The role of bone scintigraphy parameters in the diagnosis of implant-associated paraendoprosthetic complications in hip and knee arthroplasty

P.O. Korol

Abstract


Background. In recent years in Ukraine, is becomes relevant the question the incidence of degenerative-dystrophic processes of the hip and knee joints. To date, for the purpose of diagnosis of degenerative processes of the hip and knee joints, the method of bone scintigraphy is actively used in clinical practice. At the same time, there are not fully studied the issues of determining bone scintigraphy parameters, in which you can perform arthroplasty without the risk of postoperative complications. The aim of the study was to determine the value of bone scintigraphy parameters in the diagnosis of implant-associated complications in hip and knee joints. Materials and methods. Bone scintigraphy was performed on the tomographic scintillation gamma camera Tama-ra 301T in the static mode, the front line, side and rear views. For the purpose of bone scintigraphy, we have administered intravenously 99m-Tc-pyrophosphate with activity of 550–770 MBq. Static bone scan was performed 2–3 hours after administration of the drug. Results. According to the analysis, in patients with deforming and post-traumatic osteoarthritis of the hip and knee joints, the most common implant-related complications are the dislocations of endoprosthesis components; in patients with aseptic necrosis — aseptic loosening of the endoprosthesis components; in patients with rheumatoid arthritis — acute hematogenous infection. Conclusions. The method of bone scintigraphy can be used in the diagnostic screening of patients in order to identify the implant-associated complications in hip and knee joints. In the diagnostic group of patients with indicators of radiopharmaceutical hyperfixation in the range of more than +350 % in the area of the damaged articular complex, the incidence of implant-associated complications 1 year after arthroplasty is significantly higher than the number of complications in patients with indicators of radiopharmaceutical hyperfixation in the range from +171 to +350 % in the area of the damaged articular complex (p < 0.001).

Keywords


bone scintigraphy; hip and knee joints; arthroplasty; implant-associated complications

References


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DOI: https://doi.org/10.22141/1608-1706.1.18.2017.95590

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