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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 11, 1513-1518.
doi: 10.1302/0301-620X.88B11.17986  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Very low-dose computed tomography for planning and outcome measurement in knee replacement

THE IMPERIAL KNEE PROTOCOL

J. Henckel, MRCS, Honorary Research Fellow1; R. Richards, PhD, Senior Research Fellow2; K. Lozhkin, PhD, Principle Physicist3; S. Harris, PhD, Project Manager4; F. M. Rodriguez y Baena, PhD, Lecturer5; A. R. W. Barrett, PhD, Project Manager4; and J. P. Cobb, MCh, FRCS, Professor1

1 Department of Musculoskeletal Surgery, Imperial College London, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.
2 Department of Medical Physics & Bio-Engineering, Malet Place University College London, Gower Street, London WC1E 6BT, UK.
3 Department of Medical Physics, University College London Hospitals NHS Trust, 250 Euston Road, 1st Floor North Wing, London NW1 2PQ, UK.
4 Acrobot Company Limited, The Leathermarket, Weston Street, London SE1 3ER, UK.
5 Mechatronics in Medicine Laboratory, Department of Mechanical Engineering, Imperial College London, Mechanical Engineering, South Kensington Campus, London SW7 2AZ, UK.

Correspondence should be sent to Mr J. Henckel; e-mail: johann{at}doctors.org.uk

Surgeons need to be able to measure angles and distances in three dimensions in the planning and assessment of knee replacement. Computed tomography (CT) offers the accuracy needed but involves greater radiation exposure to patients than traditional long-leg standing radiographs, which give very little information outside the plane of the image.

There is considerable variation in CT radiation doses between research centres, scanning protocols and individual scanners, and ethics committees are rightly demanding more consistency in this area.

By refining the CT scanning protocol we have reduced the effective radiation dose received by the patient down to the equivalent of one long-leg standing radiograph. Because of this, it will be more acceptable to obtain the three-dimensional data set produced by CT scanning. Surgeons will be able to document the impact of implant position on outcome with greater precision.




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eLetters:

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Very low-dose computer tomography for planning and outcome measurement in knee replacement
Thomas Nunn, et al.
J Bone Joint Surg Br Online, 3 Jan 2007 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General