Incidental findings detected on preoperative CT imaging obtained for robotic-assisted joint replacements: clinical impor
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SCIENTIFIC ARTICLE
Incidental findings detected on preoperative CT imaging obtained for robotic-assisted joint replacements: clinical importance and the effect on the scheduled arthroplasty Gary Tran 1 & Lafi S. Khalil 2 & Allen Wrubel 1 & Chad L. Klochko 1 & Jason J. Davis 2 & Steven B. Soliman 1 Received: 25 August 2020 / Revised: 18 October 2020 / Accepted: 25 October 2020 # ISS 2020
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. Keywords Robotic assisted . Knee arthroplasty . Total hip arthroplasty . Joint replacement . CT imaging . Incidental findings
Introduction Total joint arthroplasty (TJA) is among the most common orthopedic procedures, reliably treating osteoarthritis-related pain [1–3]. Advancements in techniques, implant designs, and technologies of total hip (THA) and total knee arthroplasties (TKA), as well as the resurgence in unicompartmental knee arthroplasty (UKA), continue to improve outcomes and patient satisfaction while decreasing complications and readmission rates [4–6]. Nevertheless, factors outside of the surgeon’s * Steven B. Soliman [email protected] 1
Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital, Detroit, MI, USA
2
Division of Orthopedic Surgery, Department of Orthopedics, Henry Ford Hospital, Detroit, MI, USA
control, such as patient demographic and psychosocial iss
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