Novel treatment of 99Tc-MDP improves clinical and radiographic results for patients with osteochondral lesions of the talus

Objectives To investigate the effects of 99Tc-MDP (Yunke) treatment on Oosteochondral lesion of talus (OCLT)

Methods In the clinical evaluation, 66 patients were retrospectively included and treated with a combination of 99Tc-MDP and Chinese herbal fumigation (CHF) for symptomatic OCLT. They were evaluated by the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), visual analog scale (VAS), activities of daily living (Barthel index), and MRI, 99mTc-MDP SPECT/CT. Radiographic changes were also assessed by the transverse long diameter of the cyst on CT.

Results A total of 83 lesions of OCLT who failed appropriate nonoperative treatment and surgery were included. At the last follow up, AOFAS, VAS and Barthel index improved significantly from 68.66±9.76, 3.05±0.34 and 85±8.31 to 85.4±8.31, 1.85±0.36 and 94.7±4.99 (p<0.01), respectively after one course treatment in 66 patients with OCLT. Thirty one (31/66) patients had two courses treatment with 99Tc-MDP and CHF. Their AOFAS, VAS and Barthel index also improved significantly after the mean follow-up of 7 ±2 (6-15) months. And the average diameter of the cysts decreased from 8.01 ± 3.35 mm to 4.74± 2.83mm (p<0.01) in the 31 patients.

Conclusions Pain relief and return of function and decreased cystic lesions were obtained after a combination treatment of 99Tc-MDP and CHF for patients with OCLT. Our results suggest that the small cystic lesions with increased uptake of 99mTc-MDP on SPECT/CT can be well treated by 99Tc-MDP and CHF. This novel technique holds the potential to emerge as an effective conservative treatment for OCLT without adverse effects.