Bone metabolism after total hip revision surgery with impacted grafting: evaluation using H2 15O and [18F]fluoride PET; a pilot study.
OBJECTIVE
To evaluate bone blood flow and bone formation in patients after total hip revision surgery with impacted bone grafting using H2 15O and [18F]fluoride positron emission tomography (PET).


METHODS
To asses bone blood flow and bone metabolism in bone allograft after impaction grafting, four patients treated with total hip revision surgery were enrolled prospectively in this study. Six patients scheduled for primary hip arthroplasties were included as a control group. The study protocol consisted of three H2 15O and [18F]fluoride PET scans in each patient.


RESULTS
Bone blood flow increased significantly compared to the preoperative state in patients treated for primary hip arthroplasty. In patients undergoing revision surgery, bone blood flow was twofold to threefold higher compared to the preoperative state, but did not reach significance. Bone metabolism in patients undergoing revision was threefold higher 2 weeks postoperatively compared to the primary hip group. We found a significant correlation between Ki and bone blood flow.


CONCLUSIONS
Allogeneic bone grafts induce a higher rate of local periprosthetic bone formation compared to periprosthetic bone formation after a primary total hip placement. In vivo coupling between bone blood flow and bone metabolism suggests that bone metabolism in allogeneic bone grafts may partly rely on bone blood flow adaptations.
Department of Nuclear Medicine and PET Research, VU University Medical Centre, Amsterdam, The Netherlands. opp.temmerman@vumc.nl
Olivier P P
OP
Temmerman
Pieter G H M
PG
Raijmakers
Ide C
IC
Heyligers
Emile F I
EF
Comans
Mark
M
Lubberink
Gerrit J J
GJ
Teule
Adriaan A
AA
Lammertsma
D000368:Aged; D001842:Bone and Bones / Q000378:metabolism*; D003903:Deuterium; D005260:Female; D005462:Fluorine Radioisotopes; D006617:Hip Dislocation / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D010104:Oxygen Radioisotopes; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods*; D016896:Treatment Outcome
D005462:Fluorine Radioisotopes; D010104:Oxygen Radioisotopes; D003903:Deuterium