Knee radiosynovectomy with 153Sm-hydroxyapatite compared to 90Y-hydroxyapatite: initial results of a prospective trial

Abstract

Introduction Radiosynovectomy (RS) with 90 Y-hydroxyapatite ( 90 Y-HyA) aims to control knee hemarthrosis in hemophiliac patients to prevent secondary arthropathy. However, knee RS using 153 Sm-hydroxyapatite ( 153 Sm-HyA) is considered less suitable due to the lower average soft tissue range and energy of 153 Sm for large joints, such as the knees. Purpose The objective of this investigation was to assess the efficacy and safety of knee RS with 153 Sm-HyA, compared to 90 Y-HyA. Methods Forty patients were prospectively assigned to undergo knee RS with 153 Sm-HyA ( n \u2009=\u200919) or with 90 Y-HyA ( n \u2009=\u200921). The frequency of hemarthrosis episodes before and after treatment were compared. Results After six months of knee RS, 153 Sm-HyA and 90 Y-HyA promoted a similar reduction of hemarthrosis episodes (50% and 66.7%, respectively). However, after 12\xa0months of knee RS, the reduction of hemarthrosis episodes was significantly ( p \u2009=\u20090.037) higher using 153 Sm-HyA (87.5%) compared to 90 Y-HyA (50.0%). This discrepancy was more pronounced ( p \u2009=\u20090.002) for 153 Sm-HyA compared to 90 Y-HyA in adults/adolescents. Conclusion Knee radiosynovectomy with 153 Sm-HyA is safe, reduces hemarthrosis episodes after 12\xa0months of treatments, especially in adults/adolescents and even with grades III/IV arthropathy, similar to 90 Y-HyA. 90 Y-HyA seems to promote better hemarthrosis control in small children.