[Nuclear medical imaging in case of painful knee arthroplasty].
BACKGROUND
The aim of the present study was to calculate the overall diagnostic accuracy of nuclear medical imaging in patients with painful knee arthroplasty.


METHODS
This retrospective study of all patients (n=87) where a (99m)Tc-triple phase bone scintigraphy (TPBS; n=120) and (99m)Tc-anti-granulocyte scintigraphy (BW 250/183; n=20) for a painful knee arthroplasty was performed between 2003 and 2007.


RESULTS
A total of 87 patients with 94 knee arthroplasties were examined to detect septic and aseptic loosening and to differentiate between them. The sensitivity, specificity, the positive and negative predictive value and accuracy of TPBS for the detection of septic knee arthroplasty loosening was 100%, 85%, 55%, 100%, 73% and for BW 250/183 was 91%, 66%, 76%, 85%, 80% for sepsis, respectively. A significant increase in diagnostic accuracy with 94%, 88%, 89%, 95% und 89% (p <0.001) could be achieved when both methods were used in combination.


CONCLUSIONS
Both methods alone have high negative predictive values, but the combination of both is complementary and significantly increases the diagnostic accuracy and positive predictive value for final diagnosis of knee arthroplasty loosening.
Gratz
S
S
Abteilung für Nuklearmedizin, Philipps-Universität, Marburg. Nuklearmedizin-Gratz@gmx.net
Höffken
H
H
Kaiser
J W
JW
Behr
T M
TM
Strosche
H
H
Reize
P
P
D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D002648:Child; D004164:Diphosphonates; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010019:Osteomyelitis / Q000000981:diagnostic imaging; D010149:Postoperative Pain / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011475:Prosthesis Failure; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging*; D013667:Technetium
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D004164:Diphosphonates; D015609:Organotechnetium Compounds; C033905:technetium Tc 99m 1,1-diphosphonopropane-2,3-dicarboxylic acid; C101172:Sulesomab; D013667:Technetium