Radiosynoviorthesis in arthritis and decompensated osteoarthrosis

Overview

Purpose of the study: Radiosynoviorthesis (RSO), previously also called radiosynovectomy (RS), is a method focused on the treatment of joint pain and swelling caused by synovitis in arthritis and decompensated osteoarthrosis using beta emitters. Radiation-induced surface necrosis of part of the cells in the synovial membrane can, as a result, relieve pain, reduce swelling, and improve joint function.

Material and method: Between 2013-2024, 436 patients were treated with RSO, primarily for knee joint swelling due to decompensated osteoarthrosis (291 patients) and arthritis (172 patients). RSO was performed on the knee (268 cases) and on small/medium joints (50 cases), using yttrium for knee joints, rhenium for medium joins or erbium for small joints. The procedure involved puncture of the joint and suction of any joint effusion, injecting the radioactive isotope, and subsequently immobilizing the joint for 2–3 days.

Results: We selected treatments in 2022 and 2023 to evaluate the clinical effect of RSO. In 2022, 45 treatments were performed, and in 2023 another 26. One year post-treatment, 61 % of patients with knee joint involvement were fully satisfied, reporting reduced swelling and improved range of motion. Among patients treated for small and medium-sized joints, 57 % experienced overall improvement. Some patients observed recurring effusions of smaller volume or only partial improvement.

Conclusion: Radiosynoviorthesis is an effective treatment for joint swelling and pain caused by synovitis, with positive outcomes seen in knee as well as smaller joints. Both objective and subjective assessments confirmed significant benefits.

Keywords:

radiosynoviorthesis – radiosynovectomy – radionuclide – yttrium – rhenium erbium – synovitis