Effect of Intertrochanteric Osteotomy on the Proximal Femur of Rabbits: Assessment With Power Doppler Sonography and Scintigraphy

Abstract

1Doria AS, Cunha FG, Modena M, Rodrigues CJ, Garcez AT, Junior RG, Bolliger Neto R, Melo IB, Buchpiguel C, Molnar LJ, Guarniero R. Effect of intertrochanteric osteotomy on the proximal femur of rabbits: assessment with power doppler sonography and scintigraphy. Clinics. 2007;62(6):741-8. OBJECTIVE:In bone injury, repair results in local increased vascularity and bone marrow remodeling. Characterizing the vascular and metabolic imaging patterns of the proximal femur following an intertrochanteric osteotomy may help clinicians decide proper management of the patient. Our objective was to measure Doppler sonography and scintigraphy interval changes in the proximal femur following intertrochanteric osteotomy and compare imaging and histomorphometric measurements in the late post-operative stage (6 weeks after surgery) in a rabbit model of bone injury. MATERIALS AND METHODS: Both hips of 12 adult rabbits were imaged with power Doppler sonography and scintigraphy prior to and after (7 days and 6 weeks) unilateral osteotomy. Accuracy of the imaging methods was evaluated using hip operative status and histomorphometric results (vascular fractional area and number of vessels per area unit) as reference standard measures. RESULTS: A significant difference in the mean number of pixels was noted between operated and non-operated femura in late post-operative power Doppler examinations (P=0.049). Although without reaching statistical significance, the AUC of Doppler measurements (AUC=0.99) was numerically greater than the AUC of scintigraphy measurements (AUC=0.857±0.099) (P=0.15) in differentiating proximal femura with regard to their fractional vascular areas in the late post-operative stage. In contrast, scintigraphy tended to perform better (AUC=0.984±0.022) than Doppler ultrasound (AUC=0.746±0.131) to demonstrate the vascularity intensity per area unit (P=0.07) in the late stage. CONCLUSION: Our results warrant further investigation to determine the value of different imaging modalities for assessment of pathologic changes following hip surgery. Power Doppler sonography demonstrated larger AUCs (representing higher accuracy) for the discrimination of vascular fractional areas and scintigraphy, for discrimination of the number of vessels per area unit.

Radial Overgrowth After Radial Shortening Osteotomies for Skeletally Immature Patients With Kienböck's Disease

“…Bone overgrowth is thought to be caused by 2 increased vascularity. Doria et al 25 showed postoperative hypervascularity after femoral 3 osteotomy in rabbits. This report did not deal with postoperative radius hypervascularity.…”

Avaliação da interação biológica entre polímero de poliuretana de mamona acrescido de carbonato de cálcio e tecido ósseo de equinos

“…pode auxiliar em casos onde não há clareza no diagnóstico radiográfico. Com relação à regeneração óssea, o trabalho descreveu a facilidade na visualização do calo e salientou a antecipação da identificação com relação ao exame radiográfico, inclusive com relação à consolidação da fratura, sendo esta Power Doppler pode ser utilizado para reconhecer padrão vascular de imagem, porém, esta técnica exige do examinador conhecimento prévio do processo que ocorre durante os fenômenos fisiológicos do processo regenerativo das fraturas(DORIA et al, 2007;RAHIMZADEH et al, 2012). Este método pode detectar temperatura superficial de forma mais objetiva quando comparada ao exame clínico de palpação(HEAD;DYSON, 2001;REDAELLI et al, 2014).…”