Document Detail


Complications following radiosynoviorthesis in osteoarthritis and arthroplasty: osteonecrosis and intra-articular infection.
MedLine Citation:
PMID:  20381398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: In the literature, radiosynoviorthesis (RSO) has been associated only with a small number of complications. There is a trend towards increasing the use of RSO in diverse indications. After repeatedly observing several complications following RSO, a retrospective evaluation was undertaken to estimate the safety of this method. METHODS: Between 1995-2007, we evaluated the outcome of RSO in 93 patients (143 knees, seven hips, seven shoulders, three elbows, one ankle) who presented to our orthopaedic department after joint treatment with yttrium-90((90)Y) or Rhenium-186((186)Re) colloid in an external nuclear medicine institution. RESULTS: Seventy-nine of the 93 RSO treated patients had advanced primary or secondary osteoarthritis (OA), 12 had an arthroplasty. In seven cases, rheumatoid arthritis (RA) was responsible for secondary OA. The benefit in pain relief, as self-reported by the patients was low. Twenty-two of the 93 patients showed complications following RSO. We observed osteonecrosis (ON) in 19 and infection in five patients, including two with both complications. These findings were proven clinically, radiologically, intraoperatively, microbiologically and histologically. Statistical analysis revealed a strong correlation of arthroplasty to infection (rho=0.798, alpha=0.01), and a strong correlation of chronic obstructive pulmonary disease (COPD) and RA to ON following RSO (rho=0.674, alpha=0.01). Diabetes mellitus (DM) was also significantly correlated to ON after RSO treatment (rho=0.488,alpha=0.05). CONCLUSIONS: Our data suggest that RSO may not be as safe as it has previously been reported, especially in advanced OA and arthroplasty.
Authors:
Kai Kisielinski; Dirk Bremer; Anders Knutsen; Peter Röttger; Josef G Fitzek
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Publication Detail:
Type:  Journal Article     Date:  2010-04-08
Journal Detail:
Title:  Joint, bone, spine : revue du rhumatisme     Volume:  77     ISSN:  1778-7254     ISO Abbreviation:  Joint Bone Spine     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100938016     Medline TA:  Joint Bone Spine     Country:  France    
Other Details:
Languages:  eng     Pagination:  252-7     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
Affiliation:
Orthopaedic Surgery Department at the Kliniken Oberallgäu gGmbH, Trettachstr, 16, 87561 Oberstdorf, Germany. kaikisielinski@yahoo.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arthritis, Rheumatoid / epidemiology,  radionuclide imaging,  surgery
Arthroplasty
Combined Modality Therapy
Female
Humans
Male
Middle Aged
Osteoarthritis, Hip / epidemiology,  radionuclide imaging*,  surgery
Osteoarthritis, Knee / epidemiology,  radionuclide imaging*,  surgery
Osteonecrosis / etiology*,  pathology,  radiography
Prosthesis-Related Infections / etiology*,  pathology,  radiography
Radioisotopes / adverse effects
Radiopharmaceuticals / adverse effects*
Retrospective Studies
Rhenium
Risk Factors
Staphylococcal Infections / etiology*,  pathology,  radiography
Yttrium Radioisotopes / adverse effects
Chemical
Reg. No./Substance:
0/Radioisotopes; 0/Radiopharmaceuticals; 0/Yttrium Radioisotopes; 7440-15-5/Rhenium

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