Clinical value of SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty- a new dimension of diagnostics?
نویسندگان
چکیده
BACKGROUND The purpose of our study was to evaluate the clinical value of hybrid SPECT/CT for the assessment of patients with painful total knee arthroplasty (TKA). METHODS Twenty-three painful knees in patients following primary TKA were assessed using Tc-99m-HDP-SPECT/CT. Rotational, sagittal and coronal position of the TKA was assessed on 3D-CT reconstructions. The level of the SPECT-tracer uptake (0-10) and its anatomical distribution was mapped using a validated localization scheme. Univariate analysis (Wilcoxon-Mann-Whitney, Spearmean's-rho test, p < 0.05) was performed to identify any correlations between component position, tracer uptake and diagnosis. RESULTS SPECT/CT imaging changed the suspected diagnosis and the proposed treatment in 19/23 (83%) knees. Progression of patellofemoral OA (n = 11), loosening of the tibial (n = 3) and loosening of the femoral component (n = 2) were identified as the leading causes of pain after TKA.Patients with externally rotated tibial trays showed higher tracer uptake in the medial patellar facet (p = 0.049) and in the femur (p = 0.051). Patients with knee pain due to patellofemoral OA showed significantly higher tracer uptake in the patella than others (p < 0.001). CONCLUSIONS SPECT/CT was very helpful in establishing the diagnosis and guiding subsequent management in patients with painful knees after TKA, particularly in patients with patellofemoral problems and malpositioned or loose TKA.
منابع مشابه
Author's response to reviews Title: Clinical value of SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty- a new dimension of diagnostics? Authors:
متن کامل
Clinical value of SPECT/CT in the ‘unhappy’ total knee arthroplasty (TKA)- a prospective study in a consecutive series of 100 painful knees after TKA
This open-access article is published and distributed under the Creative Commons Attribution NonCommercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article witho...
متن کاملA novel standardized algorithm using SPECT/CT evaluating unhappy patients after unicondylar knee arthroplasty– a combined analysis of tracer uptake distribution and component position
BACKGROUND The introduction of a standardized SPECT/CT algorithm including a localization scheme, which allows accurate identification of specific patterns and thresholds of SPECT/CT tracer uptake, could lead to a better understanding of the bone remodeling and specific failure modes of unicondylar knee arthroplasty (UKA). The purpose of the present study was to introduce a novel standardized S...
متن کاملAcute Primary Total Knee Arthroplasty for Proximal Tibial Fractures in Elderly
Background: Proximal tibial fractures in elderly patients with osteoporosis or knee osteoarthritis (OA) are challengingcases. In the current study, we present our experience with uncommon acute primary total knee arthroplasty (PTKA)in this patient population.Methods: PTKAs were performed following proximal tibial fractures in 30 consecutive patients over 60 years of agewith osteoporosis or knee...
متن کاملMagnetic resonance imaging of total knee arthroplasty.
Evaluation of painful total knee arthroplasty can be clinically difficult, and traditional imaging techniques such as conventional radiographs, arthrography, and bone scintigraphy are limited by poor contrast resolution and specificity. Traditional magnetic resonance imaging techniques often are nondiagnostic because of significant metal artifact. Forty-one patients (46 knees) had magnetic reso...
متن کامل