title: Comparison of the effect of knee synovectomy in haemophilic patients with 153Sm- and 90Y-labelled hydroxyapatite 1 year after.
abstract: To compare the use of 740 Mbq (20 mCi) of (153) Sm and 185 Mbq (5mCi) of (90) Y, both labelling hydroxyapatite (HA), for knee synovectomy in haemophilic patients, 1 year after the intervention. Thirty three men (36 knees) were studied, divided into two groups: 1 - treatment using 740 Mbq of (153) Sm-HA: 20 knees of 18 patients, with mean age of 21.4 ± 13.3 years (ranging from 7 to 56 years) and mean Pettersson score of 5.3; 2 - treatment using 185 Mbq of (90) Y-HA: 16 knees of 15 patients, with mean age of 26.3 ± 10.3 (ranging from 7 to 51 years) and mean Pettersson score of 6.3. The following criteria were adopted for the evaluation before and 1 year after synovectomy: reduction in haemarthrosis episodes and pain using a visual analogue scale, as well as improved joint mobility. The occurrence of adverse events in the treatment was also considered. The chi-square, Wilcoxon and Mann-Whitney tests were used with P ≤ 0.05 set as significant. The occurrence of haemarthrosis declined by 65.7% with the use of (153) Sm-HA and 82.6% for (90) Y-HA, with no statistical difference between the groups (P = 0.632); pain reduction was 42.5% in group 1 and 30.7% in group 2, once again with no statistical difference (P = 0.637). Improvement in joint mobility was not significant for both groups. Two cases of mild reactive synovitis were observed in group 1 and one in group 2, which cleared up without medical intervention. Although the beta energy from (90) Y is the gold standard for knee synovectomy, higher activities of (153) Sm may be used in places which have only production of this material.
authors.affiliation: Hospital de Base, Nuclear Medicine Service, São Paulo, Brazil.
authors.forename: J
authors.initials: J
authors.lastname: Calegaro
authors.forename: C
authors.initials: C
authors.lastname: Silveira
authors.forename: D
authors.initials: D
authors.lastname: Hage
authors.forename: M
authors.initials: M
authors.lastname: Sayago
authors.forename: D
authors.initials: D
authors.lastname: de Landa
authors.forename: J
authors.initials: J
authors.lastname: Mengatti
authors.forename: A P
authors.initials: AP
authors.lastname: de Paula
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D006395:Hemarthrosis / Q000209:etiology* / Q000628:therapy*; D006467:Hemophilia A / Q000150:complications*; D002836:Hemophilia B / Q000150:complications*; D006801:Humans; D006882:Hydroxyapatites / Q000008:administration & dosage / Q000627:therapeutic use*; D007719:Knee Joint / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012493:Samarium / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult; D015021:Yttrium Radioisotopes
chemical_list: D006882:Hydroxyapatites; D015021:Yttrium Radioisotopes; C091049:samarium hydroxyapatite; D012493:Samarium
keywords: 153Sm-hydroxyapatite; 90Y-hydroxyapatite; synovectomy of haemophilic knees