EN PL
ORIGINAL PAPER
Efficacy of radiation synovectomy (radiosynovectomy or radiosynoviorthesis) with yttrium-90 in exudative inflammation of synovial membrane of knee joints in patients with rheumatic diseases – preliminary report
 
More details
Hide details
 
Submission date: 2015-10-22
 
 
Final revision date: 2016-01-25
 
 
Acceptance date: 2016-02-22
 
 
Online publication date: 2016-03-24
 
 
Publication date: 2016-02-26
 
 
Reumatologia 2016;54(1):3-9
 
KEYWORDS
TOPICS
ABSTRACT
Objectives: Hypertrophic and exudative synovitis of the knee is one of the earliest symptoms in rheumatic diseases. In the case of pharmacotherapy failure, other methods which directly remove the inflamed synovial membrane are used – synovectomies. Radiosynovectomy (RSV) is the radiopharmaceutical application of colloidal solution to joint cavities. In this study, the authors assessed the efficacy of knee radiosynovectomy with yttrium-90 (Y-90) in several groups of patients divided into certain rheumatic diseases.
Material and methods: The study group consisted of 70 patients aged from 29 to 65 years with hypertrophic and exudative synovitis of the knee in rheumatic diseases such as rheumatoid arthritis, osteoarthrosis and spondyloarthropathies. Radiopharmaceutical colloid of Y-90, with a radiation dose of 185-222 MBq in a volume of 2-3 ml, was administered to joint. Then the knee joint was immobilized for 72 h. During visits V1, V2, V3 and V4, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured and ultrasound of the knee was performed. Disease activity was evaluated by the WOMAC scale, HAQ and 100-mm visual analog scale (VAS).
Results: The most significant difference of synovial hypertrophy, before and after the procedure, was obtained in patients with rheumatoid arthritis. Variability of effusion before and after the procedure in all groups was comparable and statistically significant. The greatest improvement in variability of inflammatory parameters, before and 4 weeks after radiosynovectomy, was observed in patients with rheumatoid arthritis.
Conclusions: In the therapeutic algorithm radiosynovectomy should be located between conservative treatment and operative procedures. Radiosynovectomy does not require hospitalization or prolonged rehabilitation. Radiosynoviorthesis affects the patient’s general condition, which is associated with eliminating pain and restoring joint function.
 
REFERENCES (14)
1.
Zwolak R, Majdan M, Zaorska-Rajca J, et al. Porównanie skuteczności oraz ocena wpływu synowiortezy chemicznej i radioizotopowej na nasilenie procesu zapalnego w terapii uporczywych wysięków w stawach kolanowych. Reumatologia 2005; 43: 327-330.
 
2.
Hagner W, Jeka S, et al. Ręka reumatoidalna – leczenie zachowawcze. In: Ręka reumatoidalna. UMK CM, Bydgoszcz 2006; 106-110.
 
3.
Delbarre F, Cayla J, Menkes C, et al. La synoviorthese par les radio-isotypes. Pres Med 1968; 76: 1045-1050.
 
4.
Fiedorowicz-Fabrycy I. Wyniki leczenia przewlekłych wysiękowych zapaleń stawów kolanowych za pomocą synowiortezy izotopowej P-32 w świetle badań własnych. Ann Acad Med Stetin 1984; 30: 321-357.
 
5.
Królicki L. Medycyna nuklearna. Fundacja im. Ludwika Rydygiera, Warszawa 1996; 30-33.
 
6.
Kampen WU, Brenner W, Czech N, et al. Intraarticular application of unsealed beta-emitting radionuclides in the treatment course of inflammatory joint diseases. Curr Med Chem – Anti-Inflammatory Anti-Allergy Agents 2002; 1: 77-87.
 
7.
Miszczyk L, Woźniak G, Jochymek B, et al. Ocena skuteczności radiosynowektomii stawu kolanowego przy użyciu 90Y. Przegl Lek 2007; 64: 450-453.
 
8.
Miszczyk L, Jochymek B, Spindel J, et al. Radiosynowektomia stawu kolanowego – doświadczenia własne. Chir Narz Ruchu Ortop Pol 2009; 74: 151-157.
 
9.
Jahangier ZN, Moolenburgh JD, Jacobs JW, et al. The effect of radiation synovectomy in patients with persistent arthritis: a prospective study. Clin Exp Rheumatol 2001; 19: 417-424.
 
10.
O’Duffy EK, Clunie GP, Lui D, et al. Double blind glucocorticoid controlled trial of samarium-153 particulate hydroxyapatite radiation synovectomy for chronic knee synovitis. Ann Rheum Dis 1999; 58: 554-558.
 
11.
Roch-Bras F, Daurès JP, Legouffe MC, et al. Treatment of chronic knee synovitis with arthroscopic synovectomy: longterm results. J Rheumatol 2002; 29: 1171-1175.
 
12.
Fischer M, Modder G. Radionuclide therapy of inflammatory joint diseases. Nucl Med Commun 2002; 23: 829-831.
 
13.
Chrapko B, Zwolak R, Nocuń A, et al. Radiation synovectomy with 90Y colloid in the therapy of recurrent knee joint effusions in patients with inflammatory joint diseases. Rheumatol Int 2007; 27: 729-734.
 
14.
Kresnik E, Mikosch P, Gallowitsch HJ, et al. Clinical outcome of radiosynoviorthesis: a meta-analysis including 2190 treated joints. Nucl Med Commun 2002; 23: 683-688.
 
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
eISSN:2084-9834
ISSN:0034-6233
Journals System - logo
Scroll to top