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柠檬酸钇[90Y]放射性核素滑膜切除术治疗膝关节骨关节炎滑膜炎症的前瞻性观察研究长期结果。

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

机构信息

Department of Rheumatology, Polyclinic of the Hospitaller Brothers of St. John of God Budapest, Semmelweis University, Budapest, Hungary.

Nuclear Medicine Spitalerhof, Hamburg, Germany.

出版信息

Eur J Nucl Med Mol Imaging. 2019 Jul;46(8):1633-1641. doi: 10.1007/s00259-019-04350-3. Epub 2019 May 25.

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 Yttrium 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.

摘要

目的

放射性滑膜切除术(RSO)用于治疗炎症性关节疾病。然而,目前尚未发表将其与保守治疗进行比较的长期结果。因此,本前瞻性观察研究的目的是评估在 10 年内患有膝关节骨关节炎的患者接受放射性核素治疗后的反应率。

方法

对骨关节炎患者(Kellgren-Lawrence 分级 I/II(n=69)和 Kellgren-Lawrence 分级 III(n=72))进行关节内胶体柠檬酸钇放射性核素治疗。

结果

在早期疾病患者中,治疗后 1 年时,疼痛、关节活动度和功能的优良/良好反应率为 82.5%,8 年时为 73.7%。10 年后反应率下降至 50%。在 3 级患者中,观察到 45.9%的优良/良好反应;前 8 年反应率下降至 41.2%。在这组中,在 8 年后有 51 名患者可进行 9 年和 10 年的随访,而在 9 年后只有 30 名患者,在 10 年后只有 9 名患者。因此,这些反应率无法评估。

结论

膝关节骨关节炎放射性滑膜切除术的长期结果在许多患者中是优良的。反应率取决于 Kellgren-Lawrence 分期,建议对骨关节炎进行早期放射性核素治疗。

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