Abstract
Introduction: Femoral neck failure due to avascular necrosis (AVN) is one of the most significant complications following resurfacing hip arthroplasty. It is likely that the surgical approach is one of the factors influenc-ing the development of AVN. Positron emission tomography (PET) is the only form of imaging that allows visualisation of bone metabolic activity deep to a metal surface.
Objectives: To establish the reliability and accuracy of PET using fluorine-18 to evaluate viability of the femoral head and neck after resurfacing hip arthroplasty. To assess the viability of ten proximal femora after Birmingham resurfacing hip arthroplasty via a modified lateral approach.
Design: A convenience case series of ten patients taken from the first fifteen from one orthopaedic surgeon’s experience of Birmingham resurfacing hip arthroplasty.
Setting: The PET unit of a major urban teaching hospital with a large academic orthopaedic department.
Participants: Patients that had undergone unilateral Birmingham resurfacing hip arthroplasty via a modified lateral approach were asked to volunteer for the study. The main criterion for inclusion was ease of attendance for imaging.
Intervention: Participants were given a single intravenous dose of 250MBq fluorine-18. After a period of 40 minutes uptake time, PET images of adjacent, sequential 10cm transverse sections including both acetabulae and proximal femora were obtained.
Main Outcome Measures: Images were reconstructed to allow relative quantification of uptake between operated and non-operated femoral heads and necks.
Results: PET imaging was successful in all subjects and demonstrated activity within the resurfaced femoral heads and femoral necks. No evidence of AVN was found.
Conclusions: Static positron emission tomography using fluorine-18 is an accurate and reliable method of assessing femoral head and neck viability after resurfacing hip arthroplasty. No evidence of avascular necrosis was found in this initial series of patients that had undergone Birmingham resurfacing hip arthroplasty via a modified lateral approach.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
