetic resonance imaging (MRI) can diagnose soft tissue reactions near implants. Ultrasound is less frequently used in orthopaedics but can provide assessments on tendons and ligaments as well as diagnose tissue pathologies. Additional modalities are becoming available that show promise for orthopaedic implant applications, including weight-bearing CT (WBCT), dynamic or four-dimensional CT (4DCT), low field strength (0.55 T) MRI, and positron emission tomography (PET). However, hardware and software costs, scanner accessibility, and high burden for the analyses has limited many of the more advanced imaging techniques to research centres or tertiary care facilities. Across all modalities, computational modelling and artificial intelligence applied to medical images allow more complex uses of imaging data. Time-consuming segmentation tasks can be automated, which allows patient-specific finite element modelling and other types of simulations to be performed more routinely for surgical planning and implant evaluation. Additionally, radiomics can be applied to images to identify implant models and improve diagnoses of implant complications. Metal artifacts near implants are also being reduced by new reconstruction algorithms. Thanks to innovations in medical imaging technology, the care of patients with orthopaedic implants is being improved by enabling more patient-specific interventions.