{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:05:00Z","timestamp":1789722300073,"version":"4.0.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of robotically assisted arthroplasty has increased substantially in recent years. Some robotic platforms require preoperative computed tomography for surgical planning. These scans frequently include anatomical regions beyond the primary operative field, creating potential for incidental findings. Planning computed tomography is not formally reported routinely, raising the possibility that clinically relevant incidental findings may be overlooked.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The reports of all computed tomography performed for preoperative planning of robotically assisted arthroplasty at the authors\u2019 institution between October 2019 and February 2024 were reviewed retrospectively. Incidental findings were noted, and their clinical significance assessed. The notes of patients with significant findings were reviewed to ascertain the final diagnosis and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1602 patients (mean age 66.8 years, median 68 (range 16\u201398) years; 847 women) were identified within the study period. Some 447 patients (27.9%) demonstrated incidental findings, 136 (8.5%) of which were significant, requiring further investigation or management. Eighty-six significant findings (5.4%) were suspicious for malignancy and, of these, five (0.3%) resulted in a new cancer diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, the rate of significant incidental findings was 8.5% and the risk of discovery of previously undiagnosed malignancy was 0.3%. A new significant finding was demonstrated in 1 in every 12 patients, and a new cancer diagnosis in 1 in every 320 patients. Planning imaging for robotic arthroplasty should be reported by a radiologist to prevent significant findings and malignancy being missed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrag044","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:44:48Z","timestamp":1775735088000},"source":"Crossref","is-referenced-by-count":0,"title":["Incidental findings on preoperative computed tomography for the planning of robotic arthroplasty: retrospective cohort study"],"prefix":"10.1093","volume":"10","author":[{"given":"Robin J S","family":"Jones","sequence":"first","affiliation":[{"name":"Exeter Hip Unit, Royal Devon University Healthcare NHS Foundation Trust , Exeter ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R A","family":"Phillips","sequence":"additional","affiliation":[{"name":"Exeter Knee Reconstruction Unit, Royal Devon University Healthcare NHS Foundation Trust , Exeter ,","place":["UK"]},{"name":"Academic Department of Trauma and Orthopaedics, School of Medicine, University of Exeter , Exeter ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Wilson","sequence":"additional","affiliation":[{"name":"Exeter Hip Unit, Royal Devon University Healthcare NHS Foundation Trust , Exeter ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0905-1432","authenticated-orcid":false,"given":"Michalis","family":"Panteli","sequence":"additional","affiliation":[{"name":"Exeter Hip Unit, Royal Devon University Healthcare NHS Foundation Trust , Exeter ,","place":["UK"]},{"name":"Academic Department of Trauma and Orthopaedics, School of Medicine, University of Exeter , Exeter ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"2026091804592516700_zrag044-B1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1302\/2633-1462.41.BJO-2022-0070.R1","article-title":"Comparative assessment of current robotic-assisted systems in primary total knee arthroplasty","volume":"4","author":"Walgrave","year":"2023","journal-title":"Bone Jt Open"},{"key":"2026091804592516700_zrag044-B2","author":"Stryker"},{"key":"2026091804592516700_zrag044-B3","author":"Zimmer Biomet"},{"key":"2026091804592516700_zrag044-B4","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1097\/SLA.0000000000004204","article-title":"Should radiation exposure be an issue of concern in children with multiple trauma?","volume":"275","author":"Howard","year":"2022","journal-title":"Ann Surg"},{"key":"2026091804592516700_zrag044-B5","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.2106\/JBJS.18.01334","article-title":"An estimation of lifetime fatal carcinogenesis risk attributable to radiation exposure in the first year following polytrauma: a major trauma center\u2019s experience over 10 years","volume":"101","author":"Howard","year":"2019","journal-title":"J Bone Joint Surg Am"},{"key":"2026091804592516700_zrag044-B6","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.arth.2019.11.030","article-title":"Frequency, cost, and clinical significance of incidental findings on preoperative planning images for computer-assisted total joint arthroplasty","volume":"35","author":"Hassebrock","year":"2020","journal-title":"J Arthroplasty"},{"key":"2026091804592516700_zrag044-B7","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1055\/s-0037-1607450","article-title":"Patient satisfaction outcomes after robotic arm-assisted total knee arthroplasty: a short-term evaluation","volume":"30","author":"Marchand","year":"2017","journal-title":"J Knee Surg"},{"key":"2026091804592516700_zrag044-B8","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1302\/0301-620X.104B5.BJJ-2021-1506.R1","article-title":"Robotic arm-assisted versus manual unicompartmental knee arthroplasty: a systematic review and meta-analysis of the MAKO robotic system","volume":"104-b","author":"Zhang","year":"2022","journal-title":"Bone Joint J"},{"key":"2026091804592516700_zrag044-B9"},{"key":"2026091804592516700_zrag044-B10","author":"Stryker"},{"key":"2026091804592516700_zrag044-B11","author":"Stryker"},{"key":"2026091804592516700_zrag044-B12","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.jacr.2010.06.013","article-title":"Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee","volume":"7","author":"Berland","year":"2010","journal-title":"J Am Coll Radiol"},{"key":"2026091804592516700_zrag044-B13","doi-asserted-by":"crossref","first-page":"555","DOI":"10.2214\/AJR.12.10306","article-title":"Malignant incidental extracardiac findings on cardiac CT: systematic review and meta-analysis","volume":"201","author":"Flor","year":"2013","journal-title":"AJR Am J Roentgenol"},{"key":"2026091804592516700_zrag044-B14","doi-asserted-by":"crossref","first-page":"k2387","DOI":"10.1136\/bmj.k2387","article-title":"Prevalence and outcomes of incidental imaging findings: umbrella review","volume":"361","author":"O\u2019Sullivan","year":"2018","journal-title":"BMJ"},{"key":"2026091804592516700_zrag044-B15","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.injury.2013.10.009","article-title":"Incidental findings on total-body CT scans in trauma patients","volume":"45","author":"Sierink","year":"2014","journal-title":"Injury"},{"key":"2026091804592516700_zrag044-B16","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1259\/bjr\/58438178","article-title":"Resources and costs associated with incidental extracolonic findings from CT colonography: a study in a symptomatic population","volume":"79","author":"Xiong","year":"2006","journal-title":"Br J Radiol"},{"key":"2026091804592516700_zrag044-B17","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1302\/0301-620X.102B6.BJJ-2019-1498.R1","article-title":"CT planning studies for robotic total knee arthroplasty","volume":"102-b","author":"Abdelfadeel","year":"2020","journal-title":"Bone Joint J"},{"key":"2026091804592516700_zrag044-B18","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1111\/ans.18393","article-title":"Incidental findings on CT scans for robot-assisted total joint arthroplasty","volume":"93","author":"Qadiri","year":"2023","journal-title":"ANZ J Surg"},{"key":"2026091804592516700_zrag044-B19","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1007\/s00256-020-03660-0","article-title":"Incidental findings detected on preoperative CT imaging obtained for robotic-assisted joint replacements: clinical importance and the effect on the scheduled arthroplasty","volume":"50","author":"Tran","year":"2021","journal-title":"Skeletal Radiol"},{"key":"2026091804592516700_zrag044-B20","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.eururo.2019.08.005","article-title":"Recent global patterns in prostate cancer incidence and mortality rates","volume":"77","author":"Culp","year":"2020","journal-title":"Eur Urol"},{"key":"2026091804592516700_zrag044-B21","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1159\/000447083","article-title":"Sarcomas of soft tissue and bone","volume":"43","author":"Ferrari","year":"2016","journal-title":"Prog Tumor Res"},{"key":"2026091804592516700_zrag044-B22","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.canep.2019.03.002","article-title":"Bone sarcoma incidence in the Netherlands","volume":"60","author":"Goedhart","year":"2019","journal-title":"Cancer Epidemiol"},{"key":"2026091804592516700_zrag044-B23","author":"The Ionising Radiation (Medical Exposure)"},{"key":"2026091804592516700_zrag044-B24","author":"American College of Radiology"},{"key":"2026091804592516700_zrag044-B25"}],"container-title":["BJS Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/10\/5\/zrag044\/71220887\/zrag044.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/10\/5\/zrag044\/71220887\/zrag044.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:00:03Z","timestamp":1789722003000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjsopen\/article\/doi\/10.1093\/bjsopen\/zrag044\/8816871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9,4]]}},"URL":"https:\/\/doi.org\/10.1093\/bjsopen\/zrag044","relation":{},"ISSN":["2474-9842"],"issn-type":[{"value":"2474-9842","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,9,4]]},"article-number":"zrag044"}}