Lutetium-177 hydroxyapatite radiosynovectomy in refractory chronic inflammatory arthritis of the knee joint

Abstract

Objective: To determine the efficacy of 177Lutetium hydroxyapatite radiosynovectomy (RSV) in patients with refractory chronic inflammatory arthritis of the knee joint. Materials and Methods: Overall, 24 knees in 22 patients with refractory chronic inflammatory arthritis were enrolled in this prospective study. All patients were assessed clinically for pain, tenderness, range of motion, analgesic intake, Oxford knee score and blood pool activity on three phase bone scan. Various scores were assigned to clinical these parameters. RSV of the knee joint was done using intra-articular injection of 177Lutetium hydroxyapatite. Patients were assessed clinically at 1 and 3 months, and scintigraphically at 3 months using blood pool index on three phase bone scan. Patients were categorised as responders and non-responders on the basis of change in percentage of cumulative scores. Results: Out of 24 knees, 18 knees were responders and 6 knees were non-responders at 3 months. There was a significant improvement in clinical scores at 1 month post RSV, which persisted at 3 months post RSV (p < 0.05). However, the change in blood pool activity on three phase bone scan was not significant. Reported adverse effects were mild and not significant. Conclusion: This study confirmed the safety and efficacy of 177Lutetium hydroxyapatite radiosynovectomy for patients with chronic inflammatory knee joint arthritis refractory to conventional medical treatment.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

CTRI/2022/04/041884

Funding Statement

This study did not receive any funding.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee/IRB of All India Institute of Medical Sciences, Jodhpur gave ethical approval for this work.

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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