Clinical value of SPECT/CT in the painful total knee arthroplasty (TKA): a prospective study in a consecutive series of 100 TKA

Purpose Bone single photon emission computed tomography (SPECT)/CT is considered as beneficial in unhappy patients with pain, stiffness or swelling after total knee arthroplasty (TKA). The purpose of this study was to identify typical patterns of bone tracer uptake (BTU), distribution and intensity...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2015-11, Vol.42 (12), p.1869-1882
Main Authors: Hirschmann, Michael T., Amsler, Felix, Rasch, Helmut
Format: Article
Language:English
Subjects:
Aged
Arthroplasty, Replacement, Knee - adverse effects
Cardiology
Female
Humans
Imaging
Intraoperative Period
Joint surgery
Knee
Male
Medical diagnosis
Medicine
Medicine & Public Health
Multimodal Imaging
Nuclear Medicine
Oncology
Original Article
Orthopedics
Osteoarthritis - diagnostic imaging
Osteoarthritis - etiology
Pain - diagnosis
Pain - diagnostic imaging
Pain - etiology
Patellofemoral Joint - diagnostic imaging
Prospective Studies
Prosthesis Failure - etiology
Prosthesis-Related Infections - diagnostic imaging
Prosthesis-Related Infections - etiology
Radiology
Sensitivity and Specificity
Tomography
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed
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Summary:Purpose Bone single photon emission computed tomography (SPECT)/CT is considered as beneficial in unhappy patients with pain, stiffness or swelling after total knee arthroplasty (TKA). The purpose of this study was to identify typical patterns of bone tracer uptake (BTU), distribution and intensity values in patients after TKA. The above findings were correlated with the type and fixation of TKA, the time from TKA and intraoperative findings at revision surgery. Methods A total of 100 knees of 84 consecutive patients (mean age ± SD 70 ± 11 years) after TKA with persistent knee pain were prospectively included. All patients underwent clinical examination, standardized radiographs and 99m Tc-hydroxymethane diphosphonate (HDP) SPECT/CT as part of a routine diagnostic algorithm. The diagnosis before and after SPECT/CT and final treatment were recorded. TKA component position was determined on 3-D reconstructed images. Intensity and anatomical distribution of BTU was determined. Maximum intensity values were recorded as well as ratios in relation to the proximal midshaft of the femur. Univariate analyses (chi-square test, Pearson’s correlation and t test for independent samples) were performed ( p  
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-015-3095-5