Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Bruderholz, CH-4101, Liestal, Switzerland.
University of Basel, Basel, Switzerland.
Skeletal Radiol. 2020 Jul;49(7):1127-1133. doi: 10.1007/s00256-020-03387-y. Epub 2020 Feb 18.
The purpose of the study was to investigate if the TKA design (cruciate retaining (CR), posterior stabilized (PS), revision prostheses) had an influence on the bone tracer uptake (BTU) pattern at the origin of the popliteus muscle.
A total of 92 knees (male:female = 46:46) which had undergone prior TKA were included in this retrospective study, comprising the following 3 groups: (i) CR primary TKA (n = 45); (ii) PS primary TKA (n = 24); (iii) revision TKA (n = 23). All patients received a SPECT/CT after TKA surgery. SPECT/CT images were reviewed for the presence of BTU in the lateral femoral condyle (origin of the popliteus muscle) by two observers using Syngo.via software (Siemens Healthcare, Erlangen, Germany). The observers recorded the BTU pattern qualitatively in the lateral femoral condyle as either (i) absent; (ii) present and diffuse; and (iii) present and focal in the region of the popliteus muscle origin.
In patients with a CR and PS design, focal increased BTU at the origin of the popliteus muscle was found in 80.0% and 83.3% respectively. Diffuse BTU was the predominant finding in patients with revision TKA (60.9%). The patterns of BTU did not show significant differences between the CR and the PS design. However, patterns of BTU differed significantly between primary TKA designs and revision TKA (p < 0.001).
Differences in patterns of BTU at the popliteus muscle origin between primary TKA and revision prosthesis may be the result of decreased insertional tensile forces of the popliteus muscle after revision surgery due to increased stability provided by the revision design.
本研究旨在探讨全膝关节置换术（TKA）设计（保留交叉韧带（CR）、后稳定型（PS）、翻修假体）是否会影响腘肌起点处的骨示踪剂摄取（BTU）模式。
本回顾性研究共纳入 92 例（男：女=46:46）接受过 TKA 的膝关节，包括以下 3 组：（i）CR 初次 TKA（n=45）；（ii）PS 初次 TKA（n=24）；（iii）翻修 TKA（n=23）。所有患者在 TKA 手术后均接受 SPECT/CT 检查。使用 Syngo.via 软件（德国西门子医疗公司），由两名观察者对 SPECT/CT 图像进行评估，以评估外侧股骨髁（腘肌起点）处 BTU 的存在情况。观察者使用该软件对外侧股骨髁处的 BTU 模式进行定性记录，分为（i）无；（ii）存在且弥散；和（iii）存在且局限于腘肌起点区域。
在 CR 和 PS 设计的患者中，分别有 80.0%和 83.3%的患者出现腘肌起点处的局限性 BTU 增加。在翻修 TKA 患者中，弥漫性 BTU 是主要表现（60.9%）。CR 和 PS 设计之间的 BTU 模式无显著差异。然而，初次 TKA 设计和翻修 TKA 之间的 BTU 模式存在显著差异（p<0.001）。
初次 TKA 和翻修假体之间腘肌起点处 BTU 模式的差异可能是由于翻修设计提供的稳定性增加，导致腘肌插入张力下降所致。
