Aim: The aim of the study was to describe first experiences using FDG-PET in the examination of painful arthroplasties.
Method: 12 patients prior to revision of a total hip or knee joint replacement underwent PET. Histopathology, microbiological analysis and intraoperative diagnosis were compared to preoperative PET findings.
Results: The analysis of intraoperative findings, of microbiological examinations and of histopathology showed that besides the well known determinants infection and early postoperative granulation tissue, polyethylene wear induced foreign-body reaction was a major cause for increased FDG consumption.
Conclusion: In vivo imaging of marked foreign-body tissue reaction induced by polyethylene wear is feasible by FDG-PET. This observation, however, leads to reduced specificity of PET imaging for the diagnosis of periprosthetic infection.