Inconclusive Benefit of Adjuvant 90Yttrium Hydroxyapatite to Radiosynovectomy for Diffuse Type Tenosynovial Giant-Cell Tumor of the Knee
2Department of Orthopaedic Surgery, Assuta Medical Center, Affiliated with the Faculty of Health and Science and Ben Gurion University, Israel
3Orthopedic Department, Rabin Medical Center, Affiliated to Sackler Faculty of Medicine and Tel Aviv University, Israel
4Department of Orthopaedic Surgery, Tel Aviv Medical Center, Affiliated with the Sackler Faculty of Medicine and Tel Aviv University, Israel
Aims: Intra-articular injected 90Yttrium (90Y) is an adjunct to surgical treatment by synovectomy for diffuse type tenosynovial giant-cell tumor (dtTGCT) of the knee with variable success rates. Clinical information is sparse, and its value is unclear. We investigated the long-term outcome of patients who underwent synovectomy with and without adjuvant 90Yttrium radiosynovectomy.
Patients and Methods: All patients with dtTGCT of the knee joint who underwent synovectomy between 1991-2014 were enrolled. Group A patients underwent synovectomy and intra-articular injection of 90Yttrium 6-8 weeks after surgery and Group B patients underwent surgery alone.
Results: There were 34 patients in Group A and 22 patients in Group B. Recurrence of dtTGCT was identified by MRI studies obtained in patients with clinical symptoms of recurrent pain and/or swelling and impaired function. At final follow-up, residual disease was present in 15 Group A patients and 11 Group B patients (p < 0.363). The mean MSTS score at last follow-up was 85% and 83%, respectively (p < 0.91).
Conclusion: There were no significant differences in the examined parameters between the patients treated surgically for dtTGCT of the knee with or without adjuvant intra-articular injections of 90Yttrium. We could not provide conclusive evidence of any benefits derived from the adjuvant treatment.
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