2021 ISAKOS Biennial Congress ePoster
SPECT/CT Helps Predict Degree of Clinical Improvement Following Medial Opening-Wedge High Tibial Osteotomy
Yong Gyu Sung, MD, Seoul KOREA, REPUBLIC OF
Man-Soo Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Dong-Chul Park, MD, Seoul, South Korea KOREA, REPUBLIC OF
Jae Jung Kim, MD, Seoul KOREA, REPUBLIC OF
Yong In, MD, PhD, Seoul KOREA, REPUBLIC OF
Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
SPECT/CT was a useful tool to help predict degree of improvement in clinical outcomes in patients undergoing MOWHTO.
ePosters will be available shortly before Congress
Abstract
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.