| Complications following radiosynoviorthesis in osteoarthritis and arthroplasty: osteonecrosis and intra-articular infection. | |
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MedLine Citation:
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PMID: 20381398 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Kai Kisielinski; Dirk Bremer; Anders Knutsen; Peter Röttger; Josef G Fitzek |
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Publication Detail:
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Type: Journal Article Date: 2010-04-08 |
Journal Detail:
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Title: Joint, bone, spine : revue du rhumatisme Volume: 77 ISSN: 1778-7254 ISO Abbreviation: Joint Bone Spine Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-25 Completed Date: 2010-08-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100938016 Medline TA: Joint Bone Spine Country: France |
Other Details:
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Languages: eng Pagination: 252-7 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved. |
Affiliation:
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Orthopaedic Surgery Department at the Kliniken Oberallgäu gGmbH, Trettachstr, 16, 87561 Oberstdorf, Germany. kaikisielinski@yahoo.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Radioisotopes; 0/Radiopharmaceuticals; 0/Yttrium Radioisotopes; 7440-15-5/Rhenium |
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