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Erschienen in:
06.06.2019 | Original Article • SHOULDER - ARTHROPLASTY
Quantitative in vivo assessment of bone allograft viability using 18F-fluoride PET/CT after glenoid augmentation in reverse shoulder arthroplasty: a pilot study
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 7/2019
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Background
Success after glenoid bone augmentation in total shoulder arthroplasty depends on osseous integration and non-resorption. Standard imaging techniques, such as computed tomography (CT) and X-rays, cannot quantify bone viability. Therefore, we introduce a new technique to assess graft viability using 18F-sodium fluoride (18F-NaF) PET–CT for femoral allografts in reverse total shoulder arthroplasty (RSA).
Materials and methods
Patient charts were reviewed following glenoid augmentation using femoral allografts in reverse total shoulder arthroplasty. A total of seven patients were included in this study. 18F-NaF PET–CT was used to assess graft viability and graft fusion. Semiquantitative assessment of 18F-NaF uptake was performed by means of a standardized uptake value (SUV). Radiographs were used to assess fusion. The mean age of the patients at the time of follow-up was 83.4 years (range 79–92), and the mean follow-up was 44.4 months.
Results
Viability and fusion were confirmed in all allografts using semiquantitative analysis of 18F-NaF PET–CT by means of standardized uptake value (SUVmax). Metabolic activity of medullary region of a vertebral spine was defined as a reference background. The mean value of maximum tracer activity in the allograft was not statistically different from native bone in the reference vertebrae (p = 0.14).
Conclusions
18F-NaF PET–CT is a practicable tool to quantitatively assess viability in large bone allografts after glenoid augmentation in RSA. The study shows viability and fusion in all allografts.
Level of Evidence
Level IV, treatment study.