Effectiveness of radiation synovectomy with samarium-153 particulate hydroxyapatite in rheumatoid arthritis patients with knee synovitis: a controlled randomized double-blind trial

OBJECTIVES: The aim of the present study was to investigate the effectiveness of Samarium153-particulate hydroxyapatite radiation synovectomy in rheumatoid arthritis patients with chronic knee synovitis. METHODS: Fifty-eight rheumatoid arthritis patients (60 knees) with chronic knee synovitis participated in a controlled double-blinded trial. Patients were randomized to receive either an intra-articular injection with 40 mg triamcinolone hexacetonide alone (TH group) or 40 mg triamcinolone hexacetonide combined with 15 mCi Samarium153-particulate hydroxyapatite (Sm/TH group). Blinded examination at baseline (T0) and at 1 (T1), 4 (T4), 12 (T12), 32 (T32), and 48 (T48) weeks post-intervention were performed on all patients and included a visual analog scale for joint pain and swelling as well as data on morning stiffness, flexion, extension, knee circumference, Likert scale of improvement, percentage of improvement, SF-36 generic quality of life questionnaire, Stanford Health Assessment Questionnaire (HAQ), Lequesne index, use of non-steroidal anti-inflammatory drugs or oral corticosteroids, events and adverse effects, calls to the physician, and hospital visits. RESULTS: The sample was homogeneous at baseline, and there were no withdrawals. Improvement was observed in both groups in relation to T0, but no statistically significant differences between groups were observed regarding all variables at the time points studied. The Sm/TH group exhibited more adverse effects at T1 (p<0.05), but these were mild and transitory. No severe adverse effects were reported during follow-up. CONCLUSION: Intra-articular injection of Samarium153-particulate hydroxyapatite (15 mCi) with 40 mg of triamcinolone hexacetonide is not superior to triamcinolone hexacetonide alone for the treatment of knee synovitis in patients with rheumatoid arthritis at 1 y of follow-up.

Estudo da reaçäo tecidual ao implante subcutâneo de dois tipos de partículas de hidroxiapatita em ratos / Study of the tissue reaction to the subcutaneous implantation of two kinds of hydroxyapatite in rats

Os autores estudaram a reaçäo tecidual ao implante subcutâneo de hidroxiapatita (HA) em ratos. Partículas de HA de coral e HA-40 foram implantadas no subcutâneo dos animais. A análise histológica após 7, 14, 21 e 30 dias demonstrou que ambos os tipos de HA induziram respostas inflamatórias, que persistiram por todo o período de estudo. A HA de coral demonstrou menor reaçäo inflamatória do que a HA-40. Os dois tipos de materiais utilizados näo mostraram potencial osteoindutivo

Resposta tecidual óssea frente à hidroxiapatita granular implantada em efeitos criados na mandíbula de ratos / Bone tissue response to granular hydroxyapatite implanted in experimental defects in the rat mandible

Foi realizada avaliaçäo histológica da resposta tecidual óssea frente à hidroxiapatita (HA) granular implantada em defeitos criados experimentalmente na mandíbula de ratos. Inicialmente, foi observada a presença de exsudato sero-fibrinoso, com grande quantidade de polimorfonucleares neutrófilos e, a seguir, ocorreu processo inflamatório crônico. Posteriormente, foram observadas células gigantes multinucleadas ao redor da imagem negativa dos cristais. Esse achado permaneceu até os períodos finais do experimento, configurando reaçäo do tipo corpo estranho, havendo também, nessa fase, atividade osteogênica ao redor do defeito ósseo