SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty
24 Feb 2014
Knee arthroplasty is a very successful treatment for osteoarthritis of the knee joint,however, careful scrutiny of the orthopaedic and radiological literature reveals that up to 20– 40 % of patients are not fully satisfied and symptom free following joint replacement, and complain of pain, stiffness, and loss of range of motion. The most common explanations for these are infection, aseptic loosening, instability, malposition of the prosthetic components, arthrofibrosis, and patellofemoral problems. To date, the clinical and radiological diagnostics tools (radiographs, CT, MRI, scintigraphy, SPECT, PET) are limited and do not clearly identify the site and cause of the patient’s symptoms.
In patients with unexplained symptoms following arthroplasty, SPECT/CT offers both radiologists and surgeons a rich source of information, combining mechanical, structural, and metabolic data on the patient’s knee joint. The combination of the use of three-dimensional (3D) reconstructed CT-based analysis of component position, orientation, mechanical and anatomical leg axes, as well as both the distribution and intensity of SPECT tracer uptake values has introduced a new dimension on diagnostics. Biomechanics and biology are brought together.
This video gives an overview on the clinical value, and current and future applications of SPECT/CT in patients after knee arthroplasty. In addition, clinical cases are shown and the clinical benefit in the treatment of these patients is highlighted.
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In patients with unexplained symptoms following arthroplasty, SPECT/CT offers both radiologists and surgeons a rich source of information, combining mechanical, structural, and metabolic data on the patient’s knee joint. The combination of the use of three-dimensional (3D) reconstructed CT-based analysis of component position, orientation, mechanical and anatomical leg axes, as well as both the distribution and intensity of SPECT tracer uptake values has introduced a new dimension on diagnostics. Biomechanics and biology are brought together.
This video gives an overview on the clinical value, and current and future applications of SPECT/CT in patients after knee arthroplasty. In addition, clinical cases are shown and the clinical benefit in the treatment of these patients is highlighted.
1 CPD credit
Watch the video and complete the online self-reflection form. Go to "My events" to download your certificate.
You must login to watch the video and receive CPD.
Duration:42 mins
Speaker info
Dr Michael T Hirschmann
Michael Hirschmann finished his medical school from the Johannes Gutenberg University in Mainz, Germany in 2003. As a former athlete it was his wish to become an orthopaedic surgeon. After his common trunk residency in surgery at the University Hospital of Basel, Switzerland he started his orthopaedic residency at Kantonsspital Bruderholz, Switzerland, under the leadership of Prof Niklaus Friederich. During his residency he specialised in knee surgery (reconstructive and arthroplasty) and achieved his board certification as an orthopaedic surgeon. Mr Hirschmann went on numerous fellowships such as a clinical and research fellowship at Imperial College in London, UK with Prof Justin Cobb and Prof Andrew Amis and a clinical sports medicine fellowship (AOA) with Dr John Bartlett in Melbourne, Australia. Other clinical fellowships took him to Tampere, Finland and Auckland, New Zealand. Since August 2013 he has served as the head of knee surgery at Kantonsspital Baselland (Bruderholz, Laufen, Liestal). This unit offers the entire variety of knee surgery from reconstructive to arthroplasty and revision surgery. From the beginning of his career he has been interested in clinical and experimental research, in particular imaging related research. In his residency he founded a research unit at Kantonsspital Bruderholz, which focuses on the improvement of orthopaedic related imaging and imaging analysis as well as clinical outcome studies. Mr Hirschmann is an internationally renowned orthopaedic surgeon and researcher having published over 90 peer-reviewed publications in international journals. He is active board member of numerous societies as well as editorial boards. His research is supported by national and international grant authorities. One major research focus lies in the investigation of the clinical applicability and value of SPECT/ CT for orthopaedic imaging. For this work his research group was awarded the Swiss Quality Award 2013 and the EANM Young Investigator Award 2013 for their contribution in SPECT/CT imaging in unhappy knee arthroplasty.