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Related Experiment Videos

Quantitative bone scanning after asymptomatic Charnley arthroplasty

A B Mullaji1, R C Todd, S Robinson

  • 1University Department of Orthopedic and Accident Surgery, Royal Liverpool University Hospital, UK.

Acta Orthopaedica Scandinavica
|June 1, 1994
PubMed
Summary

This study tracked 99mtechnetium methylene diphosphonate uptake after hip replacement surgery. Tracer levels in bone around the implant decrease over time, but acetabular uptake remains elevated.

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Area of Science:

  • Orthopedic Surgery
  • Nuclear Medicine
  • Radiology

Background:

  • Assessing normal tracer uptake patterns post-hip replacement is crucial for interpreting scans.
  • Complications can alter bone scan findings, necessitating a baseline understanding in uncomplicated cases.

Purpose of the Study:

  • To define the typical pattern of 99mtechnetium methylene diphosphonate (99mTc-MDP) uptake in the early to mid-term postoperative period following primary hip arthroplasty.
  • To establish a reference range for tracer uptake in various peri-prosthetic regions.

Main Methods:

  • 73 patients underwent 99mTc-MDP scans at 6-24 months after primary Charnley hip replacement for arthrosis.
  • Patients were grouped by scan timing (6-24 months post-op).
  • Uptake ratios in 10 peri-prosthetic zones compared to normal bone were calculated using high-resolution gamma camera imaging.

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Main Results:

  • Femoral 99mTc-MDP uptake decreased linearly from 6 to 12 months post-surgery.
  • Post-12 months, femoral uptake stabilized at approximately twice normal in the greater trochanter and 1.5 times normal in the lesser trochanter.
  • Uptake in other femoral zones returned to near-normal levels, while acetabular uptake remained consistently elevated.

Conclusions:

  • A predictable pattern of decreasing femoral and persistently elevated acetabular 99mTc-MDP uptake exists after uncomplicated hip replacement.
  • These findings provide a normative dataset for interpreting bone scans in patients with hip arthroplasty.
  • Understanding this normal uptake variation is essential for accurate diagnosis and management of potential complications.