Knee radiosynovectomy with Sm-153 hydroxyapatite compared to Y-90 hydroxyapatite

Abstract

Aim/Introduction: Introduction: The most common clinical presentation in hemophilia patients consists of hemarthrosis. Various treatment strategies aim to control hemarthrosis to prevent secondary arthropathy, among them, radiosynovectomy with Y-90 hydroxyapatite (90YHA). A few studies have shown a lower efficiency of knee radiosynovectomy with Sm-153 hydroxyapatite (153Sm- HA) compared to 90Y-HA. Purpose: The purpose of this investigation was to assess the efficacy and safety of knee radiosynovectomy with 153Sm-HA compared to 90Y-HA. Materials and Methods: Forty patients were prospectively assigned to undergo knee radiosynovectomy with 153Sm- HA (19 patients) or with 90Y-HA (21 patients). The frequency of hemarthrosis episodes before and after treatment was compared. Results: The response to knee radiosynovectomy stratifying according to radiotracer showed that after 6 months the median response rate with 153Sm-HA was not significantly different from 90Y-HA (87.5% vs 80.9%; p = 0.576). However, after 12 months the median response rate of knee radiosynovectomy with 153Sm-HA was significantly better than with 90Y-HA (87.5% vs 50%; p = 0.037), respectively. The reduction of joint bleeding by at least 50%, after 12 months, was greater in the group of patients treated with 153Sm-HA compared to 90Y-HA (74% vs 52%), respectively. Conclusion: Knee radiosynovectomy with high doses of 153Sm-HA is safe, with an efficiency rate similar that is described in the literature by the 90Y-HA.