Article
Radiation synovectomy – a new therapy option for chronic, therapy-refractory capsulitis of the finger and toe joints in rock climbers
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Authors
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Michael Simon
- Sozialstiftung Bamberg, Klinik für Orthopädie und Unfallchirurgie, Sektion Sportorthopädie, Sporttraumatologie, Sportmedizin, Bamberg, Germany
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Christoph Lutter
- Universitätsmedizin Rostock, Orthopädische Klinik und Poliklinik, Rostock, Germany
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Volker Schöffl
- Sozialstiftung Bamberg, Klinik für Orthopädie und Unfallchirurgie, Sektion Sportorthopädie, Sporttraumatologie, Sportmedizin, Bamberg, Germany
| Published: | October 25, 2022 |
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Outline
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Objectives: The aim of this study was to assess the treatment results of 20MBq Erbium radiation synovectomy (radiosynoviorthesis; RSO) for chronic, therapy-refractory capsulitis of the finger and toe joints in rock climbers.
Methods: In this retrospective study, 12 rock climbers (3 female, 9 male, mean age 44y, SD 9, range 30-56) with a chronic, therapy-refractory capsulitis of the finger or toe joints were treated with a 20MBq Erbium radiation synovectomy (radiosynoviorthesis; RSO). All patients had been treated previously with rest from climbing, nonsteroidal anti-inflammatory drug (NSAID) and X-ray controlled intraarticular corticosteroid injections without symptom alleviation for at least 1 year (mean 2, SD 1, range 1-3). All patient's complaint about swelling of the respective small joint and pain in daily life and during rock climbing (mean Visual Analog Scale (VAS) during rock climbing 6, SD 1, range 4-8).
The outcome was assessed on average 45 months after the RSO (SD 37, range 5-114) with a standardized questionnaire and a clinical examination. The postoperative sports-specific outcome was analyzed using the Union Internationale des Associations d'Alpinisme Scale of Difficulty (UIAA scale) for climbing and a sport specific finger injury recovery score.
Results and conclusion: All patients returned to sport on average 7 weeks (SD 4, range 2-12) after the RSO and did regain their pre-treatment rock climbing grade. Out of 12 patients 7 patients achieved a complete recovery for daily life activities (58%) while only 5 patients (42%) were free of symptoms during rock climbing. 5 Patients showed a significant improvement of symptoms (42%) in daily life and rock climbing (decrease of pain on VAS mean 3, SD1, range 2-4). Only 2 patients (17%) had consistent symptoms in daily life and sports.
The results of this study support the hypothesis that radiation synovectomy (RSO) is a viable therapy option for chronic, therapy-refractory capsulitis of the finger and toe joints in rock climbers.
