Josef Hochreiter1, Georg Mattiassich1, Wolfgang Hitzl2, Georg Weber1, Mohsen Beheshti3, Reinhold Ortmaier4,5. 1. Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Seilerstätte 4, 4020, Linz, Austria. 2. Department of Biostatistics, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria. 3. Department of Nuclear Medicine, Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe, Seilerstätte 4, 4020, Linz, Austria. 4. Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Seilerstätte 4, 4020, Linz, Austria. r.ortmaier@gmail.com. 5. Research Unit for Orthopedic Sports Medicine and Injury Prevention, ISAG/UMIT, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria. r.ortmaier@gmail.com.
Abstract
BACKGROUND: Success after glenoid bone augmentation in total shoulder arthroplasty depends on osseous integration and non-resorption. Standard imaging techniques, such as computed tomography (CT) and X-rays, cannot quantify bone viability. Therefore, we introduce a new technique to assess graft viability using 18F-sodium fluoride (18F-NaF) PET-CT for femoral allografts in reverse total shoulder arthroplasty (RSA). MATERIALS AND METHODS: Patient charts were reviewed following glenoid augmentation using femoral allografts in reverse total shoulder arthroplasty. A total of seven patients were included in this study. 18F-NaF PET-CT was used to assess graft viability and graft fusion. Semiquantitative assessment of 18F-NaF uptake was performed by means of a standardized uptake value (SUV). Radiographs were used to assess fusion. The mean age of the patients at the time of follow-up was 83.4 years (range 79-92), and the mean follow-up was 44.4 months. RESULTS: Viability and fusion were confirmed in all allografts using semiquantitative analysis of 18F-NaF PET-CT by means of standardized uptake value (SUVmax). Metabolic activity of medullary region of a vertebral spine was defined as a reference background. The mean value of maximum tracer activity in the allograft was not statistically different from native bone in the reference vertebrae (p = 0.14). CONCLUSIONS: 18F-NaF PET-CT is a practicable tool to quantitatively assess viability in large bone allografts after glenoid augmentation in RSA. The study shows viability and fusion in all allografts. LEVEL OF EVIDENCE: Level IV, treatment study.
BACKGROUND: Success after glenoid bone augmentation in total shoulder arthroplasty depends on osseous integration and non-resorption. Standard imaging techniques, such as computed tomography (CT) and X-rays, cannot quantify bone viability. Therefore, we introduce a new technique to assess graft viability using 18F-sodium fluoride (18F-NaF) PET-CT for femoral allografts in reverse total shoulder arthroplasty (RSA). MATERIALS AND METHODS:Patient charts were reviewed following glenoid augmentation using femoral allografts in reverse total shoulder arthroplasty. A total of seven patients were included in this study. 18F-NaF PET-CT was used to assess graft viability and graft fusion. Semiquantitative assessment of 18F-NaF uptake was performed by means of a standardized uptake value (SUV). Radiographs were used to assess fusion. The mean age of the patients at the time of follow-up was 83.4 years (range 79-92), and the mean follow-up was 44.4 months. RESULTS: Viability and fusion were confirmed in all allografts using semiquantitative analysis of 18F-NaF PET-CT by means of standardized uptake value (SUVmax). Metabolic activity of medullary region of a vertebral spine was defined as a reference background. The mean value of maximum tracer activity in the allograft was not statistically different from native bone in the reference vertebrae (p = 0.14). CONCLUSIONS: 18F-NaF PET-CT is a practicable tool to quantitatively assess viability in large bone allografts after glenoid augmentation in RSA. The study shows viability and fusion in all allografts. LEVEL OF EVIDENCE: Level IV, treatment study.
Entities:
Keywords:
Bone allograft; Fusion; PET-CT; Reverse shoulder arthroplasty; Viability
Authors: M Beheshti; F M Mottaghy; F Paycha; F F F Behrendt; T Van den Wyngaert; I Fogelman; K Strobel; M Celli; S Fanti; F Giammarile; B Krause; W Langsteger Journal: Eur J Nucl Med Mol Imaging Date: 2015-07-23 Impact factor: 9.236
Authors: Eric Wagner; Matthew T Houdek; Timothy Griffith; Bassem T Elhassan; Joaquin Sanchez-Sotelo; John W Sperling; Robert H Cofield Journal: J Bone Joint Surg Am Date: 2015-10-21 Impact factor: 5.284