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Quantitative Analysis of Technetium-99m-Methylene Diphosphonate Uptake in Unilateral Hydroxyapatite-Coated Total Hip Prostheses: First Year of Follow-Up

Departments of Nuclear Medicine and Orthopedic Surgery, De Wever Hospital, Heerlen, The Netherlands

Correspondence: For correspondence or reprints contact: Ali I. A. Rahmy, MD, Department of Nuclear Medicine, De Wever Hospital, PO Box 4446, 6401 CX Heerlen, The Netherlands.

ABSTRACT

A prospective study was performed on 80 patients who had undergone a unilateral hydroxyapatite (HA)-coated total hip arthroplasty to establish the normal periprosthetic uptake of methylenediphosphonate (MDP) as a function of implant age. Methods: Patients were imaged periodically while they were asymptomatic at 1, 3, 6 and 12 mo postoperatively. Quantitative measurements were performed with a region of interest (ROI) technique. The MA-coated and uncoated areas were marked in comparison with the normal contralateral femur. The uptake ratios of the MDP were determined postoperatively in the following 12 mo. Results: It was found that a decrease of the uptake ratios occurred in all ROIs. However, for the HA-coated areas, the uptake ratios still remained raised as a result of bony in-growth. Conclusion: The results of the first year of follow-up were considered to be a normal database that will be used as a reference when the same group of patients are followed up to 5 yr postoperatively to detect any potential modes of failure of the implant.

Key Words: hydroxyapatite • total hip arthroplasty • radionuclide