{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T14:22:48Z","timestamp":1793283768039,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T00:00:00Z","timestamp":1618617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T00:00:00Z","timestamp":1618617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T00:00:00Z","timestamp":1618617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008595","name":"Medizinische Abteilung der Margarete und Walter Lichtenstein-Stiftung","doi-asserted-by":"publisher","award":["3MS1036, 2019"],"award-info":[{"award-number":["3MS1036, 2019"]}],"id":[{"id":"10.13039\/501100008595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008375","name":"Universit\u00e4t Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008595","name":"Medizinische Abteilung der Margarete und Walter Lichtenstein-Stiftung","doi-asserted-by":"publisher","award":["3MS1036, 2019"],"award-info":[{"award-number":["3MS1036, 2019"]}],"id":[{"id":"10.13039\/501100008595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018842","name":"Deutsche Arthrose-Hilfe e.V.","doi-asserted-by":"crossref","award":["P458-A439, 2019"],"award-info":[{"award-number":["P458-A439, 2019"]}],"id":[{"id":"10.13039\/100018842","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008375","name":"Universit\u00e4t Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The diagnostic process in patients after painful total knee arthroplasty (TKA) is challenging. The more clinical and radiological information about a patient with pain after TKA is included in the assessment, the more reliable and sustainable the advice regarding TKA revision can be. The primary aim was to investigate the position of TKA components and evaluate bone tracer uptake (BTU) using pre\u2010revision SPECT\/CT and correlate these findings with previously published pain patterns in painful patients after TKA.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospectively collected cohort of 83 painful primary TKA patients was retrospectively evaluated. All patients followed a standardized diagnostic algorithm including 99m\u2010Tc\u2010HDP\u2010SPECT\/CT, which led to a diagnosis indicating revision surgery. Pain character, location, dynamics and radiation were systematically assessed as well as TKA component position in 3D\u2010CT. BTU was anatomically localized and quantified using a validated localization scheme. Component positioning and BTU were correlated with pain characteristics using non\u2010parametric Spearman correlations (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on Spearman\u2019s rho, significant correlations were found between pain and patients characteristics and SPECT\/CT findings resulting in nine specific patterns. The most outstanding ones include: Pattern 1: More flexion in the femoral component correlated with tender\/splitting pain and patella\u2010related pathologies. Pattern 3: More varus in the femoral component correlated with dull\/heavy and tingling\/stinging pain during descending stairs, unloading and long sitting in patients with high BMI and unresurfaced patella. Pattern 6: More posterior slope in the tibial component correlated with constant pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this study help to place component positioning in the overall context of the \"painful knee arthroplasty\" including specific pain patterns. The findings further differentiate the clinical picture of a painful TKA. Knowing these patterns enables a prediction of the cause of the pain to be made as early as possible in the diagnostic process before the state of pain becomes chronic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level III<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06567-y","type":"journal-article","created":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T06:03:11Z","timestamp":1618639391000},"page":"3007-3023","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Correlations of typical pain patterns with SPECT\/CT findings in unhappy patients after total knee arthroplasty"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0081-7734","authenticated-orcid":false,"given":"Dominic T.","family":"Mathis","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> University of Basel 4051 Basel Switzerland"},{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Tschudi","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> University of Basel 4051 Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Amsler","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Amsler Consulting 4059 Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Hauser","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> University of Basel 4051 Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Rasch","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Institute of Radiology and Nuclear Medicine Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Hirschmann","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> University of Basel 4051 Basel Switzerland"},{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,17]]},"reference":[{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MNM.0000000000000028"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259\u2010015\u20103278\u20100"},{"key":"e_1_2_11_4_2","first-page":"405","article-title":"Component alignment in total knee arthroplasty","volume":"55","author":"Benjamin J","year":"2006","journal-title":"Instr Course Lect"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010199301000\u201000008"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.08.008"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.3928\/0147\u20107447\u201020011101\u201013"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.02.038"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010200011000\u201000010"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2014.940573"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259\u2010015\u20103095\u20105"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00256\u2010013\u20101657\u20109"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010010\u20101070\u2010z"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u201012\u201036"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010012\u20101704\u20105"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102342\u201012\u20105"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101634\u20106"},{"key":"e_1_2_11_18_2","first-page":"455","article-title":"Alignment in total knee replacement","volume":"44","author":"Hungerford DS","year":"1995","journal-title":"Instr Course Lect"},{"key":"e_1_2_11_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010016\u20104257\u20100"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.3928\/0147\u20107447\u201019990901\u201027"},{"key":"e_1_2_11_21_2","unstructured":"No authors listed (2019)American Joint Replacement Registry (AJRR).Sixth AJRR Annual Report 2019 on Hip and Knee Arthroplasty Data.https:\/\/connect.ajrr.net\/hubfs\/PDFs%20and%20PPTs\/AAOS_AJRR_2019_Annual_Report_Update_FINAL_150DPI.pdf?utm_campaign=2019%20AJRR%20AR&utm_medium=email&_hsenc=p2ANqtz\u2010_R9e0yFLoCd0ilZVdi\u2010Kx2fWPDNQKU55Z\u2010MaFp5uUfeJUAIm2rJh\u2010Lca146_R2hFgmvbRSs0CNPzjVEuIFjUh5cnj8k4QZYaNRm3lAyiu\u2010JH3Pc2s&_hsmi=79114016&utm_content=79114016&utm_source=hs_automation&hsCtaTracking=f8fa4e79\u20106709\u201045d2\u2010b51b\u2010908382b7d5a7%7Cb61796dc\u2010af0d\u20104a90\u20109b72\u2010871845865e0b(accessed July 5 2020)"},{"key":"e_1_2_11_22_2","unstructured":"No authors listed (2019)National Joint Registry for England Wales Northern Ireland and the Isle of Man.16th Annual Report 2019.https:\/\/reports.njrcentre.org.uk\/Portals\/0\/PDFdownloads\/NJR%2016th%20Annual%20Report%202019.pdf(accessed July 6 2020)"},{"key":"e_1_2_11_23_2","unstructured":"No authors listed (2019)Swedish Knee Arthroplasty Register.Annual Report 2019.http:\/\/myknee.se\/pdf\/SVK_2019_1.0_Eng.pdf(accessed July 6 2020)"},{"key":"e_1_2_11_24_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.90B3.20140"},{"key":"e_1_2_11_25_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100034\u20101396079"},{"key":"e_1_2_11_26_2","doi-asserted-by":"crossref","unstructured":"MathisDT HauserA IordacheE AmslerF HirschmannMTTypical pain patterns in unhappy patients after total knee arthroplasty.J Arthroplasty(2021)10.1016\/j.arth.2021.01.04033583666","DOI":"10.1016\/j.arth.2021.01.040"},{"key":"e_1_2_11_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2020.12.008"},{"key":"e_1_2_11_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304\u20103959(87)91074\u20108"},{"key":"e_1_2_11_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005609\u2010w"},{"key":"e_1_2_11_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010019\u201004370\u20106"},{"key":"e_1_2_11_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/2049463717719774"},{"key":"e_1_2_11_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00256\u2010013\u20101643\u20102"},{"key":"e_1_2_11_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010008\u20100399\u20109"},{"key":"e_1_2_11_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010017\u20104627\u20102"},{"key":"e_1_2_11_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.10.010"},{"key":"e_1_2_11_36_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.91B2.20995"},{"key":"e_1_2_11_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010200209000\u201000018"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-021-06567-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-021-06567-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-021-06567-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-021-06567-y","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T08:56:55Z","timestamp":1760864215000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-021-06567-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,17]]},"references-count":36,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1007\/s00167-021-06567-y"],"URL":"https:\/\/doi.org\/10.1007\/s00167-021-06567-y","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,17]]},"assertion":[{"value":"2 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"One or more authors of this paper have disclosed potential conflict of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. Full disclosure statements have been provided for each of the authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the local ethical committee (2017-02048) and was performed in accordance with the ethical standards of the responsible committee and with the guidelines of the Helsinki Declaration of 1975, as revised in 2008.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"A written informed consent was signed by every patient.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}