Skip to main content
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 8/2019

25.05.2019 | Original Article

A prospective observational study on the long-term results of 90Yttrium citrate radiosynoviorthesis of synovitis in osteoarthritis of the knee joint

verfasst von: Margit Szentesi, Zoltán Nagy, Pal Géher, István Papp, Willm Uwe Kampen

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 8/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Radiosynoviorthesis (RSO) is used for the treatment of inflammatory joint diseases. However, there are no long-term results published comparing it to conservative therapy. Therefore, the aim of this prospective observational study was to evaluate response rates after radionuclide therapy in patients suffering from knee osteoarthritis over a time period of 10 years.

Methods

Radionuclide therapy with intra-articular administration of colloidal 90Yttrium citrate was performed in osteoarthritic patients [Kellgren–Lawrence grades I/II (n = 69) and Kellgren–Lawrence grade III (n = 72)].

Results

In patients with early-stage disease, an excellent/good response with respect to pain, joint mobility, and function was observed in 82.5% for 1 year and in 73.7% for 8 years after therapy. Responses declined to 50% at 10 years post treatment. In grade III patients, an excellent/good response was observed in 45.9%; a decline to 41.2% was observed in the first 8 years. In this group, the number of patients available for follow-up after 9 and 10 years dropped significantly from 51 patients after 8 years to only 30 patients after 9 years, and to nine patients after 10 years. As a result, these response rates were not appraisable.

Conclusion

Long-term results of radiosynoviorthesis in knee osteoarthritis are excellent/good in many patients. The response rate depends on Kellgren–Lawrence stages, and early-stage radionuclide therapy for osteoarthritis is suggested.
Literatur
2.
Zurück zum Zitat Conaghan PG, Kloppenburg M, et al. Osteoarthritis research priorities: a report from a EULAR ad hoc expert committee. Ann Rheum Dis. 2014;73:1442–5. CrossRefPubMed Conaghan PG, Kloppenburg M, et al. Osteoarthritis research priorities: a report from a EULAR ad hoc expert committee. Ann Rheum Dis. 2014;73:1442–5. CrossRefPubMed
4.
Zurück zum Zitat March IM, Bachmeier CMJ. Economics of osteoarthritis: a global perspective. Baillieres Clin Rheumatol. 1997;11:817–34. CrossRefPubMed March IM, Bachmeier CMJ. Economics of osteoarthritis: a global perspective. Baillieres Clin Rheumatol. 1997;11:817–34. CrossRefPubMed
5.
Zurück zum Zitat Reginster JY, Khaltaev NG. Introduction and WHO perspective on the global burden of musculoskeletal conditions. Rheumatology. 2002;41(Suppl. 1):1–2. CrossRefPubMed Reginster JY, Khaltaev NG. Introduction and WHO perspective on the global burden of musculoskeletal conditions. Rheumatology. 2002;41(Suppl. 1):1–2. CrossRefPubMed
7.
Zurück zum Zitat Nwosu IN, Mapp PI, et al. Relationship between structural pathology and pain behaviour in a model of osteoarthritis (OA). Osteoarthr Cartil. 2016;24:1910–7. CrossRefPubMedPubMedCentral Nwosu IN, Mapp PI, et al. Relationship between structural pathology and pain behaviour in a model of osteoarthritis (OA). Osteoarthr Cartil. 2016;24:1910–7. CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Miller RE, Malfait AM, Block JA. Current status of nerve growth factor antibodies for the treatment of osteoarthritis pain. Clin Exp Rheumatol. 2017;35(Suppl 107):85–7. PubMedPubMedCentral Miller RE, Malfait AM, Block JA. Current status of nerve growth factor antibodies for the treatment of osteoarthritis pain. Clin Exp Rheumatol. 2017;35(Suppl 107):85–7. PubMedPubMedCentral
9.
Zurück zum Zitat Neogi T, Guermazi A, et al. Association of joint inflammation with pain sensitization in knee osteoarthritis: a multicenter osteoarthritis study. Arthritis Rheumatol. 2016;68:654–61. CrossRefPubMedPubMedCentral Neogi T, Guermazi A, et al. Association of joint inflammation with pain sensitization in knee osteoarthritis: a multicenter osteoarthritis study. Arthritis Rheumatol. 2016;68:654–61. CrossRefPubMedPubMedCentral
10.
11.
Zurück zum Zitat Gent YYJ, terWee MM, et al. Subclinical synovitis detected by macrophage PET, but not MRI, is related to short-term flare of clinical disease activity in early RA patients: an exploratory study. Arthritis Res Ther. 2015;17:266. CrossRefPubMedPubMedCentral Gent YYJ, terWee MM, et al. Subclinical synovitis detected by macrophage PET, but not MRI, is related to short-term flare of clinical disease activity in early RA patients: an exploratory study. Arthritis Res Ther. 2015;17:266. CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Fellinger K, Schmidt J. Die lokale Behandlung der rheumatischen Erkrankungen [Local treatment of rheumatoid diseases]. Wien Z Inn Med. 1952;33:351–63 (German). PubMed Fellinger K, Schmidt J. Die lokale Behandlung der rheumatischen Erkrankungen [Local treatment of rheumatoid diseases]. Wien Z Inn Med. 1952;33:351–63 (German). PubMed
14.
Zurück zum Zitat Altmann RD, Meenan RF, et al. An approach to developing criteria for the clinical diagnosis and classification of osteoarthritis. J Rheumatol. 1983;10:180–3. Altmann RD, Meenan RF, et al. An approach to developing criteria for the clinical diagnosis and classification of osteoarthritis. J Rheumatol. 1983;10:180–3.
16.
Zurück zum Zitat Szentesi M, Piroska E. Yttrium-90 radiosynoviorthesis in rheumatoid and traumatic chronic synovitis of the knee. Comparative evaluation. M Traumat Orth. 1995;38:129–34 (Hungarian). Szentesi M, Piroska E. Yttrium-90 radiosynoviorthesis in rheumatoid and traumatic chronic synovitis of the knee. Comparative evaluation. M Traumat Orth. 1995;38:129–34 (Hungarian).
17.
Zurück zum Zitat Szentesi M, Berkes I, et al. Macroscopic and microscopic changes following Yttrium-90 radiosynoviorthesis in rheumatoid arthritis. Hung Rev Sports Med. 1994;35:107–16 (Hungarian). Szentesi M, Berkes I, et al. Macroscopic and microscopic changes following Yttrium-90 radiosynoviorthesis in rheumatoid arthritis. Hung Rev Sports Med. 1994;35:107–16 (Hungarian).
19.
Zurück zum Zitat Royal College of Physicians. Osteoarthritis — national clinical guideline for care and management in adults. Sudbury: Lavenham Press; 2008. Royal College of Physicians. Osteoarthritis — national clinical guideline for care and management in adults. Sudbury: Lavenham Press; 2008.
20.
Zurück zum Zitat AAOS American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (non-arthroplasty). J Am Acad Orthop Surg. 2009;17(9):591–600. CrossRef AAOS American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (non-arthroplasty). J Am Acad Orthop Surg. 2009;17(9):591–600. CrossRef
21.
Zurück zum Zitat Tracy CL, Edison JD. Intra-articular corticosteroid treatment of inflammatory joint diseases. In: Kampen WU, Fischer M, editors. Local treatment of inflammatory joint diseases. Benefits and risks. Heidelberg: Springer; 2015. Tracy CL, Edison JD. Intra-articular corticosteroid treatment of inflammatory joint diseases. In: Kampen WU, Fischer M, editors. Local treatment of inflammatory joint diseases. Benefits and risks. Heidelberg: Springer; 2015.
22.
Zurück zum Zitat Weber MEA. Rational intra-articular corticoid injection. Schweiz Med Wochenschr. 1997;127:945–53. PubMed Weber MEA. Rational intra-articular corticoid injection. Schweiz Med Wochenschr. 1997;127:945–53. PubMed
25.
Zurück zum Zitat Raynold J-P, Buckland-Wright C, et al. Safety and efficacy of long-term intra-articular steroid injections in osteoarthritis of the knee — a randomized, double blind, placebo-controlled trial. Arthritis Rheum. 2003;48:370–7. CrossRef Raynold J-P, Buckland-Wright C, et al. Safety and efficacy of long-term intra-articular steroid injections in osteoarthritis of the knee — a randomized, double blind, placebo-controlled trial. Arthritis Rheum. 2003;48:370–7. CrossRef
27.
Zurück zum Zitat Kampen WU, Hellweg L, et al. Clinical efficacy of radiation synovectomy in digital joint osteoarthritis. Eur J Nucl Med Mol Imaging. 2005;32:575–80. CrossRefPubMed Kampen WU, Hellweg L, et al. Clinical efficacy of radiation synovectomy in digital joint osteoarthritis. Eur J Nucl Med Mol Imaging. 2005;32:575–80. CrossRefPubMed
28.
Zurück zum Zitat Szentesi M, Piroska E, et al. The effectiveness of 90Yttrium radiosynoviorthesis following orthopedic interventions. M Traumat Ortop. 1996;39:247–58 (Hungarian). Szentesi M, Piroska E, et al. The effectiveness of 90Yttrium radiosynoviorthesis following orthopedic interventions. M Traumat Ortop. 1996;39:247–58 (Hungarian).
29.
Zurück zum Zitat Kresnik E, Mikosch P, et al. Clinical outcome of radiosynoviorthesis: a meta-analysis including 2190 treated joints. Nucl Med Commun. 2002;23:683–8. CrossRefPubMed Kresnik E, Mikosch P, et al. Clinical outcome of radiosynoviorthesis: a meta-analysis including 2190 treated joints. Nucl Med Commun. 2002;23:683–8. CrossRefPubMed
30.
Zurück zum Zitat Chatzopoulos D, Moralidis E, et al. Yttrium-90 radiation synovectomy in knee osteoarthritis: a prospective assessment at 6 and 12 months. Nucl Med Commun. 2009;30:472–9. CrossRefPubMed Chatzopoulos D, Moralidis E, et al. Yttrium-90 radiation synovectomy in knee osteoarthritis: a prospective assessment at 6 and 12 months. Nucl Med Commun. 2009;30:472–9. CrossRefPubMed
31.
Zurück zum Zitat Zuderman L, Liepe K. Radiosynoviorthesis (RSO): influencing factors and therapy monitoring. Ann Nucl Med Imaging. 2008;22:735–41. CrossRef Zuderman L, Liepe K. Radiosynoviorthesis (RSO): influencing factors and therapy monitoring. Ann Nucl Med Imaging. 2008;22:735–41. CrossRef
32.
Zurück zum Zitat Wong Y, Cherk MH, et al. Efficacy of yttrium-90 synovectomy across a spectrum of arthropathies in an era of improved modifying drugs and treatment protocols. Int J Rheum Dis. 2014;17:78–83. CrossRefPubMed Wong Y, Cherk MH, et al. Efficacy of yttrium-90 synovectomy across a spectrum of arthropathies in an era of improved modifying drugs and treatment protocols. Int J Rheum Dis. 2014;17:78–83. CrossRefPubMed
33.
Zurück zum Zitat Clunie G, Fischer M. EANM procedure guideline for radiosynovectomy. Eur J Nucl Med. 2003;30:BP12–6. CrossRef Clunie G, Fischer M. EANM procedure guideline for radiosynovectomy. Eur J Nucl Med. 2003;30:BP12–6. CrossRef
34.
Zurück zum Zitat Jahangier ZN, Jacobs JWG, et al. Pretreatment macrophage infiltration of the synovium predicts the clinical effect of both radiation synovectomy and intra-articular glucocorticoids. Ann Rheum Dis. 2006;65:1286–92. Jahangier ZN, Jacobs JWG, et al. Pretreatment macrophage infiltration of the synovium predicts the clinical effect of both radiation synovectomy and intra-articular glucocorticoids. Ann Rheum Dis. 2006;65:1286–92.
35.
Zurück zum Zitat Krenn V, Morawietz L, et al. Synovitis score: discrimination between chronic low-grade and high-grade synovitis. Histopathology. 2006;49:358–64. CrossRefPubMed Krenn V, Morawietz L, et al. Synovitis score: discrimination between chronic low-grade and high-grade synovitis. Histopathology. 2006;49:358–64. CrossRefPubMed
36.
Zurück zum Zitat Fischer M, Brinker A, Sickmüller B. Safety of medicines: detection and reporting adverse reactions. In: Kampen WU, Fischer M, editors. Local treatment of inflammatory joint diseases. Benefits and risks. Heidelberg: Springer; 2015. Fischer M, Brinker A, Sickmüller B. Safety of medicines: detection and reporting adverse reactions. In: Kampen WU, Fischer M, editors. Local treatment of inflammatory joint diseases. Benefits and risks. Heidelberg: Springer; 2015.
Metadaten
Titel
A prospective observational study on the long-term results of 90Yttrium citrate radiosynoviorthesis of synovitis in osteoarthritis of the knee joint
verfasst von
Margit Szentesi
Zoltán Nagy
Pal Géher
István Papp
Willm Uwe Kampen
Publikationsdatum
25.05.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 8/2019
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-019-04350-3

Weitere Artikel der Ausgabe 8/2019

European Journal of Nuclear Medicine and Molecular Imaging 8/2019 Zur Ausgabe