Weight-bearing computed tomography in knee pathologies: current evidence and future perspectives

Weight-bearing computed tomography (WBCT) provides three-dimensional (3D), high-resolution imaging with patients in either a unipodal or bipodal stance, allowing visualization of dynamic joint alterations that might be missed in conventional radiographs or in non-weight-bearing exams, such as conventional computed tomography (CT) or magnetic resonance imaging (MRI) scans. Multiple lines of research are exploring its application for the evaluation of knee osteoarthritis, knee ligamentous instability, malalignment syndromes, patellofemoral disorders, and postoperative assessment following total knee arthroplasty. Despite its growing clinical utility, the development of standardized imaging protocols, broader accessibility, and integration with advanced image-analysis tools remain important areas for further progress. This review summarizes the current evidence supporting the clinical applications of WBCT in knee assessment and discusses future directions aimed at optimizing its role in personalized musculoskeletal care.