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A total knee arthroplasty (TKA) removed from a patient was reviewed. The extracted prosthesis [NexGen Legacy Posterior Stabilized (LPS) TKA] was analyzed as were pre-operative imaging examination and compared with a MARS-CT examination obtained of the extracted TKA prosthesis. Radiographs, fluoroscopy, ultrasound and MRI preoperatively did not reveal the cause of the implant failure. MARS CT images of the extracted prosthesis clearly showed the presence of posteromedial polyethylene and tibial tray wear which is compatible with the clinical appearance of the extracted TKA. MARS can identify polyethylene insert and metallic tibial tray wear as a cause of TKA failure, that could not be identified with on standard pre-operative imaging. Although clinical MARS CT system is still under development, this case does illustrate its potential clinical usefulness. This is the first study to document how MARS CT imaging can detect orthopedic implant failure not detected by standard current imaging techniques. This system has a potential clinical application in orthopedic patients.<\/jats:p>","DOI":"10.1038\/s41598-020-80463-2","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T11:02:30Z","timestamp":1610708550000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Multi-energy spectral photon-counting computed tomography (MARS) for detection of arthroplasty implant failure"],"prefix":"10.1038","volume":"11","author":[{"given":"Lawrence Chun Man","family":"Lau","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne Yuk Wai","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony P. 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H. Butler, Philip H. Butler own the MARS Bioimaging Ltd that produce the MARS scanner used in this study. Alex I. Chernoglazov is employed by the MARS Bioimaging Ltd that produce the MARS scanner used in this study. Lawrence C.M. Lau, Wayne Y.W. Lee, Kwong-Yin Chung, Kevin K.W. Ho, James Griffith and Patrick S.H. Yung have no conflict of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1554"}}