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Acta Orthop. 2012 Feb;83(1):22-5. doi: 10.3109/17453674.2011.641108. Epub 2011 Nov 23.

Metabolic development of necrotic bone in the femoral head following resurfacing arthroplasty. A clinical [18F]fluoride-PET study in 11 asymptomatic hips.

Author information

1
Department of Orthopedics, Gävle Hospital, Sweden. gosta.ullmark@lg.se

Abstract

BACKGROUND AND PURPOSE:

One concern regarding resurfacing arthroplasty is the viability of the diminished femoral head and the postoperative risk of collapse, or a femoral neck fracture. (18)F-fluoride positron emission tomography (F-PET) enables us to assess bone viability despite there being a covering metal component. By F-PET studies, we recently showed the absence of metabolism in the remaining part of femoral heads, 1-4 years after surgery in 11 of 46 consecutive cases. We now present the further development of bone metabolism in these 11 cases.

PATIENTS AND METHODS:

10 patients (11 chips) with previously shown loss of femoral head metabolism were evaluated by radiography and repeated F-PET scans, 3-6.5 years after surgery. The size of the area with low (18)F-fluoride PET uptake in the femoral head was compared to that in earlier PET images.

RESULTS:

No patients had any clinical symptoms; nor was any necrotic bone area visible in plain radiographs. On F-PET scans, 2 patients showed a diminished area with low uptake, 4 were unchanged, and 5 had enlarged areas.

INTERPRETATION:

Bone metabolism surrounding a volume of bone with no metabolic activity changes dynamically even 5 years after surgery. The presence of bone with minor uptake of F-tracer, indicating low or no bone metabolism, with further progression in 5 of 11 cases leads us to conclude that resurfacing THA should be used restrictively.

PMID:
22112156
PMCID:
PMC3278652
DOI:
10.3109/17453674.2011.641108
[Indexed for MEDLINE]
Free PMC Article

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