The British Journal of Rheumatology, Vol 36, 1100-1105, Copyright © 1997 by British Society for Rheumatology
WJ Taylor, MM Corkill and CN Rajapaske
We reviewed the case notes and X-rays of all patients with knee arthritis
treated with yttrium-90 for the first time at a single institution from
November 1981 to November 1995. Outcomes were assessed as 'improved' or
'not improved' by review of the case notes at 3, 6 and 12 months, and by
the absence of further intra-articular (IA) steroid injections. Of the 121
knees treated, 87 had adequate follow-up information to allow an assessment
of outcomes. Overall, 46% (95% CI 36- 57) were improved at 12 months and
37% (95% CI 27-47) had no further IA injections (mean follow-up of 3.5 yr).
Knees with osteoarthritis (OA) fared significantly worse with 10% (95% CI
0-29) vs 51% (95% CI 39-63) improved at 12 months (P < 0.05). Knees
younger than 30 appeared to do better with 78% (95% CI 51-100) vs 28% (95%
CI 17-45) having no further IA injections (P < 0.02). Knees with normal
X-rays (Kellgren grade 0-1) did significantly better than those with more
severe radiographic abnormalities (Kellgren grade 3-4), with 56% (95% CI
40-73) vs 24% (95% CI 8-40) improved (P < 0.01). Radiosynovectomy with
yttrium-90 for knee arthritis appears to be of less value for patients with
OA or with secondary OA changes on X-ray, and may be of more value for
younger patients and those with spondyloarthropathies.
ORIGINAL PAPERS
A retrospective review of yttrium-90 synovectomy in the treatment of knee arthritis
Wellington Regional Rheumatology Unit, Hutt Hospital, Hutt Valley Health Corporation Ltd, Lower Hutt, New Zealand.
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