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Osteonecrosis following resurfacing arthroplasty: A clinical positron emission tomography study of 14 cases

Background and purpose One of the main concerns regarding resurfacing arthroplasty is the viability of the remaining part of the femoral head, and the postoperative risk of a femoral neck fracture or collapse. In contrast to radiographic methods, positron emission tomography using the radiotracer [1...

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Autores principales: Ullmark, Gösta, Sundgren, Kent, Milbrink, Jan, Nilsson, Olle, Sörensen, Jens
Formato: Texto
Lenguaje:English
Publicado: Informa Healthcare 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823311/
https://www.ncbi.nlm.nih.gov/pubmed/19995317
http://dx.doi.org/10.3109/17453670903278258
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author Ullmark, Gösta
Sundgren, Kent
Milbrink, Jan
Nilsson, Olle
Sörensen, Jens
author_facet Ullmark, Gösta
Sundgren, Kent
Milbrink, Jan
Nilsson, Olle
Sörensen, Jens
author_sort Ullmark, Gösta
collection PubMed
description Background and purpose One of the main concerns regarding resurfacing arthroplasty is the viability of the remaining part of the femoral head, and the postoperative risk of a femoral neck fracture or collapse. In contrast to radiographic methods, positron emission tomography using the radiotracer [18F]-fluoride (Fluoride-PET) enables us to visualize the viability of bone in the remaining part of the head, despite the presence of the covering metal component. Patients and methods This is preliminary prospective study of 14 patients who underwent an ASR resurfacing arthroplasty. Apart from clinical and radiographic analyses, all patients were analyzed by PET scan 1 week, 4 months, and 1 year after surgery. Results 1 patient had a minor region of osteonecrosis on PET scan at 1 week and at 4 months. After 1 year, the necrosis had increased to include most of the head. 2 other patients, normal at 4 months, had developed equally large osteonecrosis at 1 year. A fourth patient had a minor osteonecrosis at 1 year. None of the patients had clinical symptoms, and the necrotic areas were not visible on plain radiographs. Conclusions We found Fluoride PET to be a sensitive and useful method for evaluation of bone metabolism at resurfacing arthroplasty. 3 of the 14 patients had developed osteonecrosis, involving most of the head at 1 year. The late onset of the phenomenon does not support the hypothesis of surgically damaged vascularity. The presence of this complication together with the lack of visibility on plain radiographs gives reason for concern.
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spelling pubmed-28233112010-02-18 Osteonecrosis following resurfacing arthroplasty: A clinical positron emission tomography study of 14 cases Ullmark, Gösta Sundgren, Kent Milbrink, Jan Nilsson, Olle Sörensen, Jens Acta Orthop Research Article Background and purpose One of the main concerns regarding resurfacing arthroplasty is the viability of the remaining part of the femoral head, and the postoperative risk of a femoral neck fracture or collapse. In contrast to radiographic methods, positron emission tomography using the radiotracer [18F]-fluoride (Fluoride-PET) enables us to visualize the viability of bone in the remaining part of the head, despite the presence of the covering metal component. Patients and methods This is preliminary prospective study of 14 patients who underwent an ASR resurfacing arthroplasty. Apart from clinical and radiographic analyses, all patients were analyzed by PET scan 1 week, 4 months, and 1 year after surgery. Results 1 patient had a minor region of osteonecrosis on PET scan at 1 week and at 4 months. After 1 year, the necrosis had increased to include most of the head. 2 other patients, normal at 4 months, had developed equally large osteonecrosis at 1 year. A fourth patient had a minor osteonecrosis at 1 year. None of the patients had clinical symptoms, and the necrotic areas were not visible on plain radiographs. Conclusions We found Fluoride PET to be a sensitive and useful method for evaluation of bone metabolism at resurfacing arthroplasty. 3 of the 14 patients had developed osteonecrosis, involving most of the head at 1 year. The late onset of the phenomenon does not support the hypothesis of surgically damaged vascularity. The presence of this complication together with the lack of visibility on plain radiographs gives reason for concern. Informa Healthcare 2009-12-04 2009-12-04 /pmc/articles/PMC2823311/ /pubmed/19995317 http://dx.doi.org/10.3109/17453670903278258 Text en Copyright: © Nordic Orthopedic Federation http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
spellingShingle Research Article
Ullmark, Gösta
Sundgren, Kent
Milbrink, Jan
Nilsson, Olle
Sörensen, Jens
Osteonecrosis following resurfacing arthroplasty: A clinical positron emission tomography study of 14 cases
title Osteonecrosis following resurfacing arthroplasty: A clinical positron emission tomography study of 14 cases
title_full Osteonecrosis following resurfacing arthroplasty: A clinical positron emission tomography study of 14 cases
title_fullStr Osteonecrosis following resurfacing arthroplasty: A clinical positron emission tomography study of 14 cases
title_full_unstemmed Osteonecrosis following resurfacing arthroplasty: A clinical positron emission tomography study of 14 cases
title_short Osteonecrosis following resurfacing arthroplasty: A clinical positron emission tomography study of 14 cases
title_sort osteonecrosis following resurfacing arthroplasty: a clinical positron emission tomography study of 14 cases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823311/
https://www.ncbi.nlm.nih.gov/pubmed/19995317
http://dx.doi.org/10.3109/17453670903278258
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