ArticleActa orthopaedica2026
Inducible displacement CT for implant loosening detection: a scoping review on methods, validation, and challenges.
Article in Acta orthopaedica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Inducible displacement measured with radiostereometric analysis in primary knee arthroplasty: a systematic review of clinical studies.Acta orthopaedica · 2026Pooled it
- CT-based micromotion analysis for tracking fracture displacement and fragment movement in trochanteric hip fractures: an agreement study.Acta orthopaedica · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeInducible displacement CT (ID-CT) is an emerging method for diagnosing implant loosening by (i) acquiring CT scans under different joint loading conditions, (ii) analyzing scans via segmentation and registration, and (iii) quantifying and visualizing relative implant-bone displacement. With multiple centers approaching these steps differently, this scoping review aimed to summarize current methodologies and key challenges.
methodsPubMed, Cochrane, and Embase were searched for clinical and experimental ID-CT studies on spinal and arthroplasty implants. Data was extracted using a table based on updated CT-radiostereometric analysis (RSA) guidelines, including study characteristics, CT acquisition parameters, image analysis methods, validation approaches, outcomes, and loading protocols. Diagnostic studies were assessed with QUADAS-2.
results22 studies were included concerning the hip (10), knee (7), spine (4), and wrist (1), covering clinical and experimental (phantom and cadaveric) designs. Loading protocols varied widely, applying compressive, rotational, and angular forces with external stabilization or loading devices. CT acquisition ranged from µCT to conventional and weight-bearing CT, with variation in kVp, mAs, reconstruction spacing, and metal artefact reduction. Image-analysis workflows were broadly similar, though reporting of algorithms and displacement metrics was often incomplete. Diagnostic validation was limited by variable reference standards, non-prespecified loosening thresholds, and non-blinded assessments, undermining true performance. Technical validation, although often precise, did not cover the full ID-CT pipeline (i.e., complete loading protocol), leaving key sources of measurement variance untested.
conclusionWe showed that ID-CT is used with a wide variation in approach and limited reporting prevents the establishment of its true diagnostic accuracy.
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