Журнал «Травма» Том 16, №3, 2015

Aim. Definition of the basic parameters of bone scintigraphy in surgery of patients with deforming osteoarthritis in hip arthroplasty.

Material and methods. The method of bone scintigraphy was studied 85 patients with deforming osteoarthritis , which was planned hip arthroplasty (57 women and 28 men) aged 31 to 75 years.
Bone scintigraphy was performed on single head scintillation gamma camera in a static mode in the front line and lateral projections . For the methodology used radiopharmaceutical 99mTc- pyrophosphate, 550-770 MBq activity that administered to the patient intravenously. Static bone scan was performed 3 hours after drug administration.

Results. According to the results of the preoperative diagnostic scan patients were divided into three groups. In all 39 (100 %) patients in the first group at a diagnostic postoperative scintigram projected complex articular prosthetic joint radiopharmaceutical accumulation percentage was 5 % - 65 %, in the projection of the proximal femur - 5 % - 20 %, compared with the symmetrical area of research. Functional state of Harris scale improved from 39 ± 4 to 77 ± 5. In 22 (76%) patients in the second group of diagnostic 6 months after prosthetic scans percentage accumulation indicator in the projection of the operated joint was 160% - 250%, in the projection of the proximal femur - 55% - 120%, compared with a symmetrical field of study . Functional state of Harris scale slightly improved from 31 ± 2 to 42 ± 4. In 19 (65%) patients of the second group a year after the joint replacement have been diagnosed post-operative complications in the operated articular complex (dislocation of the femoral head - in 13 (68%) patients, purulent-inflammatory complications - in 6 (32%) of the patients). In 14 (82%) patients of the third group according to postoperative diagnostic scintigraphy projected prosthetic joint radiopharmaceutical accumulation percentage was 215% - 380%, and the projections of the proximal femur 90% - 200%, compared to a symmetric area of research. Functional state of the scale Harris declined from 29 ± 3 to 22 ± 5. In 13 (76%) patients of the third group a year after the prosthesis was diagnosed with post-operative complications (purulent-inflammatory complications - in 5 (38%) patients, dislocation of the femoral head - in 6 (46%) patients, periprosthetic fracture - in 1 (8 %) patients, pulmonary embolism - in 1 (8%) patients).

Conclusion. The main parameters of the surgical bone scan activity in patients with osteoarthritis deforming, which allow hip arthroplasty without the risk of postoperative complications, you can define the following:
- percentage of accumulation of the radiopharmaceutical for diagnostic osteostsintigrammah osteoarthritis in the affected joint projection should be between 10% - 110%, relative to the symmetric field research;
- percentage of accumulation of the radiopharmaceutical in the projection of the proximal femur should be 5% - 50%, in relation to the symmetrical field of study.