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Metabolic development of necrotic bone in the femoral head following resurfacing arthroplasty: A clinical [(18)F]fluoride-PET study in 11 asymptomatic hips
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
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2012 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 83, no 1, 22-25 p.Article in journal (Refereed) Published
Abstract [en]

Background and purpose

One concern regarding resurfacing arthroplasty is the viability of the diminished femoral head and the postoperative risk of collapse, or a femoral neck fracture. (18)F-fluoride positron emission tomography (F-PET) enables us to assess bone viability despite there being a covering metal component. By F-PET studies, we recently showed the absence of metabolism in the remaining part of femoral heads, 1-4 years after surgery in 11 of 46 consecutive cases. We now present the further development of bone metabolism in these 11 cases.

Patients and methods

10 patients (11 chips) with previously shown loss of femoral head metabolism were evaluated by radiography and repeated F-PET scans, 3-6.5 years after surgery. The size of the area with low (18)F-fluoride PET uptake in the femoral head was compared to that in earlier PET images.

Results

No patients had any clinical symptoms; nor was any necrotic bone area visible in plain radiographs. On F-PET scans, 2 patients showed a diminished area with low uptake, 4 were unchanged, and 5 had enlarged areas.

Interpretation

Bone metabolism surrounding a volume of bone with no metabolic activity changes dynamically even 5 years after surgery. The presence of bone with minor uptake of F-tracer, indicating low or no bone metabolism, with further progression in 5 of 11 cases leads us to conclude that resurfacing THA should be used restrictively.

Place, publisher, year, edition, pages
2012. Vol. 83, no 1, 22-25 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-164305DOI: 10.3109/17453674.2011.641108ISI: 000300022600004PubMedID: 22112156OAI: oai:DiVA.org:uu-164305DiVA: diva2:467218
Available from: 2011-12-19 Created: 2011-12-19 Last updated: 2017-12-08Bibliographically approved

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Ullmark, GöstaMilbrink, JanNilsson, OlleSörensen, Jens

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Centre for Research and Development, GävleborgOrthopaedicsSection of Nuclear Medicine and PET
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