SPECT/CT demonstrates the osseointegrative response of a stemless shoulder prosthesis

Berth, Alexander; März, Vincent; Wissel, Heiko; Awiszus, Friedemann; Amthauer, Holger; Lohmann, Christoph H.

doi:10.1016/j.jse.2015.09.009

Cited by 34 publications

(21 citation statements)

References 32 publications

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“…The latter has been attributed to different loading conditions of the bone. 15 This study demonstrates the ability of nuclear imaging to evaluate the extent and timing of bone remodelling processes secondary to total joint implantation while providing 3D information.…”

Section: Is Imaging Useful In Evaluating Osse-ointegration Of the Impmentioning

confidence: 79%

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Imaging in peri-prosthetic assessment: an orthopaedic perspective

et al. 2017

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As imaging techniques are ever-evolving, this article aims to provide a brief overview of the various modalities including their limitations. The ability of imaging for evaluation of implant osseo-integration will be addressed and also the role of imaging in assessing septic and aseptic loosening, with a particular focus on adverse tissue reactions, will be discussed. Specific features when imaging the big joints such as shoulder, hip, knee and ankle joint will also be outlined.Overall, a lack of standardisation and validity was noted and despite the gross variety of imaging modalities, there is no technique covering all aspects required for evaluation of implant fixation and septic and aseptic loosening. Each imaging modality has a role, depending on the information required and anticipated. The choice of imaging technique should not be primarily based on medical considerations but also on availability, accessibility, expertise and costs. Plain radiographs alone have been recommended in cases of suspected peri-prosthetic joint infections, given the lack of evidence for additional imaging techniques in this context. For aseptic loosening, ultrasound and plain radiographs may serve as initial screening tools. Metal artefact reducing sequences (MARS) MRI are advancing cross-sectional imaging and are likely to promote their role in patient evaluation.We conclude that imaging is one essential part in the work-up of patients with total joint replacements, within a specific clinical context. Close teamwork between experienced radiologists and orthopaedic surgeons is required for optimal patient care.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160058. Originally published online at www.efortopenreviews.org

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Section: Is Imaging Useful In Evaluating Osse-ointegration Of the Impmentioning

confidence: 79%

“…15 It has been demonstrated that primary osseo-integration is almost completed within the first three months, with the highest metabolic activity at the superior aspect of the stem. The latter has been attributed to different loading conditions of the bone.…”

Section: Is Imaging Useful In Evaluating Osse-ointegration Of the Impmentioning

confidence: 99%

Imaging in peri-prosthetic assessment: an orthopaedic perspective

et al. 2017

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“…Implant fixation is obtained through direct contact with the cut surface of metaphyseal bone. [23][24][25][26] This fixation must be adequate to provide the patient with a functioning, long-lasting, stabile implant that maintains adequate strength and mobility. Osseointegration is the method by which long-term stability in all of these implants is sustained, except for Catalyst, which has a cemented option.…”

Section: Current Implants Fixationmentioning

confidence: 99%

Stemless Total Shoulder: A Review of Biomechanical Fixation and Recent Results

Wodarek

Shields

2021

Journal of Shoulder and Elbow Arthroplasty

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Introduction: Anatomic total shoulder arthroplasty is the replacement of the humeral head and glenoid surfaces with the goal of replicating normal anatomy. It is commonly utilized for patients with osteoarthritis, rheumatoid arthritis, and osteonecrosis, who have decreased range of motion (ROM), persistent pain, and loss of strength. Total shoulder Arthroplasty (TSA) is the third most common joint replacement in the United States. The incidence of TSA has been increasing, some data suggest that by the year 2025, TSA incidence may rise to 439,206 operations per year. In recent years, stemless total shoulder implants have become available. Results: These implants preserve bone stock while decreasing complications such as osteolysis, stress shielding and periprosthetic fracture. Stemless implants improve anatomic reconstruction and biomechanical function of the shoulder joint. Conclusion: Increasing amounts of data suggest stemless TSA to be a safe and effective technology that will become more common in the coming year.

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“…Nevertheless, due to differences in patient positioning within the scanner or anthropometric differences between patients, SPECT/CT scans are usually not mutually aligned and thus cannot be directly compared. To overcome this challenge, regional classification systems, in which several regions are manually defined based on anatomic landmarks and/or predefined dimensions, have been developed for evaluating unicondylar knee [14,18], total knee [9,10,19], total hip [20,21] and shoulder [22] arthroplasty. Despite prior success with this approach, it is limited in that it significantly reduces data resolution as thousands of SPECT voxels are reduced into just a few regions for analysis (around 200 voxels per region) leading to the loss of local information.…”

Section: Introductionmentioning

confidence: 99%

SCreg: a registration-based platform to compare unicondylar knee arthroplasty SPECT/CT scans

Dandois

Buck

Beckers

et al. 2020

BMC Musculoskelet Disord

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Background: A combination of conventional computed tomography and single photon emitted computed tomography (SPECT/CT) provides simultaneous data on the intensity and location of osteoblastic activity. Currently, since SPECT/CT scans are not spatially aligned, scans following knee arthroplasty are compared by extracting average and maximal values of osteoblastic activity intensity from large subregions of the structure of interest, which leads to a loss of resolution, and hence, information. Therefore, this paper describes the SPECT/CT registration platform (SCreg) based on the principle of image registration to spatially align SPECT/CT scans following unicondylar knee arthroplasty (UKA) and allow full resolution intra-subject and inter-subject comparisons. Methods: SPECT-CT scans of 20 patients were acquired before and 1 year after UKA. Firstly, scans were preprocessed to account for differences in voxel sizes and divided in volumes of interest. This was followed by optimization of registration parameters according to their volumetric agreement, and alignment using a combination of rigid, affine and non-rigid registration. Finally, radiotracer uptakes were normalized, and differences between pre-operative and post-operative activity were computed for each voxel. Wilcoxon signed rank sum test was performed to compare Dice similarity coefficients pre-and post-registration. Results: Qualitative and quantitative validation of the platform assessing the correct alignment of SPECT/CT scans resulted in Dice similarity coefficient values over 80% and distances between predefined anatomical landmarks below the fixed threshold of (2;2;0) voxels. Locations of increased and decreased osteoblastic activity obtained during comparisons of osteoblastic activity before and after UKA were mainly consistent with literature. Conclusions: Thus, a full resolution comparison performed on the platform could assist surgeons and engineers in optimizing surgical parameters in view of bone remodeling, thereby improving UKA survivorship.

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SPECT/CT demonstrates the osseointegrative response of a stemless shoulder prosthesis

Cited by 34 publications

References 32 publications

Imaging in peri-prosthetic assessment: an orthopaedic perspective

Imaging in peri-prosthetic assessment: an orthopaedic perspective

Stemless Total Shoulder: A Review of Biomechanical Fixation and Recent Results

SCreg: a registration-based platform to compare unicondylar knee arthroplasty SPECT/CT scans

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