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Use of technetium bone scans to help predict whether patellar resurfacing will be successful in treating pain after primary total knee arthroplasty

Fine, Stephen, MBBCh, FRACS; Watson, Anna, BPhty, MBBS, FRACS

doi: 10.1097/BCO.0000000000000746
Original Research

Background: Patellar resurfacing does not always alleviate anterior knee pain after total knee arthroplasty. This study sought to determine if technetium 99 bone scan after primary total knee arthroplasty helps predict if subsequent patellar resurfacing surgery will be successful.

Methods: A retrospective review of patients who had isolated patellar resurfacing (or patellar resurfacing and tibial insert exchange) after primary total knee arthroplasty was performed via a telephone interview. Patients had technetium 99 bone scans in their workup, and the scans were considered positive if uptake in the patella was greater than elsewhere in the knee. Three outcome measures were used: level of patient satisfaction, amount of pain relief, and whether the patient would choose to have the surgery again. Correlations were sought between the results of the bone scans and patient outcome measures.

Results: Twenty-two of 35 patients were interviewed. There were 15 (68%) positive bone scans, and of these 14 (93%) had good outcomes and one (7%) had a poor outcome. There were seven (32%) negative bone scans, and of these two (29%) had good outcomes and five (71%) had poor outcomes.

Conclusions: In patients who develop pain after primary total knee arthroplasty, a technetium bone scan may help to predict which patients will benefit from a subsequent patellar resurfacing procedure

Department of Orthopaedic Surgery, Greenslopes Private Hospital, Greenslopes, Brisbane, Qld, Australia

Financial Disclosure: The authors report no conflicts of interest.

Correspondence to Stephen Fine, MBBCh, FRACS, P.O. Box 1226, Carindale Qld 4152, Australia Tel: +61 7 38479966; fax: +61 7 33977877; e-mail:

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