Abstract
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Objectives: To evaluate the role of Lutetium-177 (Lu-177) tin colloid radiosynovectomy (RSV) in patients with inflammatory knee joint conditions who are not responding to conventional modalities in a setup where Re-188 & Y-90 not available.
Methods: In this prospective study 29 knee joints in 27 patients with chronic synovitis due to different inflammatory knee joint conditions not responding to conventional therapy underwent radiosynovectomy. Patients were assessed clinically for pain, swelling, tenderness, joint mobility, analgesic use and on bone scan (blood pool). Different scores were given to all these clinical parameters. RSV of knee joint was done using intra-articular injection of 370 -740 MBq of Lu-177 tin colloid. Treatment response was assessed at 3-12 months with various clinical parameter scores and dynamic bone scan. Patients were categorized as responders and non-responders on the basis of change in percentage of clinical scores & change in blood pool activity.
Results: Out of 29 joints, 21 were responder while 8 were non-responder at 3 months post-RSV. On further follow up at 6 month, relapse was noted in 9 joints and another 7 joints have shown recurrence at 12 months. There was a statistically significant reduction in clinical parameters cumulative scores on follow-up when compared with baseline in responder group. Also there was significant reduction in blood pool activity in responder when compared with the baseline.
Conclusion: Lu-177 tin colloid synovectomy can be used as treatment modality in patients with chronic inflammatory knee joint conditions who are not responding to conventional treatment in a setup where Re-188 & Y-90 is not available. However there are early chances of recurrence of arthritis. Research Support: nO RESEARCH SUPPORT