Study finds, Increased Patellar bone tracer uptake in preope
The purpose of this study was to investigate whether specific bone tracer uptake (BTU) patterns on preoperative SPECT/CT could predict which patients with varus alignment and medial overload would particularly benefit from medial opening-wedge high tibial osteotomy (MOWHTO).

23 knees from 22 patients who underwent MOWHTO for medial compartment overload were investigated preoperatively using Tc-99m-SPECT/CT. BTU was quantified and localised to specific joint areas according to a previously validated scheme. Pre- and postoperative mechanical alignment was measured. Clinical outcome was assessed at a median of 24 months after MOWHTO by collecting the WOMAC score.

--Significant correlations between BTU in the patellar area and the total WOMAC score and its subcategories pain and stiffness were found.

--Thus, BTU in the 1sPat area (superior lateral patellar compartment) correlated with total WOMAC (rho=0.43), pain subcategory (rho=0.43), and stiffness subcategory (rho=0.59).

--No significant correlations were found between alignment correction, age, gender and WOMAC.

Conclusively, this study highlights the role of preoperative SPECT in modern knee surgery to obtain information about the loading pattern on different compartments of the knee. It can help the treating surgeons to identify patients who may be at risk of inferior clinical outcome if an MOWHTO is considered, as an elevated BTU in the patellar region on preoperative SPECT/CT appears to be a potential risk factor for postoperative pain and stiffness.