Leucocytscintigraphy. Lene Rørdam Senior Consultant DMSci Department of Clinical Physiology and Nuclear Medicine Bispebjerg University Hospital
|
|
- Philip Mosley
- 5 years ago
- Views:
Transcription
1 Leucocytscintigraphy Lene Rørdam Senior Consultant DMSci Department of Clinical Physiology and Nuclear Medicine Bispebjerg University Hospital
2 Indications for leucocytscintigraphy in the past Inflammatory Bowel disease Akut and chronic osteomyelitis Failed joint replacements Fever of unknown origin Suspected antrabdominal absceses Suspected prosthetic graft infection
3 Two different radioactive pharmaceuticals for in-vitro labeled white blood cells 99m Tc- HMPAO Advantage Daily delivery Only labeling of the neutrophils (the other white cells dies). Plasma can be used as medium. Excelent imaging. Possibility for SPECT. Aquisition of imagies after 1-20 h. Low radiation dose (5.5mSv/500MBq) Disadvantage Unspecific excreation to the intestines via the bile (can be seen in 2-6% after some hours and nearly alwayes the day after injection) Excreated via the urine. 111 Indium Quantification of aktivity in the collected faeces over days. Possibility of imaging several days after injection. Dual isotope imaging. Has to be delivered. Labeling of all white blood cells. Plasma can be not used as medium due to high affinity to platelets and and plasmaproteines. Low imaging quality. Only late images High radiation dose (11.8mSv/20MBq)
4 Illustration of image quality with the two different radiopharmaceuticals
5 In-vitro labeling of the white blood cells Demands special laboratory facilities Not rutinely available Involves contact with blood from a potential infected patient Is time consuming (takes about 2½-3 hours) Labeling enough leucocytes to produce usefull studies Gentle handling of the blood to avoid activation of the leucocytes Repeating imaging some times up to 24 hours after injection In special cases supplementing with a marrow imaging It is not an easy investgation
6 Is there still indication for leukocyte scintigraphy if you have acces to other imaging modalities e.g. 18 FDG-PET/CT Yes But there are only few indications
7 Hip and knee arthroplasties Denmark: 8500 hip arthroplasties/year 9000 knee arthroplasties/year 95% uncomplicated for > 10 years 85% uncomplicated for > 15 years About 20% will get an aseptic loosening which often leeds to a revision arthroplasty 1%-2% will be infected (Revision arthroplasties 3%-10%) If infection is discovered less than 4 weeks after operation it can be saved othervise it has to be removed.
8 Palestro CJ: Nuclear medicine and the failed joint replacement: past, present and future. World J Radiol 2014; 6: The failed joint replacement The most common cause for prosthetic failore is aseptic loosening (about 20% of the devices) Results from an inflammatory reaction instigated by prosthetic components The debris created by component breakdown activates and draws surrounding leucocytes,(not neutrophils but monotcytes and macrophages) and trigger secreation of cytocines and enzymes damaging the osseus tissues leading to prosthetic loosening Septic loosening occurs in up to 1-2% of primary implants and in about 5% of revision implants Results in an inflammatory reaction characterized by a neutrophilic response, often intense. It is extremely important for the surgean to know if there is infection because it demands a two stage operation instead of a single stage exchange arthroplasty
9 Case 64 year old woman with a right knee prosthesis. Postoperative complicated by local infection. 8 months later there is increased infection parameters but no pain. Leucocytscintigraphy with 99m Tc-HMPAO was performed
10 Posterior Anterior
11 The normal distribution of leucocytes are the liver, spleen and red bone marrow. In subjects with joint arthroplasty there can be seen red bone marrow in the periprosthetic bone. This can be confirmed by a bone marrow scintigraphy In this patient a bone marrow scintigraphy ( 99m Tc- Nannocoll ) was performed 2 days later.
12 Posterior Anterior
13 Take home message If you are in doubt Do always a bone marrow scintigraphy to reduce false positive results
14 Case 49 year old woman with a left hip arthroplasty 10 years ago. During the last months there were increasing pain in the left hip and femur. X-ray was supected for loosening of the femur component. There is increased CRP but normal leucocytes. A 18F FDG-PET scanning was performed
15 There was increased FDG uptake around the prosthesis and in the synovialis of the hip joint Operation showed inflammation due to the polyethylene material. No infection
16 Case 80 year old woman had a right hip athroplasty 4 years ago. Came to a 18F FDG-PET/CT scanning as a control 1 year after operation for coloncancer.
17
18 Ultraguided puncture from the hip was positive for infection, wich was confirmed during operation.
19 Take home message There is a high likelihood for infection in an arthroplasty if you find 18F FDG uptake in the periphrostetic soft tissues Reinartz P et al. J Bone Joint Surg Br 2005; 87:
20 Case 71 year old man with a 2 year old revision arthroplasty in the right hip. He had pain on the lateral side of the femur and blood test showed increased CRP. X-ray without loosening. Ultrasound of the hip: i.a. A lucocytscintigrafphy was performed ( 99m Tc-HMPAO), And later on a bone marrow scintigraphy was performed ( 99m Tc-Nannocol )
21
22 The patient did not want a removal of the prosthesis, so an exploration was performed. There were clinical infection around a cerclage around trochanter major distally for the joint, which was removed. Puncture from the hip was clinically without infection, but all peroperative biopsies were after cultivation positive with staphylococcus capitis and staphylococcus epidermidis. The patient is now on lifelong antibiotic treatment.
23 Case 81 year old woman with a left hip arthroplasty from Due to luxations she got a revision arthroplasty in Now there is increasing pain from the left hip and x-ray suspects loosening. Leucocytscintigraphy with 99m Tc-HMPAO was performed
24 3 hours postinj. 21 hours postinj.
25 Bone marrow scintigraphy. Conclusion: Leucocytes are located in the red marrow. Operation: Aseptic loosening due to debris from metal breakdown from the prosthesis. (Metal-to.metal hip arthroplasty)
26 Case 66 year old man with a left knee prosthesis 10 months ealier. It has never been perfect and there is now increased pain and a swollen knee. Leucocytscintigraphy with 99m Tc-HMPAO was performed
27 Leucocytescintigraphy shows increased neutophile leucocytes around the prosthesis and in the syovialis of the knee joint. A bone marrow scintigraphy was performed after 6 days
28
29 Leucocyte scintigraphy Bone marrow scintigraphy There was no increase in neutrophile leucocytes accumulation from the early to the delayed images and the the red bone marrow showed the same distribution around the prosthesis, but there was synoviitis which gives suspecion of inflammation and not infection. Dermatological tests revealed allergy for neomycine (cross-allergy to gentamycine which is in the cement of the prosthesis) and puncture from the knee was negative for infection.
30 Take home message Leucocyte scintigraphy images should be taken both early (3 hours) and late (20 hours). Increasing accumulation of neutrophile leucocytes indicate infection. If you are in doubt do a bone marrow scintigraphy
31 Case 68 year old man with a left hip arthroplasty. (It was a revision arthroplasty due to infection.) Now there is constant pain in the hip and x-ray suspects loosening of the femur and acetabulum. Leucocytscintigraphy with 99m Tc-HMPAO and a 18F FDG-PET scanning was performed
32
33 18F FDG-PET/CT
34 Case There was clear signs of infection during the operation (Staphylococcus epidermidis). The arthroplasty was removed, and he was treated with antibiotics for 3 months. 6 month later a new prosthesis was inserted and he has been without symptoms now for 2 years.
35 49-year old woman had earlier an anterior cruciate ligament injury for which she was operated on several times. Got a right knee arthroplasty 1½ year ago.
36 Due to pain a bone scintigraphy was performed
37 Leucocytscintigraphy with 99m Tc-HMPAO. 3 hours postinj.
38 21 hours postinj.
39 Bone marrow scintigraphy with 99m Tc-Nanocoll Conclusion: Infection on the lateral side of femur. No signs of infection in tibia.
40 18F FDG-PET/CT
41 18F FDG-PET/CT
42 Operation results Clinical suspicion of infection on the lateral side of femur but biopsies were negative. Clinical no suspicion of infection in tibia and biopsies were negative.
43 66 year old man got a right hip hybrid arthroplasty after a hip fracture. 10 days after the operation he got a fracture of Trochanter major and the arthroplasty was replaced with a cemented arthroplasty. Since the operation there have been pain during walk. The patient has type 2 DM
44 Bone scintigraphy hø
45 Leucocytscintigraphy with 99m Tc-HMPAO 3 hours postinj. hø hø 22 hours postinj.
46 18F FDG-PET/CT
47 Operation results Totally loose femur arthroplasty Infection around trochanter major A large absces along the medial side of femur starting 10 cm distal for trochanter minor. Was left with a Girdlestone status and got a revision arthroplasty 4 month later. Without symptoms after 3 years
48 Leucocytscintigraphy with 99m Tc-HMPAO 3 hours postinj. hø hø 22 hours postinj.
49 18F FDG-PET/CT
50 Conclusion Elucidation of a failed joint replacement with radionuclide imaging: 1) Leucocytscintigraphy with early and late imaging. 2) If the results are difficult to interpretate: Do a bone marrow scintigraphy
51 END
Nuclear medicine and Prosthetic Joint Infections
Nuclear medicine and Prosthetic Joint Infections Christophe Van de Wiele, M.D., Ph.D. Department of Nuclear Medicine, University Hospital Ghent, Belgium Orthopedic prostheses: world market 1996 Prosthetic
More informationBone and prosthetic joint infections: what the ID specialist needs?
Bone and prosthetic joint infections: what the ID specialist needs? Andrej Trampuz Charité University Medicine Berlin Center for Septic Surgery Hip and knee replacements in Europe Germany Austria Belgium
More informationThe Painful Prosthetic Joint: Role of Nuclear Medicine
The Painful Prosthetic Joint: Role of Nuclear Medicine Christopher J. Palestro, M.D. Professor of Radiology Hofstra North Shore-LIJ of Medicine Chief Division of Nuclear Medicine & Molecular Imaging North
More informationINFECTION & INFLAMMATION IMAGING
INFECTION & INFLAMMATION IMAGING Radiopharmaceutical Drug Interactions & Other Interesting Case Studies MICHELLE RUNDIO, CNMT NCT MBA PCI NUCLEAR IN-111 WHITE BLOOD CELL IMAGING Interactions, Imaging Parameters
More informationInfection Imaging In Nuclear Medicine: Arguing The Case for PET/CT.
Infection Imaging In Nuclear Medicine: Arguing The Case for PET/CT. LUIS A. TAMARA M.D. NUCLEAR MEDICINE /PET-CT SERVICE CHIEF MEDVAMC DISCLOSURES. 2 3 Not difficult to appreciate the difference! GA-67
More informationSPECT/CT Imaging. Knee & Hip Prosthesis
SPECT/CT Imaging Knee & Hip Prosthesis Helmut Rasch, Michael T. Hirschmann Institute of Radiology and Nuclear Medicine, Dept. Orthopaedic Surgery and Traumatology, -Bruderholz, Switzerland helmut.rasch@unibas.ch
More informationNuclear Medicine: Manuals. Nuclear Medicine. Nuclear imaging. Emission imaging: study types. Bone scintigraphy - technique
Nuclear Medicine - Unsealed radioactive preparations the tracer mixes with the patients body fluids on a molecular level (e.g. after intravenous injection) - 3 main fields: - In vitro : measuring concentrations
More informationa Total Hip Prosthesis by Clostridum perfringens. A Case Report
Haematogenous Infection of a Total Hip Prosthesis by Clostridum perfringens. A Case Report CHAPTER 5 CHAPTER 5 5.1. Introduction In orthopaedic surgery, an infection of a prosthesis is a very serious,
More informationNuclear Medicine in the Diabetic Foot
26.11.2015, Uniklinik Balgrist Nuclear Medicine in the Diabetic Foot Martin Hüllner Nuklearmedizin und Neuroradiologie, USZ / UZH Outline A. Imaging modalities brief technical overview B. Nuclear medicine
More informationImaging of white blood cells with Scintimun
Imaging of white blood cells with Scintimun APRAMEN Réunion, Mardi 8 février 2011, Paris Wolf S. Richter SCINTIMUN : IgG1 antibody targeting white blood cells Tc-99m kit; murine IgG1 antibody target: NCA-95
More informationComplex Fractures and Hip Dislocations
IMAGING OF HIP PAIN Patients may present with acute (< 2 weeks) or chronic hip pain. Acute pain may be related or not related to an acute traumatic event such as fall or trauma from a motor vehicle accident.
More informationKnee Revision. Portfolio
Knee Revision Portfolio I use the DePuy Revision Knee System because of its versatility. With this system I can solve nearly any situation I encounter in the OR. Dr. Thomas Fehring, OrthoCarolina Hip and
More informationProlonged infection at the tibial bone tunnel after anterior cruciate ligament reconstruction
Fukushima J. Med. Sci., Vol. 63, No. 2, 2017 [Case Report] Prolonged infection after ACL Reconstruction 121 Prolonged infection at the tibial bone tunnel after anterior cruciate ligament reconstruction
More informationDetection of abscesses and infection in soft tissues, particularly in patients without localizing findings.
NUCLEAR MEDICINE SERVICES SUBJECT: WHITE BLOOD CELL STUDY Overview Indications The White Blood Cell Study demonstrates the distribution of labeled autologous white blood cells within the body at various
More informationAmerican College of Radiology ACR Appropriateness Criteria Imaging After Total Knee Arthroplasty
Revised 2017 American College of Radiology ACR Appropriateness Criteria Imaging After Total Knee Arthroplasty Variant 1: Follow-up of the asymptomatic patient with a total knee arthroplasty. Radiologic
More information18F-FDG PET-CT IMAGING IN INFECTION AND INFLAMMATION
18F-FDG PET-CT IMAGING IN INFECTION AND INFLAMMATION Professor Dr. Alex Maes AZ Groeninge Kortrijk and KULeuven Belgium TOPICS FDG PET(-CT) IMAGING IN INFECTION Skeletal infection Fever of unknown origin
More informationDIRECT ANTERIOR APPROACH
DIRECT ANTERIOR APPROACH JOINT REPLACEMENT PROGRAM 2301 25TH STREET SOUTH FARGO ND 58103 CENTER FOR MINIMAL INVASIVE JOINT SURGERY (p) 701-241-9300 (tf) 866-887-9300 www.jointpain.md FARGO FERGUS FALLS
More informationPET and SPECT in Osteomyelitis and Prosthetic Bone and Joint Infections: A Systematic Review
PET and SPECT in Osteomyelitis and Prosthetic Bone and Joint Infections: A Systematic Review Wouter van der Bruggen, MD,* Chantal P. Bleeker-Rovers, MD, PhD,, Otto C. Boerman, PhD,*, Martin Gotthardt,
More informationKnee Replacement Complications
Knee Replacement Complications Knee replacements have become a routine surgery in the United States. Nearly 700,000 people each year receive this life-improving surgery and are able to enjoy richer, more
More informationCLINICAL AND OPERATIVE APPROACH FOR TOTAL KNEE REPLACEMENT DR.VINMAIE ORTHOPAEDICS PG 2 ND YEAR
CLINICAL AND OPERATIVE APPROACH FOR TOTAL KNEE REPLACEMENT DR.VINMAIE ORTHOPAEDICS PG 2 ND YEAR Evolution of TKR In 1860, Verneuil proposed interposition arthroplasty, involving the insertion of soft tissue
More informationPlain Film CT. Principal Modality (2): Case Report # [] Date accepted: 15 March 2014
Radiological Category: Musculoskeletal Principal Modality (1): Principal Modality (2): Plain Film CT Case Report # [] Submitted by: Dr. Jason E. Lally, M.D. Faculty reviewer: Dr. Naga Ramesh Chinapuvvula,
More informationRadionuclide Imaging of Infection & Inflammation
Radionuclide Imaging of Infection & Inflammation Christopher J. Palestro, M.D. Professor of Radiology Hofstra North Shore-LIJ School of Medicine Chief Division of Nuclear Medicine & Molecular Imaging North
More informationBalgrist Shoulder Course 2017
Diagnosis and Management of Infection in Revision Shoulder Arthroplasty Joseph P. Iannotti MD, PhD Maynard Madden Professor and Chairman Orthopaedic and Rheumatologic Institute Cleveland Clinic Conflict
More informationBilateral total knee arthroplasty: One mobile-bearing and one fixed-bearing
Journal of Orthopaedic Surgery 2001, 9(1): 45 50 Bilateral total knee arthroplasty: One mobile-bearing and one fixed-bearing KY Chiu, TP Ng, WM Tang and P Lam Department of Orthopaedic Surgery, The University
More informationSPECT CT in the Evaluation of Musculoskeletal Disease
SPECT CT in the Evaluation of Musculoskeletal Disease Dr. Kevin Banks Department of Radiology San Antonio Military Medical Center and Health Education Consortium Assistant Professor of Radiology and Nuclear
More informationCase report: Pain L THR [ post THR 2 years; with history of trivial fall] Your Diagnosis?
Case report: Pain L THR [ post THR 2 years; with history of trivial fall] Your Diagnosis? Diagnosis: Ceramic head fracture In the 1970 s, Boutin implemented ceramic in modern total hip arthroplasty (THA).
More informationR/F. Can T-smart Tomosynthesis Improve Diagnostic Accuracy on THA Component Stability? 1. Abstract
R/F Can T-smart Tomosynthesis Improve Diagnostic Accuracy on THA Component Stability? Professor and Chair Dept. of Adult Reconstructive Surgery Beijing Jishuitan Hospital, the 4th Clinical College of PKU
More informationOSTEOMYELITIS. If it occurs in adults, then the axial skeleton is the usual site.
OSTEOMYELITIS Introduction Osteomyelitis is an acute or chronic inflammatory process of the bone and its structures secondary to infection with pyogenic organisms. Pathophysiology Osteomyelitis may be
More informationClinical Study The Diagnostic Accuracy of Radionuclide Arthrography for Prosthetic Loosening in Hip and Knee Arthroplasty
BioMed Research International Volume 2013, Article ID 693436, 4 pages http://dx.doi.org/10.1155/2013/693436 Clinical Study The Diagnostic Accuracy of Radionuclide Arthrography for Prosthetic Loosening
More informationSPECT/CT in knee pain
in knee pain Dr Lu Suat Jin MB, M.Med, FRCR, FAMS Department of Diagnostic Imaging National University Hospital, Singapore Tc-99m methylene diphosphonate (MDP) Sensitivity Detect bone abnormalities early
More information04/03/2013. Second Annual BIR SPECT/CT Symposium London, UK 25/02/2013. NMD: Al-Jahra Hospital. NMD: Al-Jahra Hospital
Second Annual BIR SPECT/CT Symposium London, UK 25/02/2013 1 Muhammad Umar Khan, FCPS Al-Jahra Hospital; PET/CT Suite: Kuwait Cancer Control Center 25/02/2012 SPECT/CT in Imaging Infection Kuwait 25/02/2013
More informationTotal Knee Replacement
Total Knee Replacement A total knee replacement, also known as total knee arthroplasty, involves removing damaged portions of the knee, and capping the bony surfaces with man-made prosthetic implants.
More informationEARLY CLINICAL RESULTS OF PRIMARY CEMENTLESS TOTAL KNEE ARTHROPLASTY
EARLY CLINICAL RESULTS OF PRIMARY CEMENTLESS TOTAL KNEE ARTHROPLASTY Benkovich V. Perry T., Bunin A., Bilenko V., Unit for Joint Arthroplasty, Soroka Medical Center Ben Gurion University of Negev Beer
More informationRevision Total Hip Replacement
Revision Total Hip Replacement Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany), FJOA (Japan) Commonwealth Fellow Joint Replacement (Royal National Orthopaedic
More informationDr. Ashish Shah MD Dr. John Kirchner MD Dr. Sameer Naranje MD
Dr. Ashish Shah MD Dr. John Kirchner MD Dr. Sameer Naranje MD Assistant Professor, UAB Orthopaedic Surgery, Foot & Ankle Section, 1313 13th Street South, Birmingham, AL 35205 Clinical Instructor Fellow,
More informationBone Bangalore
Dr Suresh Annamalai MBBS, MRCS(Edn), FRCS( Tr & Orth)(Edn), FEBOT(European Board), Young Hip and Knee Fellowship(Harrogate, UK) Consultant Arthroplasty and Arthroscopic Surgeon Manipal Hospital, Whitefield,
More informationOriginal Date: December 2015 Page 1 of 8 FOR CMS (MEDICARE) MEMBERS ONLY
National Imaging Associates, Inc. Clinical guidelines TOTAL JOINT ARTHROPLASTY -Total Hip Arthroplasty -Total Knee Arthroplasty -Replacement/Revision Hip or Knee Arthroplasty CPT4 Codes: Please refer to
More informationKnee Replacement Implants
Knee Replacement Implants During knee replacement surgery, an orthopaedic surgeon will resurface your damaged knee with artificial components, called implants. There are many different types of implants.
More informationBoth Knee Re-revision Operations with Different Types of Endoprosthesis after Septic Complications
DOI: 10.2478/v10163-012-0036-2 ACTA CHIRURGICA LATVIENSIS 2011 (11) CASE REPORT Both Knee Re-revision Operations with Different Types of Endoprosthesis after Septic Complications Silvestris Zebolds*/***,
More informationSelected Issues in Nonneoplastic. Orthopaedic Pathology. Diseases of Diarthrodial Joints and their Complications
1 2 3 Selected Issues in Nonneoplastic Orthopaedic Pathology Diseases of Diarthrodial Joints and their Complications Biology of articular hyaline cartilage Arthritis Osteonecrosis Prosthetic Joints Metabolic
More informationComplications of Total Knee Arthroplasty
Progress in Clinical Medicine Complications of Total Knee Arthroplasty JMAJ 44(5): 235 240, 2001 Shinichi YOSHIYA*, Masahiro KUROSAKA** and Ryosuke KURODA*** *Director, Department of Orthopaedic Surgery,
More informationMr Aslam Mohammed FRCS, FRCS (Orth) Consultant Orthopaedic Surgeon Specialising in Lower Limb Arthroplasty and Sports Injury
Mr Aslam Mohammed FRCS, FRCS (Orth) Consultant Orthopaedic Surgeon Specialising in Lower Limb Arthroplasty and Sports Injury I qualified from the Welsh National School of Medicine in Cardiff in 1984. I
More informationMessage of the Month for GPs June 2013
Message of the Month for GPs June 2013 Dr Winn : Consultant Musculoskeletal Radiologist, Manchester Royal Infirmary Imaging of the musculoskeletal system Musculoskeletal pain is a common problem in the
More informationNational Joint Replacement Registry. Lay Summary 2015 Annual Report Hip and Knee Replacement
National Joint Replacement Registry Lay Summary 2015 Annual Report Hip and Knee Replacement SUPPLEMENTARY REPORT 2015 TABLE OF CONTENTS Introduction... 1 A brief history of the Registry origins... 1 The
More informationTotal Knee Replacement
Total Knee Replacement Frequently Asked Questions What is a knee replacement? A knee replacement is an elective surgery, replacing the bottom end of the femur and the top end of the tibia with a man made
More informationAnterior Thigh pain after Total Hip Arthroplasty (THA): Atypical case
Anterior Thigh pain after Total Hip Arthroplasty (THA): Atypical case Dr.Saurabh Agarwal 1, Dr. Jitesh Jain 2, Dr. Rajeev K Sharma 3 ABSTRACT Background: Anterior thigh pain after THA is a common reason
More informationStefan Rahm MD University Hospital Balgrist
Knee Prosthesis Models & Materials, Surgical Techniques and Approaches Stefan Rahm MD University Hospital Balgrist INTRODUCTION VARUS VALGUS 46 Y OLD MALE Pain in the medial compartment left more than
More informationCAUTION Federal law (USA) restricts this device to sale, by or on the order of a physician.
CAUTION Federal law (USA) restricts this device to sale, by or on the order of a physician. ENGLISH Mpact 3D Metal Implants and Augments 3D Metal INSTRUCTION FOR USE Important notice: the device(s) can
More informationIntroduction. A. Signore 1 & F. Jamar 2 & O. Israel 3 & J. Buscombe 4 & J. Martin-Comin 5 & E. Lazzeri 6
European Journal of Nuclear Medicine and Molecular Imaging https://doi.org/10.1007/s00259-018-4052-x GUIDELINES Clinical indications, image acquisition and data interpretation for white blood cells and
More informationOptimum implant geometry
Design Rationale Optimum implant geometry Extending proven Tri-Lock heritage The original Tri-Lock was introduced in 1981. This implant was the first proximally coated tapered-wedge hip stem available
More informationTypes of bone/joint infections. Bone and Joint Infections. Septic Arthritis. Pathogenesis. Pathogenesis. Bacterial arthritis: predisposing factors
Bone and Joint Infections Types of bone/joint infections Arthritis (infective/septic) Osteomyelitis Prosthetic bone and joint infections Septic Arthritis Common destructive athroplasty Mono-articular Poly-articular
More informationOsteoarthrosis, unspecified whether generalized or localized, lower leg. Osteoarthrosis, localized, not specified whether primary or secondary, pelvic
Page 1 Appendix TABLE E-1 Codes (and Definitions) in Humana Database Used for Study Inclusion and Exclusion of Patients Who Underwent,, or 1 to 2-Level Inclusion ICD-9-P-8154 Total knee replacement ICD-9-D-71596
More information28 Surgical Technique
Surgical Technique 10 12 14 16 18 20 22 24 28 26 Technique described by James L. Guyton, MD Campbell Clinic Memphis, Tennessee James W. Harkess, MD Campbell Clinic Memphis, Tennessee David G. LaVelle,
More informationCLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 11/24/2012 Radiology Quiz of the Week # 100 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationImaging of Complications After Limb Prostheses Implantation in Children with Bone Tumors
Signature: Pol J Radiol, 2017; 82: 227-232 DOI: 10.12659/PJR.900644 ORIGINAL ARTICLE Received: 2016.07.17 Accepted: 2016.08.12 Published: 2017.04.22 Authors Contribution: A Study Design B Data Collection
More informationMap 48: Rate of metal-on-metal hip resurfacing procedures undertaken per population by PCT
162 NHS ATLAS OF VARIATION PROBLEMS OF THE MUSCULO-SKELETAL SYSTEM Map 48: Rate of metal-on-metal hip resurfacing procedures undertaken per population by PCT Directly standardised rate 2009/10 Domain 2:
More informationThis publication is not intended for distribution in the USA.
This publication is not intended for distribution in the USA. Extraction of a CORAIL Stem Surgical Technique Introduction Given the excellent long-term results of the CORAIL stem, 1,2,3 its extraction
More informationAOTrauma / AORecon Masters Course Periprosthetic Fractures (Course with Anatomical Specimen)
Sunday, 13 May 2018 (Day 1) 15:00 17:00 Other Registration of participants 17:00 18:00 Opening remarks Opening ceremony 18:00 19:00 Other AOTRAUMA RECEPTION 120 1 / 10 Monday, 14 May 2018 (Day 2) 08:00
More informationImprove your quality of life after medially stabilized knee arthroplasty
G K SPHERE MEDIALLY STABILIZED KNEE Improve your quality of life after medially stabilized knee arthroplasty IMPROVE YOUR QUALI 2 All trademarks and registered trademarks are the property of their respective
More informationUpdate in Nuclear Imaging of Amyloidosis and Sarcoidosis
Update in Nuclear Imaging of Amyloidosis and Sarcoidosis Balaji Tamarappoo MD, PhD, Cedars-Sinai Heart Institute and Biomedical Imaging Research Institute Cedars-Sinai Medical Center Los Angeles, CA, USA.
More informationUniversity of Groningen. Nuclear medicine imaging of posttraumatic osteomyelitis Govaert, G. A. M.; Glaudemans, Andor W.J.M.
University of Groningen Nuclear medicine imaging of posttraumatic osteomyelitis Govaert, G. A. M.; Glaudemans, Andor W.J.M. Published in: European Journal of Trauma and Emergency Surgery DOI: 10.1007/s00068-016-0647-8
More informationCIRCUMFERENTIAL PROXIMAL FEMORAL ALLOGRAFTS IN REVISION SURGERY ON TOTAL HIP ARTHROPLASTY: CASE REPORTS WITH A MINIMUM FOLLOW-UP OF 20 YEARS
CASE REPORT CIRCUMFERENTIAL PROXIMAL FEMORAL ALLOGRAFTS IN REVISION SURGERY ON TOTAL HIP ARTHROPLASTY: CASE REPORTS WITH A MINIMUM FOLLOW-UP OF 20 YEARS Bruno Dutra Roos 1, Milton Valdomiro Roos 2, Antero
More informationA Patient s Guide to Partial Knee Resurfacing
A Patient s Guide to Partial Knee Resurfacing Surgical Outcomes System (SOS ) www.orthoillustrated.com OrthoIllustrated is a leading Internet-based resource for patient education. Please visit this website
More informationFor Commercial products, please refer to the following policy: Preauthorization via Web-Based Tool for Procedures
Medical Coverage Policy Total Joint Arthroplasty Hip and Knee EFFECTIVE DATE: 08/01/2017 POLICY LAST UPDATED: 06/06/2017 OVERVIEW Joint replacement surgery, also known as arthroplasty, has proved to be
More informationTotal Knee Original System Primary Surgical Technique
Surgical Procedure Total Knee Original System Primary Surgical Technique Where as a total hip replacement is primarily a bony operation, a total knee replacement is primarily a soft tissue operation. Excellent
More informationBiomechanics of. Knee Replacement. Mujda Hakime, Paul Malcolm
Biomechanics of Knee Replacement Mujda Hakime, Paul Malcolm 1 Table of contents Knee Anatomy Movements of the Knee Knee conditions leading to knee replacement Materials Alignment and Joint Loading Knee
More informationChapter 10. Summary, conclusions and future perspectives
Chapter 10 Summary, conclusions and future perspectives 10.1 SUMMARY In this thesis, a new tumor imaging tracer in nuclear medicine is studied. This 123 tracer, L-3-[ I]Iodo-alpha-methyl-tyrosine (IMT),
More informationWhat Are Hip and Knee Replacement Implants Made Of?
What Are Hip and Knee Replacement Implants Made Of? Hip and knee replacement surgery involve replacing the worn-out bone and cartilage lining your hip or knee joint with new implants that are composed
More information*smith&nephew SLR-PLUS
Surgical Technique *smith&nephew SLR-PLUS Cementless Revision Stem SLR-PLUS Table of Contents Comments from the Author s Clinic... 3 Indications... 4 Contraindications... 5 Preoperative Planning... 5
More informationProf. Dr. NAGUI M. ABDELWAHAB,M.D.; MARYSE Y. AWADALLAH, M.D. AYA M. BASSAM, Ms.C.
Role of Whole-body Diffusion MR in Detection of Metastatic lesions Prof. Dr. NAGUI M. ABDELWAHAB,M.D.; MARYSE Y. AWADALLAH, M.D. AYA M. BASSAM, Ms.C. Cancer is a potentially life-threatening disease,
More informationPotential usefulness of 68 Ga-citrate PET/CT in detecting infected lower limb prostheses
Tseng et al. EJNMMI Research (2019) 9:2 https://doi.org/10.1186/s13550-018-04-3 ORIGINAL RESEARCH Open Access Potential usefulness of Ga-citrate PET/CT in detecting infected lower limb prostheses Jing-Ren
More informationTreatment of infection
Clinica Ortopedica e Traumatologica Università degli Studi di Pavia Fondazione IRCCS Policlinico San Matteo Chairman: Prof. F. Benazzo Goals: - Healing of infection - Healing of fracture - Try to keep
More informationChallenging clinical situation
Challenging clinical situation A young patient with prosthetic aortic valve endocarditis Gilbert Habib La Timone Hospital Marseille - France October 25 th 2014 Case report History of the disease Clinical
More informationVasu Pai D orth, MS, National Board [orth],mch, FRACS, FICMR Total Hip Arthroplasty
Vasu Pai D orth, MS, National Board [orth],mch, FRACS, FICMR Total Hip Arthroplasty Introduction Hip arthritis is a common problem, most often due to osteoarthritis. In hip arthritis affects a patient,
More informationScintillations. spect lab. A group of donkeys led by a lion can defeat a group of lions led by a donkey - Socrates. nuclear medicine services
Scintillations A group of donkeys led by a lion can defeat a group of lions led by a donkey - Socrates solov - PETCT Volume III / Issue I January - March 2010 spect lab nuclear medicine services Visit
More informationTwo-Stage Revision Arthroplasty in the Management of Periprosthetic Joint Infections. Can Spacer Be a Source of Reinfection?
Dwuetapowa endoprotezoplastyka rewizyjna w leczeniu zakażeń okołoprotezowych. Czy spacer może stanowić źródło reinfekcji? Two-Stage Revision Arthroplasty in the Management of Periprosthetic Joint Infections.
More informationOptimum implant geometry
Design Rationale Optimum implant geometry Extending the proven Tri-Lock heritage The original Tri-Lock was introduced in 1981. This implant was the first proximally coated tapered-wedge hip stem available
More informationSTIMULAN POWER TO TRANSFORM OUTCOMES
STIMULAN POWER TO TRANSFORM OUTCOMES Perfect partner for your infection management strategy In contrast to today s growing economic and performance challenges, STIMULAN has been shown to transform outcomes
More informationCementing better outcomes
Cementing better outcomes The challenge Orthopaedic surgeons are demanding a simpler and superior bone cement solution for implant placement procedures. Surgeons need a bone cement portfolio with the necessary
More informationOperations included in the National Joint Registry (NJR) Quick links, go to: Hips > Knees > Ankles > Elbows > Shoulders > Trauma >
Operations included in the National Joint Registry (NJR) Quick links, go to: Hips > Knees > Ankles > Elbows > Shoulders > Trauma > Version 5 December 2013 1 Version control Version number Date Amendments
More informationSection of total knee replacement. Total Knee Replacement System. Knieendoprothesen System. Système de prothèse totale de genou
Section of total knee replacement Total Knee Replacement System Knieendoprothesen System Système de prothèse totale de genou Introduction: This knee system features great versality with its modular component
More informationOrthopaedic And Trauma Surgery Of The Hip In Obese Patients. Sébastien LUSTIG MD, PhD, Prof Albert Trillat Center Lyon - France
Orthopaedic And Trauma Surgery Of The Hip In Obese Patients Sébastien LUSTIG MD, PhD, Prof Albert Trillat Center Lyon - France Obesity and Hip Surgery Osteoarthritis and Obesity Risk factors (if surgery)
More informationRobotic-Arm Assisted Surgery
Mako TM Robotic-Arm Assisted Surgery for Total Hip Replacement A Patient s Guide Causes of Your Hip Pain Your joints are involved in almost every activity you do. Movements such as walking, bending and
More informationHip Complications Knee Complications
Hip Complications Knee Complications Early Late Definition Less than 3 months Stephen R Smith Orthopaedic Surgeon Northeast Nebraska Orthopaedics P C Norfolk Nebraska Postoperative Course of the Total
More informationIndex. orthopedic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Acetabular fractures pediatric, 494 498 classification of, 494 diagnostic imaging of, 494, 496 497 epidemiology of, 494 treatment of, 494 498
More informationSPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος
SPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος Δρ Αναστασία Κίτσιου Διευθύντρια, Καρδιολογική Κλινική, Σισμανόγλειο ΓΝΑ Chair, Education Committee, Section on Nuclear Cardiology & Cardiac CT, EACVI, ESC
More informationoperative technique Kent Hip
operative technique Kent Hip The Kent Hip Operative Technique The Kent Hip was developed by Mr Cliff Stossel, FRCS in Maidstone, Kent, UK and first implanted in 1986. It was designed to deal with problems
More informationAGGRESSIVE GRANULOMATOUS LESIONS AFTER HIP ARTHROPLASTY
AGGRESSIVE GRANULOMATOUS LESIONS AFTER HIP ARTHROPLASTY KAJ TALLROTH, ANTTI ESKOLA, SEPPO SANTAVIRTA, YRJ T. KONTTINEN, T. SAM LINDHOLM From the Orthopaedic Hospitalofthe Invalid Foundation, Helsinki We
More informationCementless Oxford unicompartmental knee replacement shows reduced radiolucency at one year
Cementless Oxford unicompartmental knee replacement shows reduced radiolucency at one year H. Pandit, C. Jenkins, D. J. Beard, J. Gallagher, A. J. Price, C. A. F. Dodd, J. W. Goodfellow, D. W. Murray From
More informationTotal Hip Replacement
PATIENT EDUCATION Total Hip Replacement A guide to understanding total hip replacement surgery, featuring The George Archer Story. BACK TO MOBILITY George Archer s Personal Adventure On April16, 1996,
More informationEXTENDED TROCHANTERIC OSTEOTOMY SURGICAL TECHNIQUE FPO EXTENSIVELY COATED FIXATION
EXTENDED TROCHANTERIC OSTEOTOMY SURGICAL TECHNIQUE FPO EXTENSIVELY COATED FIXATION SINCE 1983 PREOPERATIVE PLANNING EXPLANTATION OPTIONS the cement from inside the cement canal until the bone/ cement bond
More informationREVISION TOTAL KNEE REPLACEMENT
PATIENT INFORMATION SHEET YOU ARE GOING TO UNDERGO REVISION TOTAL KNEE REPLACEMENT and sports traumatology ORTHOPAEDIC SURGERY Doctor Philippe Paillard Office YOU HAVE A LOOSENING OF THE KNEE PROSTHESIS
More informationJOINT RULER. Surgical Technique For Knee Joint JRReplacement
JR JOINT RULER Surgical Technique For Knee Joint JRReplacement INTRODUCTION The Joint Ruler * is designed to help reduce the incidence of flexion, extension, and patellofemoral joint problems by allowing
More informationAustin Radiological Association Nuclear Medicine Procedure PET SODIUM FLUORIDE BONE SCAN (F-18 NaF)
Austin Radiological Association Nuclear Medicine Procedure PET SODIUM FLUORIDE BONE SCAN (F-18 NaF) Overview Indication Sodium Fluoride F18 injection is a radioactive diagnostic agent for positron emission
More informationDual Mobility Cups. Kris Govaers, MD, PhD Dendermonde Belgium
Dual Mobility Cups Kris Govaers, MD, PhD Dendermonde Belgium Introduction Indications Limitations Conclusions All good things in life come from France Gilles Bousquet 1979 + Rambert (SERF) Inventions Bousquet
More informationANATOMIC. Navigated Surgical Technique 4 in 1 TO.G.GB.016/1.0
ANATOMIC Navigated Surgical Technique 4 in 1 TO.G.GB.016/1.0 SCREEN LAYOUT Take screenshot Surgical step Dynamic navigation zone Information area and buttons 2 SCREEN LAYOUT Indicates action when yellow
More informationINSTRUMENTS. Product Rationale
INSTRUMENTS Product Rationale R E C O V E R Y F U N C T I O N S U R V I V O R S H I P DePuy believes in an approach to knee arthroplasty that places equal importance on recovery, function and survivorship.
More informationINSTRUMENTS. Design Rationale
INSTRUMENTS Design Rationale High Performance instruments that support your approach, your patient demand and your choice of knee system. Contemporary total knee arthroplasty demands high performance instrumentation
More information