ROLE OF ISOTOPE BONE SCAN IN MANAGEMENT OF PAINFUL ARTHROPLASTY

Abstract

Aim: Isotope bone scan has become a part of the routine workup for a painful arthroplasty. A retrospective analysis was performed to analyse the significance of isotope bone scan results in the management of painful arthroplasty.

Methods and Materials: The study group included all the 58 consecutive patients who underwent an isotope bone scan for a painful arthroplasty over a one year period. The data collected included: age, sex, date and nature of primary arthroplasty, inflammatory markers, indication, date and result of the bone scan, and the final outcome.

Results: The primary arthroplasty was a TKR (29 patients) and THR (29 patients). The average duration between primary arthroplasty and the bone scan was 44.3 months (Range 5 – 195 months). The duration was less than 1 year for 6 patients. The average age of the patients was 62 years. The male: female ratio was 31:27. 4 of the arthroplasties were uncemented and 54 were cemented. The bone scan results were normal in 32 patients, unclear in 17 patients and abnormal in 9 patients. There was no statistical correlation found between the inflammatory markers and the results of the bone scan.

Discussion: The results of the bone scan made a significant contribution in the management decision of the patient in 8 of the patients and served to reassure the patient/surgeon in most of the rest 50. In 6 patients it was performed within a year of the primary arthroplasty, during which period the results are not very specific. An isotope bone scan involves a significant radiation exposure to the patient as well utilization of time and resources, hence always ask the million dollar question: “Is it going to alter my management plan”