Scintigraphic Quantitative Surgical Parameters of Resectability in Arthroplasty in Patients with Posttraumatic Osteoarthrosis of the Knee Joints

P.O. Korol, M.M. Tkachenko, V.K. Bondar

Abstract


Background. Post-traumatic osteoarthrosis of the knee etiologically is a separate disease. The cause for the development of posttraumatic osteoarthrosis is a one-stage injury or chronic trauma, determining the impression of bone structures. Analysis of statistical data on the prevalence of osteoarthrosis has shown that in different regions of Europe, its frequency varies from 8 to 25 % of the adult population. Recent trend is to reduce the average age of patients with this patho-logy. In the population, osteoarthrosis is registered in 3.5 % of patients younger than 39 years, and after the age of 50 years their number is significantly increased. The course of posttraumatic osteoarthrosis of the knee is chronic (5–15 years). In the past medical history, the patients noted an acute injury of the knee joint with prolonged dysfunction or chronic trauma related to the professional activity [5]. Knee arthroplasty with posttraumatic arthrosis is relevant leading orthopedic correction method, which allows to significantly improve the quality of life. At this stage, there has been extensively studied the diagnostic role of modern additional methods to explore components of the knee joints in patients with osteoarthrosis, in whom arthroplasty was planned. One of the mo-dern and sensitive methods for the diagnosis of the knee pathology is a bone scan. The aim of this work to determine the quantitative scintigraphic parameters of resectability in knee arthroplasty in patients with posttraumatic osteoarthrosis. Materials and methods. Bone scan was performed on the tomographic scintillation gamma camera «Tamara-301T» after intravenous injection of 99mTc-pyrophosphate with activity of 550–770 MBq. Results. All patients were divided into three diagnostic groups. The first group included 25 (45 %) patients, in whom the accumulation of radiopharmaceuticals in the projection of the affected joint was +10–120 %, and in the projection of the proximal tibia — +5–50 %; the second group — 19 (34 %) patients, in whom the inclusion of an indicator in the projection of the affected articular complex was +121–200 %, and in the projection of the proximal tibia — +51–80 %; the third group consisted of 11 (21 %) patients with the inclusion of an indicator in the projection of the affected joint of more than +200 %, and in the projection of the proximal tibia — over +80 %. One year after arthroplasty, patients of the first group hadn’t postoperative complications. In 14 (56 %) patients of the second group and in 7 (63 %) patients of the third group, 1 year after hip replacement, there were revealed implant-associated infectious complications. Conclusions. To perform knee arthroplasty without the risk of postoperative complications, the accumulation of radiopharmaceuticals during bone scan in the projection of the joint, affected by osteoarthrosis, should be with +10–120 %, and in the projection of the proximal tibia — +5–50 %, in relation to symmetrical the research area.


Keywords


bone scintigraphy; knee joints; arthroplasty; osteoarthrosis

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DOI: https://doi.org/10.22141/1608-1706.6.17.2016.88625

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