Evidence map›Paper›PMID 26044121›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2015

Clinical value of SPECT/CT in the painful total knee arthroplasty (TKA): a prospective study in a consecutive series of 100 TKA.

Michael T Hirschmann, Felix Amsler, Helmut Rasch

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In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 4 pooled it
5.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 4 syntheses or guidelines pooled it, 75 citations in OpenAlex.

  1. Pooled it
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  4. Tibial internal rotation negatively affects clinical outcomes in total knee arthroplasty: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018
    Pooled it
  5. Review
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  10. CanIndian journal of orthopaedics · 2024
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  17. Underhang of the tibial component increases tibial bone resorption after total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019
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  20. Increased in vivo patellofemoral loading after total knee arthroplasty in resurfaced patellae.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Michael T HirschmannDepartment of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), 4101, Bruderholz, Switzerland. Michael.Hirschmann@unibas.ch.
Felix AmslerAmsler Consulting, Basel, Switzerland.
Helmut RaschInstitute of Radiology and Nuclear Medicine, Kantonsspital Baselland, 4101, Bruderholz, Switzerland.
Kantonsspital Baselland Standort Bruderholz · CHMettler-Toledo (Switzerland) · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBone single photon emission computed tomography (SPECT)/CT is considered as beneficial in unhappy patients with pain, stiffness or swelling after total knee arthroplasty (TKA). The purpose of this study was to identify typical patterns of bone tracer uptake (BTU), distribution and intensity values in patients after TKA. The above findings were correlated with the type and fixation of TKA, the time from TKA and intraoperative findings at revision surgery.

methodsA total of 100 knees of 84 consecutive patients (mean age ± SD 70 ± 11 years) after TKA with persistent knee pain were prospectively included. All patients underwent clinical examination, standardized radiographs and (99m)Tc-hydroxymethane diphosphonate (HDP) SPECT/CT as part of a routine diagnostic algorithm. The diagnosis before and after SPECT/CT and final treatment were recorded. TKA component position was determined on 3-D reconstructed images. Intensity and anatomical distribution of BTU was determined. Maximum intensity values were recorded as well as ratios in relation to the proximal midshaft of the femur. Univariate analyses (chi-square test, Pearson's correlation and t test for independent samples) were performed (p < 0.05).

resultsSPECT/CT changed the clinical diagnosis and final treatment in 85/100 (85 %) knees. Intraoperative findings confirmed the preoperative SPECT/CT diagnosis in 32/33 knees (97 %). TKA loosening as well as progression of patellofemoral osteoarthritis (OA) was correctly diagnosed in 100 % of knees. Typical patterns of BTU for specific pathologies were identified. Loose femoral TKA components significantly correlated with increased BTU at the lateral femoral regions (p < 0.05). Loose tibial TKA components significantly correlated with increased BTU at all tibial regions (p < 0.05) and around the tibial peg (p > 0.01).

conclusionThe diagnostic benefits of SPECT/CT in patients after TKA have been proven. Typical pathology-related BTU patterns were identified, which will improve reporting quality. Due to the benefits in establishing the correct diagnosis, SPECT/CT should be part of the routine diagnostic algorithm for patients with pain after TKA.

Indexed as

Multimodal ImagingTomography, Emission-Computed, Single-PhotonTomography, X-Ray ComputedAgedArthroplasty, Replacement, KneeFemaleHumansIntraoperative PeriodMaleOsteoarthritisPainPatellofemoral JointProspective StudiesProsthesis FailureProsthesis-Related InfectionsSensitivity and SpecificityBoneComponent positionCTKneeReplacementSPECTSPECT/CTTotal knee arthroplastyTracer uptake

Identifiers

PMID26044121
OpenAlexW640975153

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.