This Article Full Text Full Text (PDF) Letters to the Editor: Submit a response Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Reprints and Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Forrest, N. Articles by Ashcroft, G.P. Search for Related Content PubMed PubMed Citation Articles by Forrest, N. Articles by Ashcroft, G.P. Social Bookmarking             What's this?

Femoral Head Viability After Birmingham Resurfacing Hip Arthroplasty: Assessment with Use of [¹⁸F] Fluoride Positron Emission Tomography

Corresponding author:
N. Forrest, MRCS
Aberdeen Orthopaedic Positron Emission Tomography Group, Department of Orthopaedics, School of Medicine and Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, Scotland, AB25 2ZD.
E-mail address: n.forrest{at}doctors.org.uk

In support of their research for or preparation of this manuscript, one or more of the authors received grants or outside funding from Smith and Nephew. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Methods: The viability of the femoral heads of ten patients who had undergone successful unilateral Birmingham hip resurfacing was assessed with use of positron emission tomography in conjunction with the injection of fluorine at a mean of twenty months after surgery. For each patient, in both the hip that had undergone resurfacing and the contralateral nonresurfaced hip, activity was measured in four regions of interest: the lateral aspect of the femoral head, the medial aspect of the femoral head, the lateral aspect of the femoral neck, and the proximal aspect of the femur. The uptake of fluorine in each area was converted to standard uptake volumes.

Results: No areas of osteonecrosis were seen in the femoral head of any patient. There were no significant differences in the standard uptake volumes as measured in the four regions of the nonresurfaced hips, whereas the median values were higher in all four regions of the resurfaced hips. The difference between the values in the resurfaced hips compared with those in the nonresurfaced hips was only significant (p < 0.05) in the lateral aspect of the femoral head.

Conclusions: This study establishes positron emission tomography in conjunction with injection of fluorine as a possible modality for the assessment of femoral head viability after hip resurfacing. Viability following successful Birmingham hip resurfacing performed through a modified anterolateral approach has also been demonstrated. The increase in bone activity that was seen in the resurfaced hips in our study group may be related to bone remodeling or reperfusion of small areas of osteonecrosis. This technique offers the potential to study femoral head perfusion and viability following all types of resurfacing.

Level of Evidence: Diagnostic Level IV. See Instructions to Authors on jbjs.org for a complete description of levels of evidence.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2006 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.