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No added value using SPECT/CT to analyze persistent symptoms after anterior cruciate ligament reconstruction

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

A Correction to this article was published on 20 March 2019

This article has been updated

Abstract

Purpose

To evaluate the diagnostic and clinical value of SPECT/CT compared to the standard algorithm for patients with persistent symptoms after anterior cruciate ligament reconstructions. The standard algorithm uses clinical information, conventional radiographs, MRI and CT scan, while the trial algorithm uses the same information but SPECT/CT in addition.

Methods

In a diagnostic comparative trial three experienced surgeons evaluated 23 consecutive patients with persistent symptoms after ACL reconstruction using first standard and second the trial algorithm with a time interval. Each rater had to establish a diagnosis and therapeutic decision with each algorithm. On MRI, graft continuity, bone marrow edema, chondral and meniscal lesions, femoral notch osteophytes were evaluated. Bone tracer uptake in SPECT/CT was anatomically analyzed and compared with MRI findings. MRI findings and SPECT/CT tracer uptake were correlated using Spearman’s rho test.

Results

Additional SPECT/CT analysis did not change diagnosis in any case and did not correlate with clinical graft integrity. Treatment decisions remained unchanged as well. Chondral lesions, arthritic changes, meniscal lesions, graft impingement are best visualized in MRI and showed correspondent tracer uptake in SPECT/CT. Tunnel position was well classified with standard CT scan and showed no correlation with SPECT/CT tracer uptake.

Conclusion

Information derived by SPECT/CT in addition to the standard algorithm using clinical information, X-rays, MRI, and CT scan did not change the diagnosis or treatment plan. There is currently no justification to implement SPECT/CT for patients with persistent symptoms after anterior cruciate ligament reconstructions.

Level of evidence

Level II: diagnostic comparative study.

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Change history

  • 20 March 2019

    The shared first authorship of Christian Egloff, MD and Lukas Huber was always planned and correctly acknowledged.

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Acknowledgements

Data collection and correlation analysis were mainly conducted by the medical student Lukas Huber under the guidance of the first author and final approval and initial set-up of the senior author. This work will be used to apply for the Medical Doctor degree of Lukas Huber (dissertation at the University of Basel, Switzerland).

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland

    Christian Egloff

  2. University of Basel, Basel, Switzerland

    Lukas Huber

  3. Department of Orthopaedic Sports Medicine, Technische Universität München (TUM), Ismaninger Str. 22, 81675, Munich, Germany

    Markus Wurm

  4. Department of Clinical Research, University of Basel, Schanzenstr. 55, 4056, Basel, Switzerland

    Geert Pagenstert

  5. Clarahof Clinic of Orthopaedic Surgery, Merian-Iselin-Hospital Swiss Olympic Medical Center, Foehrenstr. 2, 4054, Basel, Switzerland

    Geert Pagenstert

  6. Knee Institute Basel, Mittlere Str. 129, 4056, Basel, Switzerland

    Geert Pagenstert

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  1. Christian Egloff
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Correspondence to Christian Egloff.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Egloff, C., Huber, L., Wurm, M. et al. No added value using SPECT/CT to analyze persistent symptoms after anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg 139, 807–816 (2019). https://doi.org/10.1007/s00402-019-03117-7

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  • DOI: https://doi.org/10.1007/s00402-019-03117-7

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