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SPECT/CT Helps Predict Degree of Clinical Improvement Following Medial Opening-Wedge High Tibial Osteotomy

Yong Gyu Sung, MD
KOREA, REPUBLIC OF

SPECT/CT Helps Predict Degree of Clinical Improvement Following Medial Opening-Wedge High Tibial Osteotomy

Yong Gyu Sung, MD, KOREA, REPUBLIC OF Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dong-Chul Park, MD, KOREA, REPUBLIC OF Jae Jung Kim, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF

Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Seoul, KOREA, REPUBLIC OF

2021 Congress ePoster Presentation Not yet rated

Anatomic Location

Knee

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Osteotomy

Patient Populations

Elderly

Diagnosis Method

X-ray CT-Scan

This media is available to current ISAKOS Members, Global Link All-Access Subscribers and Webinar/Course Registrants only.

Summary: SPECT/CT was a useful tool to help predict degree of improvement in clinical outcomes in patients undergoing MOWHTO.

Background

Qualitative studies have explored changes in Tc-99m hydroxymethylene diphosphonate (HDP) uptake on single photon emission-computed tomography and computed tomography (SPECT/CT) according to offloading after medial opening-wedge high tibial osteotomy (MOWHTO) in patients with medial compartment knee osteoarthritis (OA). However, whether changes in the Tc-99m HDP uptake on SPECT/CT reflect the degree of clinical improvement in postoperative outcomes, especially when using minimal clinically important differences (MCIDs), has not been investigated.

Purpose

In the present study, the association between changes in Tc-99m HDP uptake on SPECT/CT after MOWHTO and degree of improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score based on MCID in patients undergoing MOWHTO was investigated.

Methods

The present study included 35 MOWHTOs of 31 patients who underwent SPECT/CT preoperatively and 3 years postoperatively with clinical and radiological assessments. Uptake on SPECT/CT was measured using Mirada XD software. On SPECT/CT, the knee joint was divided into 10 regions and the radiotracer uptake amount of each region was divided by the uptake amount of the reference zone. Patients were divided into two groups based on whether they achieved MCID of 16.1 in total WOMAC score 3 years postoperatively. Changes in uptake amount on SPECT/CT were compared between the two groups.

Results

At 3 years postoperatively, 22 patients (62.9%) achieved MCID of 16.1 in the total WOMAC score (Above MCID group) and 13 patients (37.1%) did not (Below MCID group). Significant improvement was observed in total WOMAC score after MOWHTO in the Above MCID group (55.8–19.6, p < 0.05); however, significant improvement was not observed in the Below MCID group (38.8–32.3, p = 0.100). Based on average change of uptake on SPECT/CT in each region, the Above MCID group showed significantly greater change of uptake on the SPECT/CT than the Below MCID group in femur anteromedial compartment (p = 0.004), tibia anteromedial compartment (p = 0.009), and tibia anterolateral compartment (p = 0.031).

Conclusion

SPECT/CT was a useful tool to help predict degree of improvement in clinical outcomes in patients undergoing MOWHTO.

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SPECT/CT Helps Predict Degree of Clinical Improvement Following Medial Opening-Wedge High Tibial Osteotomy

SPECT/CT Helps Predict Degree of Clinical Improvement Following Medial Opening-Wedge High Tibial Osteotomy

Background

Purpose

Methods

Results

Conclusion

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SPECT/CT Helps Predict Degree of Clinical Improvement Following Medial Opening-Wedge High Tibial Osteotomy

SPECT/CT Helps Predict Degree of Clinical Improvement Following Medial Opening-Wedge High Tibial Osteotomy

Background

Purpose

Methods

Results

Conclusion