title: A retrospective review of yttrium-90 synovectomy in the treatment of knee arthritis.
abstract: 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.
authors.affiliation: Wellington Regional Rheumatology Unit, Hutt Hospital, Hutt Valley Health Corporation Ltd, Lower Hutt, New Zealand.
authors.forename: W J
authors.initials: WJ
authors.lastname: Taylor
authors.forename: M M
authors.initials: MM
authors.lastname: Corkill
authors.forename: C N
authors.initials: CN
authors.lastname: Rajapaske
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000187:drug effects / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use; D000074402:Synovectomy; D013997:Time Factors; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes
chemical_list: D013256:Steroids; D015021:Yttrium Radioisotopes