Department of Rheumatology and Clinical Immunology, Polyclinic of the Hospitaller Brothers of St. John in God, Semmelweis University, Budapest, Hungary -
Nuclear Medicine UZA, Edegem, Belgium.
Q J Nucl Med Mol Imaging. 2022 Dec;66(4):324-333. doi: 10.23736/S1824-4785.22.03473-2. Epub 2022 Sep 15.
The aim of this study was to assess the long-term anti-inflammatory effect and safety of 90-Yttrium and 166-Holmium radiosynoviorthesis (RSO) for treating chronic knee synovitis of various origins.
A total of 820 patients were included in this study and were followed up to 10 years after the procedure for objective and subjective changes in signs and symptoms of inflammation.
Five years after RSO, excellent and good results were seen in 71% (95% CI 67-74%) of patients. Six, seven, eight and nine years following RSO, efficacy did not decrease significantly. Ten years after RSO, the effectiveness of the therapy fell to 65% (95% CI 59-71%). Overall, 64% of patients did not need another joint puncture ten years after RSO. We achieved excellent to good results at 5 years in 79% of patients with rheumatoid arthritis, 59% with ankylosing spondylitis, and 62% with osteoarthritis. Efficacy was mainly affected by the local X-ray stage of the knee joint. A significant association was also found between the diagnosis of the underlying disease and the success of radiosynoviorthesis. Efficacy, however, was not substantially affected by any of the following factors: the duration of synovitis, the number of punctures before radiosynoviorthesis, the number of intraarticular steroid injections before the procedure, or the number of interventions before radiosynoviorthesis (radiotherapy, surgery).
Radiosynoviorthesis is an effective long-term method of treating chronic synovitis. The treatment showed the most favorable effects in patients with rheumatoid arthritis and those with mild to moderate degenerative osseous changes.
本研究旨在评估 90 钇和 166 钬放射性滑膜切除术（RSO）治疗各种来源慢性膝关节滑膜炎的长期抗炎效果和安全性。
共纳入 820 例患者，在 RSO 术后 10 年对其炎症体征和症状的客观和主观变化进行随访。
RSO 后 5 年，71%（95%CI：67%-74%）的患者疗效良好。RSO 后 6、7、8 和 9 年，疗效无明显下降。RSO 后 10 年，治疗的有效性降至 65%（95%CI：59%-71%）。总体而言，RSO 后 10 年，64%的患者无需再次关节穿刺。RSO 后 5 年，类风湿关节炎患者中 79%、强直性脊柱炎患者中 59%、骨关节炎患者中 62%达到良好疗效。疗效主要受膝关节局部 X 线分期的影响。基础疾病的诊断与放射性滑膜切除术的成功之间也存在显著相关性。然而，疗效并未受到滑膜炎持续时间、RSO 前关节穿刺次数、治疗前关节内类固醇注射次数或 RSO 前干预次数（放疗、手术）的显著影响。
RSO 是治疗慢性滑膜炎的一种有效长期方法。该治疗对类风湿关节炎和轻度至中度退行性骨改变患者的效果最理想。
