Role of 99mTc-Methylene Diphosphonate Bone Scintigraphy in the Evaluation of the Viability and the Incorporation of the Bone Allograft Used in Orthopedic Reconstruction

Allogenic bone is the most commonly grafted tissue which provides only osteoconductive property, in which it acts as a scaffold to facilitate the ingrowth of the vessels and migration of host cells capable of osteogenesis. It can be used as a substitute for autografts as the latter is associated with morbidity and limited donor site availability. Its applications are expanding in all aspects of orthopedic surgery, notably in revision hip replacement or surgical treatment for bone tumors or benign conditions. The balance between osteolysis and osteogenesis must be maintained for graft incorporation to occur and thus postoperative imaging is essential for differentiation between grafts and recurrent disease or viability/nonviability. Here, we present three cases, in which bone allografting was done who underwent serial 99 mTc-methylene diphosphonate three-phase bone scintigraphy with single-photon emission computed tomography/computed tomography to assess the viability, integrity, and the incorporation of the graft.