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The SPECT/CT Evaluation of Compartmental Changes after Open Wedge High Tibial Osteotomy

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ABSTRACT

Purpose: The purpose of this study was to evaluate compartmental changes using combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT) after open wedge high tibial osteotomy (OWHTO) for providing clinical guidance for proper correction.

Materials and methods: Analysis was performed using SPECT/CT from around 1 year after surgery on 22 patients who underwent OWHTO. Postoperative mechanical axis was measured and classified into 3 groups: group I (varus), group II (0°–3° valgus), and group III (>3° valgus). Patella location was evaluated using Blackburne-Peel (BP) ratio. On SPECT/CT, the knee joint was divided into medial, lateral, and patellofemoral compartments and the brighter signal was marked as a positive signal.

Results: Increased signal activity in the medial compartment was observed in 12 cases. No correlation was observed between postoperative mechanical axis and medial signal increase. Lateral increased signal activity was observed in 3 cases, and as valgus degree increased, lateral compartment’s signal activity increased. Increased signal activity of the patellofemoral joint was observed in 7 cases, and significant correlation was observed between changes in BP ratio and increased signal activity.

Conclusions: For the treatment of medial osteoarthritis, OWHTO requires overcorrection that does not exceed 3 valgus. In addition, the possibility of a patellofemoral joint problem after OWHTO should be kept in mind.

No MeSH data available.


Positive signal in the patellofemoral compartment on single-photon emission computerized tomography (CT) and conventional CT (the signal is brighter on the articular side of the patella).
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f5-ksrr-28-263: Positive signal in the patellofemoral compartment on single-photon emission computerized tomography (CT) and conventional CT (the signal is brighter on the articular side of the patella).

Mentions: Using SPECT/CT, we evaluated the signal in 3 compartments of the knee joint (medial, lateral, and patellofemoral compartments). The signal intensity was compared with the tibiofemoral shaft as a comparison group, which showed no signal in all patients. In this comparison, the brighter signal was marked as a positive signal and the same signal intensity as the comparison group was marked as a negative signal (Figs. 4 and 5). The evaluation of signal intensity was performed independently by one orthopedic surgeon and one radiologist who had no association with the surgery performed on the patients, and the results of evaluation by these two observers corresponded completely (Cohen kappa coefficient, 1).


The SPECT/CT Evaluation of Compartmental Changes after Open Wedge High Tibial Osteotomy
Positive signal in the patellofemoral compartment on single-photon emission computerized tomography (CT) and conventional CT (the signal is brighter on the articular side of the patella).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134792&req=5

f5-ksrr-28-263: Positive signal in the patellofemoral compartment on single-photon emission computerized tomography (CT) and conventional CT (the signal is brighter on the articular side of the patella).
Mentions: Using SPECT/CT, we evaluated the signal in 3 compartments of the knee joint (medial, lateral, and patellofemoral compartments). The signal intensity was compared with the tibiofemoral shaft as a comparison group, which showed no signal in all patients. In this comparison, the brighter signal was marked as a positive signal and the same signal intensity as the comparison group was marked as a negative signal (Figs. 4 and 5). The evaluation of signal intensity was performed independently by one orthopedic surgeon and one radiologist who had no association with the surgery performed on the patients, and the results of evaluation by these two observers corresponded completely (Cohen kappa coefficient, 1).

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: The purpose of this study was to evaluate compartmental changes using combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT) after open wedge high tibial osteotomy (OWHTO) for providing clinical guidance for proper correction.

Materials and methods: Analysis was performed using SPECT/CT from around 1 year after surgery on 22 patients who underwent OWHTO. Postoperative mechanical axis was measured and classified into 3 groups: group I (varus), group II (0°–3° valgus), and group III (>3° valgus). Patella location was evaluated using Blackburne-Peel (BP) ratio. On SPECT/CT, the knee joint was divided into medial, lateral, and patellofemoral compartments and the brighter signal was marked as a positive signal.

Results: Increased signal activity in the medial compartment was observed in 12 cases. No correlation was observed between postoperative mechanical axis and medial signal increase. Lateral increased signal activity was observed in 3 cases, and as valgus degree increased, lateral compartment’s signal activity increased. Increased signal activity of the patellofemoral joint was observed in 7 cases, and significant correlation was observed between changes in BP ratio and increased signal activity.

Conclusions: For the treatment of medial osteoarthritis, OWHTO requires overcorrection that does not exceed 3 valgus. In addition, the possibility of a patellofemoral joint problem after OWHTO should be kept in mind.

No MeSH data available.