Effects of low-dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty: Results of a randomized controlled trial with 9-year follow-up
The aim. To compare the incidence of knee arthroplasty in patients receiving standard treatment with non-steroidal anti-inflammatory drugs (NSAIDs) in combination with symptomatic slow acting drugs for osteoarthritis (SYSADOA), or combination of NSAIDs and SYSADOA with low-dose radiation therapy (LD...
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| Format: | Article |
| Language: | Russian |
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Scientific Сentre for Family Health and Human Reproduction Problems
2023-12-01
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| Series: | Acta Biomedica Scientifica |
| Subjects: | |
| Online Access: | https://www.actabiomedica.ru/jour/article/view/4445 |
| _version_ | 1797237158494339072 |
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| author | М. V. Makarova М. Yu. Valkov А. М. Grjibovski |
| author_facet | М. V. Makarova М. Yu. Valkov А. М. Grjibovski |
| author_sort | М. V. Makarova |
| collection | DOAJ |
| description | The aim. To compare the incidence of knee arthroplasty in patients receiving standard treatment with non-steroidal anti-inflammatory drugs (NSAIDs) in combination with symptomatic slow acting drugs for osteoarthritis (SYSADOA), or combination of NSAIDs and SYSADOA with low-dose radiation therapy (LDRT) in patients with stage 0–2 knee osteoarthritis (OA). Materials and methods. The article presents the results of randomized controlled study of 292 patients with confirmed knee OA according to Altman’s criteria (1991) and Kellgren – Lawrence radiographic stages 0–2 who were randomized into two groups. The control group (n = 146) received standard therapy of NSAIDs + SYSADOA. Patients of the study group (n = 146) received combination of standard therapy and LDRT up to a total dose of 4.5 Gy. The cumulative risk of knee arthroplasty was assessed using actuarial analysis and the Kaplan – Meier method. Attributable (AF) and population attributable (PAF) fractions were calculated to assess LDRT preventive potential. Results. The total observation period was 2131.2 person-years. Knee arthroplasty was performed in 4.1 % (n = 6) of patients in the study group against 7.5 % (n = 11) in the control group. The incidence density ratio was 0.60 (95% CI: 0.18–1.88), which corresponds to a risk reduction by 67 %, but the differences were not statistically significant due to the small number of cases (p = 0.340). The AF was 40 % while the PAF was 21 %. Conclusions. The use of LDRT reduces the risk of knee arthroplasty by two-thirds and has the potential to prevent 21 % cases of knee arthroplasty in patients with knee OA. A study on a larger sample is required. |
| first_indexed | 2024-03-08T12:15:16Z |
| format | Article |
| id | doaj.art-c535a45e8fe9427cb43ca68702a52177 |
| institution | Directory Open Access Journal |
| issn | 2541-9420 2587-9596 |
| language | Russian |
| last_indexed | 2024-04-24T17:15:18Z |
| publishDate | 2023-12-01 |
| publisher | Scientific Сentre for Family Health and Human Reproduction Problems |
| record_format | Article |
| series | Acta Biomedica Scientifica |
| spelling | doaj.art-c535a45e8fe9427cb43ca68702a521772024-03-28T07:49:29ZrusScientific Сentre for Family Health and Human Reproduction ProblemsActa Biomedica Scientifica2541-94202587-95962023-12-018510010610.29413/ABS.2023-8.5.102634Effects of low-dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty: Results of a randomized controlled trial with 9-year follow-upМ. V. Makarova0М. Yu. Valkov1А. М. Grjibovski2Northern State Medical UniversityNorthern State Medical UniversityNorthern State Medical University; North-Eastern Federal University; Northern (Arctic) Federal University named after M.V. LomonosovThe aim. To compare the incidence of knee arthroplasty in patients receiving standard treatment with non-steroidal anti-inflammatory drugs (NSAIDs) in combination with symptomatic slow acting drugs for osteoarthritis (SYSADOA), or combination of NSAIDs and SYSADOA with low-dose radiation therapy (LDRT) in patients with stage 0–2 knee osteoarthritis (OA). Materials and methods. The article presents the results of randomized controlled study of 292 patients with confirmed knee OA according to Altman’s criteria (1991) and Kellgren – Lawrence radiographic stages 0–2 who were randomized into two groups. The control group (n = 146) received standard therapy of NSAIDs + SYSADOA. Patients of the study group (n = 146) received combination of standard therapy and LDRT up to a total dose of 4.5 Gy. The cumulative risk of knee arthroplasty was assessed using actuarial analysis and the Kaplan – Meier method. Attributable (AF) and population attributable (PAF) fractions were calculated to assess LDRT preventive potential. Results. The total observation period was 2131.2 person-years. Knee arthroplasty was performed in 4.1 % (n = 6) of patients in the study group against 7.5 % (n = 11) in the control group. The incidence density ratio was 0.60 (95% CI: 0.18–1.88), which corresponds to a risk reduction by 67 %, but the differences were not statistically significant due to the small number of cases (p = 0.340). The AF was 40 % while the PAF was 21 %. Conclusions. The use of LDRT reduces the risk of knee arthroplasty by two-thirds and has the potential to prevent 21 % cases of knee arthroplasty in patients with knee OA. A study on a larger sample is required.https://www.actabiomedica.ru/jour/article/view/4445osteoarthritisknee jointjoint arthroplastylow-dose radiation therapy |
| spellingShingle | М. V. Makarova М. Yu. Valkov А. М. Grjibovski Effects of low-dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty: Results of a randomized controlled trial with 9-year follow-up Acta Biomedica Scientifica osteoarthritis knee joint joint arthroplasty low-dose radiation therapy |
| title | Effects of low-dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty: Results of a randomized controlled trial with 9-year follow-up |
| title_full | Effects of low-dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty: Results of a randomized controlled trial with 9-year follow-up |
| title_fullStr | Effects of low-dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty: Results of a randomized controlled trial with 9-year follow-up |
| title_full_unstemmed | Effects of low-dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty: Results of a randomized controlled trial with 9-year follow-up |
| title_short | Effects of low-dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty: Results of a randomized controlled trial with 9-year follow-up |
| title_sort | effects of low dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty results of a randomized controlled trial with 9 year follow up |
| topic | osteoarthritis knee joint joint arthroplasty low-dose radiation therapy |
| url | https://www.actabiomedica.ru/jour/article/view/4445 |
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