Results of radiosynoviorthesis with yttrium 90 in chronic synovitis: a long-term prospective study. I. Total results and effect of local factors

The purpose of the presented study was to investigate, whether the results of radiosynovectomy were dependent on different characteristics of the chronic synovitis. In our unit, from October 1978 to April 1981 193 joints--174 knee joints and 19 shoulder joints--of 107 patients underwent radiosynoviorthesis. 93 patients (169 joints) suffered from rheumatoid arthritis of different ARA-stages (I = 16, II = 31, III = 27, IV = 19; 67 seropositive, 26 seronegative), 14 patients with 24 treated joints had chronic synovitis other than rheumatoid arthritis. Only joints with chronic synovitis in the local stages I and II were treated if they did not respond to medical therapy and intraarticular applications of corticosteroids, respectively. Joints with local stage III and IV, respectively, with instability or with a secondary osteoarthrosis were excluded from radiosynovectomy. Every six months the patients were reinvestigated, and pain, swelling, mobility, stability of the joint, frequency of effusions and intraarticular steroid applications were assessed as well as the overall activity of the disease, SR, hemoglobin and effectivity of medical treatment. The overall result was good in 60% of cases after 6 and 12 months, respectively, in 54% of cases after 2 years and in 50% of cases after 3 years, it was fair in about 35% of cases. The results of 20 repeated radiosynovectomies were comparable. The frequency of joint effusions and of necessary intraarticular corticosteroid injections was significantly reduced even in patients showing a "poor" result of synoviorthesis.(ABSTRACT TRUNCATED AT 250 WORDS)