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The Acetabulum: A Prospective Study of Three-Phase Bone and Indium White Blood Cell Scintigraphy Following Porous-Coated Hip Arthroplasty

Nuclear Medicine Service and Orthopedic Service, Walter Reed Army Medical Center, Washington D.C.
The Uniformed Services University of Health Sciences, Bethesda, Maryland

Correspondence: For reprints contact: Douglas Van Nostrand, MD, Nuclear Medicine Dept., Good Samaritan Hospital, 5601 Loch Raven Blvd., Baltimore, MD 21239.

ABSTRACT

Although few studies address the use of three-phase bone scanning (TPBS) and indium-111-labeled white blood cell scintigraphy (¹¹¹In-WBC) in hip arthroplasty utilizing a porous-coated prosthesis, the literature suggests that scintigraphic patterns in the uncomplicated patient may differ form that seen with the cemented prosthesis. In an attempt to determine the scintigraphic natural history, 25 uncomplicated porous-coated hip arthroplasties in 21 patients were prospectively studied with serial TPBS and ¹¹¹In-WBC at 7 days, and 3, 6, 12, 18, and 24 mo postoperatively. This report deals with findings related to the acetabulum. All 25 prostheses (144 of 144 scans) demonstrated increased uptake on the bone-phase images. Although this activity decreased with time, 76% had persistent up take at 24 mo. Twenty-three of 25 prostheses (126 of 140 scans) showed increased uptake on ¹¹¹In-WBC scintigraphy,invariably decreasing with time, but with 37% having significant uptake at 24 mo. Scintigraphic patterns in the uncomplicated porous-coated hip arthroplasty patient appear to differ from patterns described in cemented prostheses.

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