Author(s)

Masakazu Kanetaka¹, Soichiro Kaneko¹, Kei Wagatsuma², Kenji Ishii², Kimiteru Ito³, Shinya Nakamura¹, Hiroshi Hamaji¹, Yukimasa Yamato⁴, Yorito Anamizu⁴, Fumiaki Tokimura¹, Tsuyoshi Miyazaki^1*

¹Department of Orthopaedic Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
²Research Team for Neuroimaging Research, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
³Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
⁴Department of Spine Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.

Artificial joint replacement surgery is the orthopedic procedure of choice to relieve pain, correct joint deformities, and help patients resume everyday activities. However, the detailed mechanisms regulating peri-implant bone remodeling at the bone-prosthesis interface remain elusive. To address this gap in knowledge, we evaluated the natural postoperative course of bone metabolism by using [¹⁸F] NaF positron emission tomography (PET)/computed tomography in 57 patients (104 joints) who underwent asymptomatic total knee arthroplasty (TKA). First, we measured total tracer uptake around TKA to determine the total bone metabolism (TBM) and used the ischial tuberosity as the reference tissue for normalization of PET images. Second, we calculated the TBM ratio (TBMR) by dividing the TBM by tracer uptake in the reference tissue. A moderate increase in TBMR was observed 4 - 5 days after implantation, and its intensity reached the maximum on the seventh postoperative day. The TBMR showed no differences until 12 weeks, after which it decreased slowly and returned to the basal levels. The new parameter TBMR and the unique pattern of postoperative metabolic changes in the bone around the prosthesis may help set accurate interpretation criteria to diagnose complications such as loosening or infections.

NaF, PET, Bone Metabolism, Total Knee Arthroplasty, Ischial Tuberosity

Kanetaka, M. , Kaneko, S. , Wagatsuma, K. , Ishii, K. , Ito, K. , Nakamura, S. , Hamaji, H. , Yamato, Y. , Anamizu, Y. , Tokimura, F. and Miyazaki, T. (2018) Natural Postoperative Bone Metabolic Changes after Total Knee Arthroplasty Determined by Positron Emission Tomography Scans. Open Journal of Orthopedics, 8, 443-457. doi: 10.4236/ojo.2018.812046.