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The utility of the ankle SPECT/CT scan to predict functional and clinical outcomes in supramalleolar osteotomy patients
Author(s) -
Gross Christopher E.,
Barfield William,
Schweizer Christine,
Rasch Helmut,
Hirschmann Michael T.,
Hintermann Beat,
Knupp Markus
Publication year - 2018
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.23860
Subject(s) - medicine , ankle , valgus , single photon emission computed tomography , radiology , nuclear medicine , surgery
Combined single‐photon emission computed tomography and conventional computed tomography (SPECT/CT) is a hybrid imaging modality that shows a combination of metabolic and structural information about the ankle, including arthritis. We hypothesize that uptake in specific locations within the ankle joint can be associated with both clinical outcomes and may help predict which patients will have a successful SMO. Eighty‐five pre‐operative SMO patients with varus (37), valgus (41), or neutral (7) alignment of the hindfoot were assessed using SPECT/CT. The level of activation on SPECT/CT scans was measured. Pre and Post‐operative functional scores were recorded. Patients with medial gutter activation had significantly worse ( p < 0.05) AOFAS alignment (AOFAS‐A) scores pre‐operatively. Patients with varus or valgus alignment did not have any difference in VAS pain scores, but those in valgus did have worse AOFAS‐P (pain) scores. Those with cystic lesions had a worse FAOS score pre‐operatively. Ten patients (12.5%) had a treatment failure. Pre or post‐operative alignment did not correlate to a treatment failure. The only statistically significant ( p = 0.036) poor prognostic indicator was a bipolar lesion. Pre‐operative SPECT/CT evaluation of an ankle before a SMO can be used to clinically correlate patient‐specific factors such as pain and function in the pre and post‐operative period. We caution against performing a SMO in patients with bipolar activation on a pre‐operative SPECT‐CT scan. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2015–2021, 2018.