Semin Musculoskelet Radiol 2019; 23(02): 177-194
DOI: 10.1055/s-0038-1677466
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Imaging of Total Ankle Arthroplasty: Normal Imaging Findings and Hardware Complications

Imran M. Omar
1   Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Samir F. Abboud
1   Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Jonathan M. Youngner
1   Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

Publication Date:
29 March 2019 (online)

Abstract

End-stage ankle osteoarthritis often significantly impacts patients' quality of life. This can be managed surgically either by ankle arthrodesis or total ankle arthroplasty (TAA). Although ankle arthrodesis is considered by some as the standard-of-care surgical option for this condition, it restricts range of motion and may lead to accelerated osteoarthritis of neighboring joints. Better understanding of ankle biomechanics, the biological effects of orthopaedic devices, and new surgical techniques have led to significant improvements in the designs of TAAs, and over the last several decades TAA has been used increasingly to treat patients with end-stage tibiotalar osteoarthritis. However, complication and ultimate failure rates remain greater than those seen with total knee and hip arthroplasty, and imaging is often critical in determining whether a prosthesis is beginning to fail. As a result, imagers should be familiar with the basic types of TAAs in clinical use, the normal radiographic appearances, as well as the common complications seen with this procedure.

 
  • References

  • 1 Cushnaghan J, Dieppe P. Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites. Ann Rheum Dis 1991; 50 (01) 8-13
  • 2 Barg A, Pagenstert GI, Hügle T. , et al. Ankle osteoarthritis: etiology, diagnostics, and classification. Foot Ankle Clin 2013; 18 (03) 411-426
  • 3 Glazebrook M, Daniels T, Younger A. , et al. Comparison of health-related quality of life between patients with end-stage ankle and hip arthrosis. J Bone Joint Surg Am 2008; 90 (03) 499-505
  • 4 Delco ML, Kennedy JG, Bonassar LJ, Fortier LA. Post-traumatic osteoarthritis of the ankle: a distinct clinical entity requiring new research approaches. J Orthop Res 2017; 35 (03) 440-453
  • 5 Goldberg AJ, MacGregor A, Dawson J. , et al. The demand incidence of symptomatic ankle osteoarthritis presenting to foot & ankle surgeons in the United Kingdom. Foot 2012; 22 (03) 163-166
  • 6 Daniels TR, Younger AS, Penner M. , et al. Intermediate-term results of total ankle replacement and ankle arthrodesis: a COFAS multicenter study. J Bone Joint Surg Am 2014; 96 (02) 135-142
  • 7 Haddad SL, Coetzee JC, Estok R, Fahrbach K, Banel D, Nalysnyk L. Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. A systematic review of the literature. J Bone Joint Surg Am 2007; 89 (09) 1899-1905
  • 8 Raikin SM, Rasouli MR, Espandar R, Maltenfort MG. Trends in treatment of advanced ankle arthropathy by total ankle replacement or ankle fusion. Foot Ankle Int 2014; 35 (03) 216-224
  • 9 Saltzman CL, Mann RA, Ahrens JE. , et al. Prospective controlled trial of STAR total ankle replacement versus ankle fusion: initial results. Foot Ankle Int 2009; 30 (07) 579-596
  • 10 Lord G, Marotte JH. Total ankle prosthesis. Technic and 1st results. Apropos of 12 cases [in French]. Rev Chir Orthop Repar Appar Mot 1973; 59 (02) 139-151
  • 11 Gougoulias N, Maffulli N. History of total ankle replacement. Clin Podiatr Med Surg 2013; 30 (01) 1-20
  • 12 Rybalko D, Schwarzman G, Moretti V. Recent national trends and outcomes in total ankle arthroplasty in the United States. J Foot Ankle Surg 2018; 57 (06) 1092-1095
  • 13 Syed F, Ugwuoke A. Ankle arthroplasty: a review and summary of results from joint registries and recent studies. EFORT Open Rev 2018; 3 (06) 391-397
  • 14 Roukis TS, Prissel MA. Registry data trends of total ankle replacement use. J Foot Ankle Surg 2013; 52 (06) 728-735
  • 15 Terrell RD, Montgomery SR, Pannell WC. , et al. Comparison of practice patterns in total ankle replacement and ankle fusion in the United States. Foot Ankle Int 2013; 34 (11) 1486-1492
  • 16 US Food and Drug Administration. Medical Device Databases. https://www.accessdata.fda.gov/SCRIPTS/cdrh/devicesatfda/index.cfm . Accessed September 27, 2018
  • 17 Lord G, Marotte JH. L'arthroplastie totale de cheville. Expérience sur 10 ans, à propos de 25 observations personnelles. Rev Chir Orthop 1980; 66: 527-530
  • 18 Saltzman CL. Perspective on total ankle replacement. Foot Ankle Clin 2000; 5 (04) 761-775
  • 19 Buchholz HW, Engelbrecht E, Siegel A. Totale Sprunggelenkprothese Modell “St. Georg.”. Chirurg 1973; 44: 241-244
  • 20 Kempson GE, Freeman MAR, Tuke MA. Engineering considerations in the design of an ankle joint. Biomed Eng 1975; 10 (05) 166-171 , 80
  • 21 Guyer AJ, Richardson G. Current concepts review: total ankle arthroplasty. Foot Ankle Int 2008; 29 (02) 256-264
  • 22 Wynn AH, Wilde AH. Long-term follow-up of the Conaxial (Beck-Steffee) total ankle arthroplasty. Foot Ankle 1992; 13 (06) 303-306
  • 23 Newton SE. An artificial ankle joint. Clin Orthop Relat Res 1979; (142) 141-145
  • 24 Dini AA, Bassett III FH. Evaluation of the early result of Smith total ankle replacement. Clin Orthop Relat Res 1980; (146) 228-230
  • 25 Kirkup J. Richard Smith ankle arthroplasty. J R Soc Med 1985; 78 (04) 301-304
  • 26 Takakura Y, Tanaka Y, Sugimoto K, Tamai S, Masuhara K. Ankle arthroplasty. A comparative study of cemented metal and uncemented ceramic prostheses. Clin Orthop Relat Res 1990; (252) 209-216
  • 27 Scholz KC. Total ankle arthroplasty using biological fixation components compared to ankle arthrodesis. Orthopedics 1987; 10 (01) 125-131
  • 28 Mulcahy H, Chew FS. Current concepts in total ankle replacement for radiologists: features and imaging assessment. AJR Am J Roentgenol 2015; 205 (05) 1038-1047
  • 29 Knecht SI, Estin M, Callaghan JJ. , et al. The Agility total ankle arthroplasty. Seven- to sixteen-year follow-up. J Bone Joint Surg Am 2004; 86-A (06) 1161-1171
  • 30 Spirt AA, Assal M, Hansen Jr ST. Complications and failure after total ankle arthroplasty. J Bone Joint Surg Am 2004; 86-A (06) 1172-1178
  • 31 Cerrato R, Myerson MS. Total ankle replacement: the Agility LP prosthesis. Foot Ankle Clin 2008; 13 (03) 485-494 , ix
  • 32 McCollum G, Myerson MS. Failure of the Agility total ankle replacement system and the salvage options. Clin Podiatr Med Surg 2013; 30 (02) 207-223
  • 33 DeVries JG, Scott RT, Berlet GC, Hyer CF, Lee TH, DeOrio JK. Agility to INBONE: anterior and posterior approaches to the difficult revision total ankle replacement. Clin Podiatr Med Surg 2013; 30 (01) 81-96
  • 34 Leszko F, Komistek RD, Mahfouz MR. , et al. In vivo kinematics of the Salto total ankle prosthesis. Foot Ankle Int 2008; 29 (11) 1117-1125
  • 35 Kofoed H. Scandinavian Total Ankle Replacement (STAR). Clin Orthop Relat Res 2004; (424) 73-79
  • 36 Robati S, Salih A, Ghosh K, Vinayakam P. The Scandinavian Total Ankle Replacement and the ideal biomechanical requirements of ankle replacements. J Orthop 2015; 13 (01) 48-51
  • 37 Yu JJ, Sheskier S. Total ankle replacement—evolution of the technology and future applications. Bull Hosp Jt Dis (2013) 2014; 72 (01) 120-128
  • 38 Reiley MA. INBONE total ankle replacement. Foot Ankle Spec 2008; 1 (05) 305-308
  • 39 Reiley MA. Total ankle arthroplasty with bone defects. Foot Ankle Spec 2009; 2 (01) 32-34
  • 40 Lewis Jr JS, Green CL, Adams Jr SB, Easley ME, DeOrio JK, Nunley JA. Comparison of first- and second-generation fixed-bearing total ankle arthroplasty using a modular intramedullary tibial component. Foot Ankle Int 2015; 36 (08) 881-890
  • 41 Adams Jr SB, Demetracopoulos CA, Queen RM, Easley ME, DeOrio JK, Nunley JA. Early to mid-term results of fixed-bearing total ankle arthroplasty with a modular intramedullary tibial component. J Bone Joint Surg Am 2014; 96 (23) 1983-1989
  • 42 Penner M, Davis WH, Wing K, Bemenderfer T, Waly F, Anderson RB. The Infinity Total Ankle System: early clinical results with 2- to 4-year follow-up. Foot Ankle Spec 2018; 11 (04) 1938640018777601
  • 43 Chou LB, Coughlin MT, Hansen Jr S. , et al. Osteoarthritis of the ankle: the role of arthroplasty. J Am Acad Orthop Surg 2008; 16 (05) 249-259
  • 44 Wood PL, Deakin S. Total ankle replacement. The results in 200 ankles. J Bone Joint Surg Br 2003; 85 (03) 334-341
  • 45 Wood PL, Crawford LA, Suneja R, Kenyon A. Total ankle replacement for rheumatoid ankle arthritis. Foot Ankle Clin 2007; 12 (03) 497-508 , vii
  • 46 Eichinger S, Forst R, Kindervater M. Indications and alternatives for arthroplasty in young patients [in German]. Orthopade 2007; 36 (04) 311-324
  • 47 Barg A, Knupp M, Hintermann B. Simultaneous bilateral versus unilateral total ankle replacement: a patient-based comparison of pain relief, quality of life and functional outcome. J Bone Joint Surg Br 2010; 92 (12) 1659-1663
  • 48 Kim BS, Knupp M, Zwicky L, Lee JW, Hintermann B. Total ankle replacement in association with hindfoot fusion: outcome and complications. J Bone Joint Surg Br 2010; 92 (11) 1540-1547
  • 49 Neufeld SK, Lee TH. Total ankle arthroplasty: indications, results, and biomechanical rationale. Am J Orthop 2000; 29 (08) 593-602
  • 50 Gill LH. Challenges in total ankle arthroplasty. Foot Ankle Int 2004; 25 (04) 195-207
  • 51 Doets HC, Brand R, Nelissen RG. Total ankle arthroplasty in inflammatory joint disease with use of two mobile-bearing designs. J Bone Joint Surg Am 2006; 88 (06) 1272-1284
  • 52 Kim BS, Lee JW. Total ankle replacement for the varus unstable osteoarthritic ankle. Tech Foot Ankle 2010; 9: 157-167
  • 53 Brunner S, Knupp M, Hintermann B. Total ankle replacement for the valgus unstable osteoarthritic ankle. Tech Foot Ankle 2010; 9: 165-174
  • 54 Hobson SA, Karantana A, Dhar S. Total ankle replacement in patients with significant pre-operative deformity of the hindfoot. J Bone Joint Surg Br 2009; 91 (04) 481-486
  • 55 Coetzee JC, Castro MD. Accurate measurement of ankle range of motion after total ankle arthroplasty. Clin Orthop Relat Res 2004; (424) 27-31
  • 56 Karantana A, Hobson S, Dhar S. The Scandinavian Total Ankle Replacement: survivorship at 5 and 8 years comparable to other series. Clin Orthop Relat Res 2010; 468 (04) 951-957
  • 57 Lee WT, Myerson MS, Grosshand KT. What variables influence final range of motion following total ankle arthroplasty. Foot and Ankle Orthopaedics 2016;1(1); http://doi.org/10.1177/2473011416S00027
  • 58 Bai LB, Lee KB, Song EK, Yoon TR, Seon JK. Total ankle arthroplasty outcome comparison for post-traumatic and primary osteoarthritis. Foot Ankle Int 2010; 31 (12) 1048-1056
  • 59 Berlet GC, Penner MJ, Lancianese S, Stemniski PM, Obert RM. Total ankle arthroplasty accuracy and reproducibility using preoperative CT scan-derived, patient-specific guides. Foot Ankle Int 2014; 35 (07) 665-676
  • 60 Hsu AR, Davis WH, Cohen BE, Jones CP, Ellington JK, Anderson RB. Radiographic outcomes of preoperative CT scan-derived patient-specific total ankle arthroplasty. Foot Ankle Int 2015; 36 (10) 1163-1169
  • 61 Werner S, Brage M. Comparison of two operative techniques for total ankle arthroplasty: intramedullary referencing vs CT scan-derived patient-specific guides. Foot Ankle Orthop 2016;1(1) Available at: https://www.aofas.org/PRC/meeting/Documents/2011.pdf
  • 62 Lawton CD, Butler BA, Dekker II RG, Prescott A, Kadakia AR. Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade. J Orthop Surg Res 2017; 12 (01) 76
  • 63 Jauregui JJ, Cherian JJ, Pierce TP, Beaver WB, Issa K, Mont MA. Long-term survivorship and clinical outcomes following total knee arthroplasty. J Arthroplasty 2015; 30 (12) 2164-2166
  • 64 Chu CR. Short-term analysis vs long-term data on total hip replacement survivorship. JAMA Surg 2015; 150 (10) 989
  • 65 Sadoghi P, Liebensteiner M, Agreiter M, Leithner A, Böhler N, Labek G. Revision surgery after total joint arthroplasty: a complication-based analysis using worldwide arthroplasty registers. J Arthroplasty 2013; 28 (08) 1329-1332
  • 66 Gougoulias N, Khanna A, Maffulli N. How successful are current ankle replacements?: a systematic review of the literature. Clin Orthop Relat Res 2010; 468 (01) 199-208
  • 67 Barg A, Zwicky L, Knupp M, Henninger HB, Hintermann B. HINTEGRA total ankle replacement: survivorship analysis in 684 patients. J Bone Joint Surg Am 2013; 95 (13) 1175-1183
  • 68 Pinar N, Vernet E, Bizot P, Brilhault J. Total ankle arthroplasty—total ankle arthroplasty in western France: influence of volume on complications and clinical outcome. Orthop Traumatol Surg Res 2012; 98 (4, Suppl): S26-S30
  • 69 Labek G, Todorov S, Iovanescu L, Stoica CI, Böhler N. Outcome after total ankle arthroplasty-results and findings from worldwide arthroplasty registers. Int Orthop 2013; 37 (09) 1677-1682
  • 70 Barnett CH, Napier JR. The axis of rotation at the ankle joint in man; its influence upon the form of the talus and the mobility of the fibula. J Anat 1952; 86 (01) 1-9
  • 71 Hicks JH. The mechanics of the foot. I. The joints. J Anat 1953; 87 (04) 345-357
  • 72 Evanski PH, Waugh TR. Management of arthritis of the ankle. An alternative of arthrodesis. Clin Orthop Relat Res 1977; (122) 110-115
  • 73 Pappas M, Buechel FF, DePalma AF. Cylindrical total ankle joint replacement: surgical and biomechanical rationale. Clin Orthop Relat Res 1976; (118) 82-92
  • 74 Vickerstaff JA, Miles AW, Cunningham JL. A brief history of total ankle replacement and a review of the current status. Med Eng Phys 2007; 29 (10) 1056-1064
  • 75 Lee AY, Ha AS, Petscavage JM, Chew FS. Total ankle arthroplasty: a radiographic outcome study. AJR Am J Roentgenol 2013; 200 (06) 1310-1316
  • 76 Glazebrook MA, Arsenault K, Dunbar M. Evidence-based classification of complications in total ankle arthroplasty. Foot Ankle Int 2009; 30 (10) 945-949
  • 77 Bestic JM, Peterson JJ, DeOrio JK, Bancroft LW, Berquist TH, Kransdorf MJ. Postoperative evaluation of the total ankle arthroplasty. AJR Am J Roentgenol 2008; 190 (04) 1112-1123
  • 78 Zaidi R, Cro S, Gurusamy K. , et al. The outcome of total ankle replacement: a systematic review and meta-analysis. Bone Joint J 2013; 95-B (11) 1500-1507
  • 79 Espinosa N, Klammer G, Wirth SH. Osteolysis in total ankle replacement: how does it work?. Foot Ankle Clin 2017; 22 (02) 267-275
  • 80 Hsu AR, Haddad SL, Myerson MS. Evaluation and management of the painful total ankle arthroplasty. J Am Acad Orthop Surg 2015; 23 (05) 272-282
  • 81 Arcângelo J, Guerra-Pinto F, Pinto A, Grenho A, Navarro A, Martin Oliva X. Peri-prosthetic bone cysts after total ankle replacement. A systematic review and meta-analysis. Foot Ankle Surg 2017; S1268-7731(17)31347-4
  • 82 van Wijngaarden R, van der Plaat L, Nieuwe Weme RA, Doets HC, Westerga J, Haverkamp D. Etiopathogenesis of osteolytic cysts associated with total ankle arthroplasty, a histological study. Foot Ankle Surg 2015; 21 (02) 132-136
  • 83 Singh G, Reichard T, Hameister R. , et al. Ballooning osteolysis in 71 failed total ankle arthroplasties. Acta Orthop 2016; 87 (04) 401-405
  • 84 Li SY, Myerson MS. Management of talar component subsidence. Foot Ankle Clin 2017; 22 (02) 361-389
  • 85 Mulcahy H, Chew FS. Current concepts in total ankle replacement for radiologists: complications. AJR Am J Roentgenol 2015; 205 (06) 1244-1250
  • 86 Jonck JH, Myerson MS. Revision total ankle replacement. Foot Ankle Clin 2012; 17 (04) 687-706
  • 87 Alrashidi Y, Galhoum AE, Wiewiorski M. , et al. How to diagnose and treat infection in total ankle arthroplasty. Foot Ankle Clin 2017; 22 (02) 405-423
  • 88 Manegold S, Haas NP, Tsitsilonis S, Springer A, Märdian S, Schaser KD. Periprosthetic fractures in total ankle replacement: classification system and treatment algorithm. J Bone Joint Surg Am 2013; 95 (09) 815-820 , S1–S3
  • 89 Brunner S, Barg A, Knupp M. , et al. The Scandinavian Total Ankle Replacement: long-term, eleven to fifteen-year, survivorship analysis of the prosthesis in seventy-two consecutive patients. J Bone Joint Surg Am 2013; 95 (08) 711-718
  • 90 Manegold S, Springer A, Landvoigt K, Tsitsilonis S. Heterotopic ossification after total ankle replacement: the role of prosthesis alignment. Foot Ankle Surg 2017; 23 (02) 122-127
  • 91 Dahabreh Z, Gonsalves S, Monkhouse R, Harris NJ. Extrusion of metal radiological marker from a total ankle replacement insert: a case report. J Foot Ankle Surg 2006; 45 (03) 185-189
  • 92 Kerkhoff YR, Kosse NM, Metsaars WP, Louwerens JW. Long-term functional and radiographic outcome of a mobile bearing ankle prosthesis. Foot Ankle Int 2016; 37 (12) 1292-1302
  • 93 Coester LM, Saltzman CL, Leupold J, Pontarelli W. Long-term results following ankle arthrodesis for post-traumatic arthritis. J Bone Joint Surg Am 2001; 83-A (02) 219-228
  • 94 Fuchs S, Sandmann C, Skwara A, Chylarecki C. Quality of life 20 years after arthrodesis of the ankle. A study of adjacent joints. J Bone Joint Surg Br 2003; 85 (07) 994-998
  • 95 Morrey BF, Wiedeman Jr GP. Complications and long-term results of ankle arthrodeses following trauma. J Bone Joint Surg Am 1980; 62 (05) 777-784
  • 96 Barg A, Wimmer MD, Wiewiorski M, Wirtz DC, Pagenstert GI, Valderrabano V. Total ankle replacement. Dtsch Arztebl Int 2015; 112 (11) 177-184
  • 97 Lee KJ, Wang SH, Lee GW, Lee KB. Accuracy assessment of measuring component position after total ankle arthroplasty using a conventional method. J Orthop Surg Res 2017; 12 (01) 115
  • 98 Kim DR, Choi YS, Potter HG. , et al. Total ankle arthroplasty: an imaging overview. Korean J Radiol 2016; 17 (03) 413-423
  • 99 Pyevich MT, Saltzman CL, Callaghan JJ, Alvine FG. Total ankle arthroplasty: a unique design. Two to twelve-year follow-up. J Bone Joint Surg Am 1998; 80 (10) 1410-1420
  • 100 Lohmann CH, Rampal S, Lohrengel M, Singh G. Imaging in peri-prosthetic assessment: an orthopaedic perspective. EFORT Open Rev 2017; 2 (05) 117-125
  • 101 Besse JL, Brito N, Lienhart C. Clinical evaluation and radiographic assessment of bone lysis of the AES total ankle replacement. Foot Ankle Int 2009; 30 (10) 964-975
  • 102 Hanna RS, Haddad SL, Lazarus ML. Evaluation of periprosthetic lucency after total ankle arthroplasty: helical CT versus conventional radiography. Foot Ankle Int 2007; 28 (08) 921-926
  • 103 Kohonen Ia, Koivu H, Pudas T, Tiusanen H, Vahlberg T, Mattila K. Does computed tomography add information on radiographic analysis in detecting periprosthetic osteolysis after total ankle arthroplasty?. Foot Ankle Int 2013; 34 (02) 180-188
  • 104 Viste A, Al Zahrani N, Brito N, Lienhart C, Fessy MH, Besse JL. Periprosthetic osteolysis after AES total ankle replacement: conventional radiography versus CT-scan. Foot Ankle Surg 2015; 21 (03) 164-170
  • 105 Kohonen Ia, Koivu H, Vahlberg T, Larjava H, Mattila K. Total ankle arthroplasty: optimizing computed tomography imaging protocol. Skeletal Radiol 2013; 42 (11) 1507-1513
  • 106 Pessis E, Campagna R, Sverzut JM. , et al. Virtual monochromatic spectral imaging with fast kilovoltage switching: reduction of metal artifacts at CT. Radiographics 2013; 33 (02) 573-583
  • 107 Khodarahmi I, Haroun RR, Lee M. , et al. Metal artifact reduction computed tomography of arthroplasty implants: effects of combined modeled iterative reconstruction and dual-energy virtual monoenergetic extrapolation at higher photon energies. Invest Radiol 2018; 53 (12) 728-735
  • 108 Lee MJ, Kim S, Lee SA. , et al. Overcoming artifacts from metallic orthopedic implants at high-field-strength MR imaging and multi-detector CT. Radiographics 2007; 27 (03) 791-803
  • 109 Koff MF, Burge AJ, Koch KM, Potter HG. Imaging near orthopedic hardware. J Magn Reson Imaging 2017; 46 (01) 24-39
  • 110 Berkowitz JL, Potter HG. Advanced MRI techniques for the hip joint: focus on the postoperative hip. AJR Am J Roentgenol 2017; 209 (03) 534-543
  • 111 Hayter CL, Koff MF, Shah P, Koch KM, Miller TT, Potter HG. MRI after arthroplasty: comparison of MAVRIC and conventional fast spin-echo techniques. AJR Am J Roentgenol 2011; 197 (03) W405-11
  • 112 de Cesar Netto C, Fonseca LF, Fritz B. , et al. Metal artifact reduction MRI of total ankle arthroplasty implants. Eur Radiol 2018; 28 (05) 2216-2227
  • 113 Awan O, Chen L, Resnik CS. Imaging evaluation of complications of hip arthroplasty: review of current concepts and imaging findings. Can Assoc Radiol J 2013; 64 (04) 306-313
  • 114 van der Bruggen W, Hirschmann MT, Strobel K. , et al. SPECT/CT in the postoperative painful knee. Semin Nucl Med 2018; 48 (05) 439-453
  • 115 Van den Wyngaert T, Paycha F, Strobel K. , et al. SPECT/CT in postoperative painful hip arthroplasty. Semin Nucl Med 2018; 48 (05) 425-438
  • 116 Hirschmann MT, Henckel J, Rasch H. SPECT/CT in patients with painful knee arthroplasty—what is the evidence?. Skeletal Radiol 2013; 42 (09) 1201-1207
  • 117 Hirschmann MT, Amsler F, Rasch H. Clinical value of SPECT/CT in the painful total knee arthroplasty (TKA): a prospective study in a consecutive series of 100 TKA. Eur J Nucl Med Mol Imaging 2015; 42 (12) 1869-1882
  • 118 Mason LW, Wyatt J, Butcher C, Wieshmann H, Molloy AP. Single-photon-emission computed tomography in painful total ankle replacements. Foot Ankle Int 2015; 36 (06) 635-640
  • 119 Van Acker F, Nuyts J, Maes A. , et al. FDG-PET, 99mtc-HMPAO white blood cell SPET and bone scintigraphy in the evaluation of painful total knee arthroplasties. Eur J Nucl Med 2001; 28 (10) 1496-1504
  • 120 Palestro CJ, Love C, Tronco GG, Tomas MB, Rini JN. Combined labeled leukocyte and technetium 99m sulfur colloid bone marrow imaging for diagnosing musculoskeletal infection. Radiographics 2006; 26 (03) 859-870