Article

One concern regarding resurfacing arthroplasty is the
viability of the diminished femoral head and the postoperative risk of collapse,
or a femoral neck fracture. (18)F-fluoride positron emission tomography (F-PET)
enables us to assess bone viability despite there being a covering metal
component. By F-PET studies, we recently showed the absence of metabolism in the
remaining part of femoral heads, 1-4 years after surgery in 11 of 46 consecutive
cases. We now present the further development of bone metabolism in these 11
cases. METHODS: 10 patients (11 chips) with previously shown loss of
femoral head metabolism were evaluated by radiography and repeated F-PET scans,
3-6.5 years after surgery. The size of the area with low (18)F-fluoride PET
uptake in the femoral head was compared to that in earlier PET images. RESULTS:
No patients had any clinical symptoms; nor was any necrotic bone area visible in
plain radiographs. On F-PET scans, 2 patients showed a diminished area with low
uptake, 4 were unchanged, and 5 had enlarged areas. INTERPRETATION: Bone
metabolism surrounding a volume of bone with no metabolic activity changes
dynamically even 5 years after surgery. The presence of bone with minor uptake of
F-tracer, indicating low or no bone metabolism, with further progression in 5 of
11 cases leads us to conclude that resurfacing THA should be used restrictively.

Langue : ANGLAIS