Tc-scintimetry in 56 cementless hip arthroplasties. A prospective, randomized comparison of two femoral components

In a prospective, randomized study of cementless total hip arthroplasties, radionuclide images as well as radiographs were obtained at 6, 12, and 36 months postoperatively. The femoral component was porous-coated, rigid in 28 patients and smooth, isoelastic in 28. The radionuclide uptake was quantified in the regions of interest and correlated to the non-operated side. Among prostheses considered to be stable 3 years after surgery, the activity had normalized in the calcar region. The uptake was also reduced below the tip of the prostheses, but the activity was still 50 percent increased compared to the non-operated side. The isoelastic prosthesis showed less reduction of activity below the tip than the rigid prosthesis. Proximally, the isoelastic prosthesis showed no reduction of activity, whereas the rigid prosthesis had normalized the uptake at the 3-year control. A high rate of non-stable fixation was observed for the flexible prosthesis at the radiographic assessment, which may have contributed to the increased radionuclide activity. Sequential scintimetry may be used as a complement to the radiographic evaluation of the femoral component of the hip prosthesis.