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Assessment of loading history of compartments in the knee using bone SPECT/CT: A study combining alignment and 99mTc‐HDP tracer uptake/distribution patterns
Author(s) -
Hirschmann Michael T.,
Schön Stephan,
Afifi Faik K.,
Amsler Felix,
Rasch Helmut,
Friederich Niklaus F.,
Arnold Markus P.
Publication year - 2013
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.22206
Subject(s) - osteoarthritis , valgus , medicine , nuclear medicine , radiography , compartment (ship) , knee joint , radiology , orthodontics , surgery , pathology , alternative medicine , geology , oceanography
This study investigates if the mechanical/anatomical alignment influences the intensity values as well as the distribution pattern of SPECT/CT tracer uptake. Eighty‐five knees (mean age 48 ± 16) undergoing 99mTc‐HDP‐SPECT/CT due to pain were prospectively included. SPECT/CTs were analyzed using a previously validated localization method. The maximum intensities in each femoral, tibial, and patellar joint compartment (medial, lateral, central, superior, and inferior) were noted using a color‐coded grading scale (0–10). The Kellgren–Lawrence osteoarthritis score (KL) was assessed on standardized radiographs. Long leg radiographs were used to assess the mechanical/anatomical leg alignment, which was classified as varus, valgus, or neutral. The alignment and KL was correlated with the intensity of tracer uptake in each area of interest ( p < 0.05). The intensity of SPECT/CT tracer uptake in the medial and lateral knee compartment significantly correlated with varus or valgus alignment of the knee. A higher degree of osteoarthritis was significantly related to higher tracer uptake in the corresponding joint compartments. SPECT/CT reflects the specific loading pattern of the knee with regard to its alignment. It is also related to the degree of osteoarthritis. Hence, SPECT/CT should be considered for follow‐up of patients after realignment treatments, osteotomies, deloader devices, or insoles. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 268–274, 2013