Inconclusive benefit of adjuvant 90 Yttrium hydroxyapatite to radiosynovectomy for diffuse-type tenosynovial giant-cell tumour of the knee

• Published in: The bone & joint journal Vol. 100-B; no. 7; p. 984
• Main Authors: Gortzak, Y, Vitenberg, M, Frenkel Rutenberg, T, Kollender, Y, Dadia, S, Sternheim, A, Morag, G, Farkash, U, Rath, E, Kramer, M, Drexler, M
• Format: Journal Article
• Language: English
• Published: England 01-07-2018
• Subjects: Adult; Durapatite - administration & dosage; Female; Follow-Up Studies; Humans; Injections, Intra-Articular; Knee Joint - pathology; Knee Joint - surgery; Male; Middle Aged; Neoplasm Recurrence, Local; Radiotherapy, Adjuvant - methods; Retrospective Studies; Synovectomy - methods; Synovial Membrane - pathology; Synovitis, Pigmented Villonodular - pathology; Synovitis, Pigmented Villonodular - radiotherapy; Synovitis, Pigmented Villonodular - surgery; Treatment Outcome; Yttrium Radioisotopes - administration & dosage; Knee; Pigmented villonodular synovitis; 90Yttrium hydroxyapatite; Diffuse-type tenosynovial giant-cell tumour; Radiosynovectomy
• ISSN: 2049-4408
• DOI: 10.1302/0301-620X.100B7.BJJ-2017-0867.R3

Intra-articular
Yttrium (
Y) is an adjunct to surgical treatment by synovectomy for patients with diffuse-type tenosynovial giant-cell tumour (dtTGCT) of the knee, with variable success rates. Clinical information is, however, sparse and its value remains unclear. We investigated the long-term outcome of patients who underwent synovectomy with and without adjuvant treatment with
Yttrium.
All patients with dtTGCT of the knee who underwent synovectomy between 1991 and 2014 were included in the study. Group A patients underwent synovectomy and an intra-articular injection of
Yttrium between six and eight weeks after surgery. Group B patients underwent surgery alone.
There were 34 patients in group A and 22 in group B. Recurrence of dtTGCT was identified by MRI, which was undertaken in patients with further symptoms. At a mean follow-up of 7.3 years (2.5 to 25.4), there was residual disease in 15 patients in group A and 11 in group B (p < 0.363). The mean Musculoskeletal Tumor Society (MSTS) score at final follow-up was 85% and 83%, respectively (p < 0.91).
There were no significant differences in outcome between patients treated surgically for dtTGCT of the knee with or without an adjuvant intra-articular injection of
Yttrium. We were unable to provide conclusive evidence of any benefits derived from the adjuvant treatment. Cite this article: Bone Joint J 2018;100-B:984-8.