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31 December 2025

Diagnostic Approaches to Total Knee Arthroplasty Loosening: From Conventional Imaging to Modern Techniques

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1
Department of Machine Design and Mechatronics, Faculty of Mechanical Engineering, Lublin University of Technology, 20-618 Lublin, Poland
2
Institute of Medical Sciences, Faculty of Medicine, The John Paul II Catholic University of Lublin, 20-708 Lublin, Poland
3
Department of Technical Computer Science, Faculty of Mathematics and Information Technology, Lublin University of Technology, 20-618 Lublin, Poland
4
Department of Trauma Surgery and Emergency Medicine, Medical University, 20-059 Lublin, Poland
This article belongs to the Special Issue Orthopaedics and Joint Reconstruction: Latest Advances and Prospects

Abstract

Osteoarthritis (OA) is a severe and progressive joint disease that usually affects elderly people. The consequence of this disease in its advanced stage is the need for total knee arthroplasty (TKA). Over the years, there has been a constant increase in the number of TKA procedures, with a predicted increase to 1.26 million procedures by 2030. Diagnostics are based on conventional radiography, although advanced techniques such as radiostereometry, SPECT/CT and PET/CT, which enable early detection of micromigration, are gaining increasing recognition. Vibroarthrography (VAG) is a proposed supplement to diagnostics, enabling the assessment of the characteristics of vibrations and friction of joint surfaces, thus supporting the process of early detection of endoprosthesis instability. The combination of conventional and alternative diagnostic methods, including vibroarthrography, may improve the detection of early TKA loosening. This may also result in increased implant durability. The aim of this article is to review the current state of knowledge on the classification and analysis of endoprosthesis loosening mechanisms. In addition, classic and modern methods of detecting and monitoring loosening are discussed, with particular emphasis on vibroarthrography as a potential tool for early diagnosis.

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