{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T15:16:29Z","timestamp":1761578189539,"version":"build-2065373602"},"reference-count":24,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0Reliable assessment of fracture healing remains a clinical challenge as radiographs and clinical examination provide only indirect information. Inducible fracture micromotion, defined as fragment displacement under load, may offer a more direct surrogate for healing. Radiostereometric analysis (RSA) can measure micromotion with high precision, but its clinical use for fracture assessment remains limited and heterogeneous. This scoping review aimed to map the existing literature on RSA for inducible fracture micromotion and summarize methodological approaches to guide future research.Methods:\u00a0We systematically searched Medline, Embase, and Scopus. Clinical studies applying RSA to assess inducible fracture micromotion were eligible. 2 reviewers independently screened and extracted data on study design, patient population, fracture location, loading protocols, thresholds for motion, and outcomes.Results:\u00a07 clinical studies were included, comprising feasibility studies, prospective cohorts, and 1 imaging study. Sample sizes ranged from 6 to 16 patients, with fractures of the distal radius, femur, proximal tibia, and pelvis. All studies required intraoperative implantation of tantalum markers. Most applied differentially loaded RSA, typically comparing unloaded and loaded conditions using weightbearing platforms, force plates, or voluntary grip dynamometry. Despite varied protocols and small, single-center designs, RSA consistently detected small-scale inducible motion and, in some studies, distinguished union from non-union.Conclusion:\u00a0This scoping review identified 7 clinical studies using RSA to assess inducible fracture micromotion, with heterogeneous methods across fracture types. These findings may guide the development of standardized approaches and support future research on RSA in fracture healing.<\/jats:p>","DOI":"10.2340\/17453674.2025.44897","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T15:04:50Z","timestamp":1761577490000},"source":"Crossref","is-referenced-by-count":0,"title":["Radiostereometric analysis for evaluating inducible fracture micromotion: a scoping review"],"prefix":"10.2340","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4975-3567","authenticated-orcid":false,"given":"Michaela Manalili","family":"Hansen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Laith","family":"Ballo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-2055","authenticated-orcid":false,"given":"Stephan Maximillian","family":"R\u00f6hrl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"131120","doi-asserted-by":"crossref","unstructured":"Bizzoca D, Vicenti G, Caiaffa V, Abate A, De Carolis O, Carrozzo M, et al. Assessment of fracture healing in orthopaedic trauma. Injury 2023; 54(Suppl 1): S46-s52. doi: 10.1016\/j.injury.2020.11.014.","DOI":"10.1016\/j.injury.2020.11.014"},{"key":"131121","doi-asserted-by":"crossref","unstructured":"Corrales L A, Morshed S, Bhandari M, Miclau T 3rd. Variability in the assessment of fracture-healing in orthopaedic trauma studies. J Bone Joint Surg Am 2008; 90(9): 1862-8. doi: 10.2106\/jbjs.G.01580.","DOI":"10.2106\/JBJS.G.01580"},{"key":"131122","doi-asserted-by":"crossref","unstructured":"Schwarzenberg P, Darwiche S, Yoon R S, Dailey H L. Imaging modalities to assess fracture healing. Curr Osteoporos Rep 2020; 18(3): 169-79. doi: 10.1007\/s11914-020-00584-5.","DOI":"10.1007\/s11914-020-00584-5"},{"key":"131123","doi-asserted-by":"crossref","unstructured":"McClelland D, Thomas P B, Bancroft G, Moorcraft C I. Fracture healing assessment comparing stiffness measurements using radiographs. Clin Orthop Relat Res 2007; 457: 214-19. doi: 10.1097\/BLO.0b013e31802f80a8.","DOI":"10.1097\/BLO.0b013e31802f80a8"},{"key":"131124","doi-asserted-by":"crossref","unstructured":"Laende E K, Richardson C G, Dunbar M J. Predictive value of short-term migration in determining long-term stable fixation in cemented and cementless total knee arthroplasties. Bone Joint J 2019; 101-b(7_Supple_C): 55-60. doi: 10.1302\/0301-620x.101b7.Bjj-2018-1493.R1.","DOI":"10.1302\/0301-620X.101B7.BJJ-2018-1493.R1"},{"key":"131125","doi-asserted-by":"crossref","unstructured":"Horsager K, Kaptein B L, R\u00f8mer L, J\u00f8rgensen P B, Stilling M. Dynamic RSA for the evaluation of inducible micromotion of Oxford UKA during step-up and step-down motion. Acta Orthop 2017; 88(3): 275-81. doi: 10.1080\/17453674.2016.1274592.","DOI":"10.1080\/17453674.2016.1274592"},{"key":"131126","doi-asserted-by":"crossref","unstructured":"Kaptein B L, Pijls B, Koster L, K\u00e4rrholm J, Hull M, Niesen A, et al. Guideline for RSA and CT-RSA implant migration measurements: an update of standardizations and recommendations. Acta Orthop 2024; 95: 256-67. doi: 10.2340\/17453674.2024.40709.","DOI":"10.2340\/17453674.2024.40709"},{"key":"131127","doi-asserted-by":"crossref","unstructured":"Munn Z, Peters M D J, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 2018; 18(1): 143. doi: 10.1186\/s12874-018-0611-x.","DOI":"10.1186\/s12874-018-0611-x"},{"key":"131128","doi-asserted-by":"crossref","unstructured":"Tricco A C, Lillie E, Zarin W, O\u2019Brien K K, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018; 169(7): 467-73. doi: 10.7326\/M18-0850.","DOI":"10.7326\/M18-0850"},{"key":"131129","doi-asserted-by":"crossref","unstructured":"Chehade M J, Solomon L B, Callary S A, Benveniste S H, Pohl A P, Howie D W. Differentially loaded radiostereometric analysis to monitor fracture stiffness: a feasibility study. Clin Orthop Relat Res 2009; 467(7): 1839-47. doi: 10.1007\/s11999-009-0708-y.","DOI":"10.1007\/s11999-009-0708-y"},{"key":"131130","doi-asserted-by":"crossref","unstructured":"Downing M R, Ashcroft P B, Johnstone A J, Bach O, Mackenzie S, Ashcroft G P. Assessment of inducible fracture micromotion in distal radial fractures using radiostereometry. J Orthop Trauma 2008; 22(8 Suppl): S96-105. doi: 10.1097\/BOT.0b013e3181839669.","DOI":"10.1097\/BOT.0b013e3181839669"},{"key":"131131","doi-asserted-by":"crossref","unstructured":"Finnil\u00e4 S, Moritz N, Strandberg N, Alm J J, Aro H T. Radiostereometric analysis of the initial stability of internally fixed femoral neck fractures under differential loading. J Orthop Res 2019; 37(1): 239-47. doi: 10.1002\/jor.24150.","DOI":"10.1002\/jor.24150"},{"key":"131132","doi-asserted-by":"crossref","unstructured":"Galea V P, Botros M A, McTague M F, Weaver M J, Vrahas M S, Malchau H, et al. Radiostereometric analysis of stability and inducible micromotion after locked lateral plating of distal femur fractures. J Orthop Trauma 2020; 34(2): e60-6. doi: 10.1097\/bot.0000000000001684.","DOI":"10.1097\/BOT.0000000000001684"},{"key":"131133","doi-asserted-by":"crossref","unstructured":"Ladurner A, Callary S A, Mitra A, Rickman M, Thewlis D, Solomon L B. Radiostereometric analysis allows assessment of the stability and inducible displacement of pelvic ring disruptions during healing: a case series. J Clin Med 2020; 9(11): 3411. doi: 10.3390\/jcm9113411.","DOI":"10.3390\/jcm9113411"},{"key":"131134","doi-asserted-by":"crossref","unstructured":"Madanat R, Strandberg N, Moritz N, Mattila K, Vahlberg T, Aro H T. Radiostereometric analysis in measurements of migration and inducible micromotion in intra-articular distal radius fractures treated with a volar plate. J Orthop Trauma 2012; 26(9): e153-60. doi: 10.1097\/BOT.0b013e3182383bcc.","DOI":"10.1097\/BOT.0b013e3182383bcc"},{"key":"131135","doi-asserted-by":"crossref","unstructured":"Solomon L B, Callary S A, Stevenson A W, McGee M A, Chehade M J, Howie D W. Weight-bearing-induced displacement and migration over time of fracture fragments following split depression fractures of the lateral tibial plateau: a case series with radiostereometric analysis. J Bone Joint Surg Br 2011; 93(6): 817-23. doi: 10.1302\/0301-620x.93b6.26122.","DOI":"10.1302\/0301-620X.93B6.26122"},{"key":"131136","doi-asserted-by":"crossref","unstructured":"Beumer A, Valstar E R, Garling E H, Niesing R, Ginai A Z, Ranstam J, et al. Effects of ligament sectioning on the kinematics of the distal tibiofibular syndesmosis: a radiostereometric study of 10 cadaveric specimens based on presumed trauma mechanisms with suggestions for treatment. Acta Orthop 2006; 77(3): 531-40. doi: 10.1080\/17453670610012557.","DOI":"10.1080\/17453670610012557"},{"key":"131137","doi-asserted-by":"crossref","unstructured":"Bojan A J, Bragdon C, J\u00f6nsson A, Ekholm C, K\u00e4rrholm J. Three-dimensional bone-implant movements in trochanteric hip fracturespPrecision and accuracy of radiostereometric analysis in a phantom model. J Orthop Res 2015; 33(5): 705-11. doi: 10.1002\/jor.22822.","DOI":"10.1002\/jor.22822"},{"key":"131138","doi-asserted-by":"crossref","unstructured":"Angelomenos V, Sandberg O, Shareghi B, Ullman M. Comparison of marker-based RSA and CT-RSA for analyzing micromotions after distal radius osteotomy: a 1-year retrospective study of 24 patients. J Orthop Res 2025; 43(3): 660-70. doi: 10.1002\/jor.26031.","DOI":"10.1002\/jor.26031"},{"key":"131139","doi-asserted-by":"crossref","unstructured":"Christensson A, Nemati H M, Flivik G. Comparison between model-based RSA and an AI-based CT-RSA: an accuracy study of 30 patients. Acta Orthop 2024; 95: 39-46. doi: 10.2340\/17453674.2024.35749.","DOI":"10.2340\/17453674.2024.35749"},{"key":"131140","doi-asserted-by":"crossref","unstructured":"Van de Vusse S F, De Laat N N, Koster L A, Kaptein B L. The accuracy and precision of CT-RSA in arthroplasty: a systematic review and meta-analysis. Acta Orthop 2025; 96: 295-303. doi: 10.2340\/17453674.2025.43334.","DOI":"10.2340\/17453674.2025.43334"},{"key":"131141","doi-asserted-by":"crossref","unstructured":"Poulsen M, St\u00f8dle A H, Nordsletten L, R\u00f6hrl S M. CT-based radiostereometric analysis for assessing midfoot kinematics: precision compared with marker-based radiostereometry. Acta Orthop 2023; 94: 366-72. doi: 10.2340\/17453674.2023.16905.","DOI":"10.2340\/17453674.2023.16905"},{"key":"131142","doi-asserted-by":"crossref","unstructured":"Poulsen M, St\u00f8dle A H, Nordsletten L, R\u00f6hrl S M. Does temporary bridge plate fixation preserve joint motion after an unstable Lisfranc injury? Foot Ankle Surg 2023; 29(2): 151-7. doi: 10.1016\/j.fas.2022.12.007.","DOI":"10.1016\/j.fas.2022.12.007"},{"key":"131143","doi-asserted-by":"crossref","unstructured":"Petersen E T, Vind T D, J\u00fcrgens-Lahnstein J H, Christensen R, de Raedt S, Br\u00fcel A, et al. Evaluation of automated radiostereometric image registration in total knee arthroplasty utilizing a synthetic-based and a CT-based volumetric model. 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