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Painful knee prosthesis: can we help with bone SPECT/CT?

Khalsa Al-Nabhani1, Sofia Michopoulou, Rayjanah Allie

  • 1Department of Nuclear Medicine, T5, University College London Hospital NHS Foundation Trust, London, UK.

Nuclear Medicine Communications
|October 25, 2013
PubMed
Summary

Single-photon emission computerized tomography/computed tomography (SPECT/CT) is valuable for assessing painful knee prostheses, aiding in diagnosis and patient management. This imaging technique proved clinically useful in over 85% of cases, guiding treatment decisions effectively.

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Area of Science:

  • Orthopedics
  • Radiology
  • Nuclear Medicine

Background:

  • Painful knee prostheses can stem from various complications, including loosening, infection, or other issues.
  • Accurate diagnosis is crucial for effective patient management and surgical planning.

Purpose of the Study:

  • To evaluate the clinical utility of single-photon emission computerized tomography/computed tomography (SPECT/CT) in diagnosing painful knee prostheses.
  • To determine the effectiveness of SPECT/CT in identifying causes of prosthesis pain, such as loosening or infection.

Main Methods:

  • A retrospective analysis of 69 patients with painful knee prostheses who underwent Tc-hydroxydiphosphonate SPECT/CT between 2009 and 2011.
  • Clinical data and imaging reports were reviewed to assess the impact of SPECT/CT on patient management.

Main Results:

  • SPECT/CT confirmed loosening in 13% and infection in 2.9% of patients.
  • Other causes were identified in 62.3% of cases.
  • The imaging test was clinically useful in 85.5% of patients, influencing management decisions.

Conclusions:

  • SPECT/CT is a highly useful diagnostic tool for painful knee prostheses, assisting in the confirmation of mechanical loosening.
  • It effectively helps exclude other potential causes like infection and patellofemoral osteoarthritis.
  • The study supports the integration of SPECT/CT into the clinical assessment of painful knee implants.