A RETROSPECTIVE REVIEW OF Y-90 SYNOVECTOMY IN THE TREATMENT OF KNEE ARTHRITIS

We reviewed the case notes and X-rays of all patients with knee arthri tis treated with yttrium-90 for the first time at a single institution from November 1981 to November 1995. Outcomes were assessed as 'impro ved' or 'not improved' by review of the case notes at 3, 6 and 12 mont hs, and by the absence of further intra-articular (IA) steroid injecti ons. Of the 121 knees treated, 87 had adequate follow-up information t o allow an assessment of outcomes. Overall, 46% (95% CI 36-57) were im proved at 12 months and 37% (95% CI 27-47) had no further IA injection s (mean follow-up of 3.5 yr). I(nees with osteoarthritis (OA) fared si gnificantly worse with 10% (95% CI 0-79) rs 51% (95% CI 39-63) improve d at 12 months (P < 0.05). Knees younger than 30 appeared to do better with 78% (95% CI 51-100) vs 28% (95% CI 17-45) having no further IA i njections (P < 0.02). Knees with normal X-rays (Kellgren grade 0-1) di d significantly better than those with more severe radiographic abnorm alities (Kellgren grade 3-4), with 56% (95% CI 40-73) vs 24% (95% CI 8 -40) improved (P < 0.01). Radiosynovectomy with yttrium-90 for knee ar thritis appears to be of less value For patients with OA or with secon dary OA changes on X-ray; and may beef more value for younger patients and those with spondyloarthropathies.