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Radiotherapy for osteoarthritis of the ankle and tarsal joints—analysis of 66 joints

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Abstract

Purpose

Osteoarthritis of the ankle and tarsal joints is less common than osteoarthritis of the knee or hip, but the associated disability is at least as severe as that of the other major joints of the lower limb. The results for total arthroplasty are still not satisfactory. For this reason, arthrodesis is still the gold standard of non-joint-conserving surgery. For the reason of functionality, joint-conserving therapies play a major role in treatment of ankle and tarsal osteoarthritis. Low-dose radiotherapy has a long history of treatment of osteoarthritis. The aim of this survey was to examine the results of low-dose radiotherapy for osteoarthritis of the ankle and tarsal joints.

Materials and methods

The analysis was performed on patients of three German radiotherapy institutions and included 66 irradiated joints. Pain was documented with the numeric rating scale (NRS). Evaluation of the NRS was done before and directly after each radiation therapy course as well as for the follow-up of 24 months. The median age of the patients was 68 years, with 24.5% male and 75.5% female patients. The upper ankle was treated in 37.9%, the lower ankle in 27.3% and the tarsal joints in 34.8%.

Results

We could find a significant response to radiotherapy. For the whole sample, the median pain was 7 on the NRS before radiotherapy, 5 after 6 and 12 weeks, and 4 after 12 months. The percentage of patients with 0 or 1 on the NRS was 19.6% 12 months after radiotherapy. An improvement of joint mobility could be detected in 56.7% of the cases. All investigated subgroups had a significant reduction in pain.

Conclusion

Radiotherapy of ankle and tarsal osteoarthritis is an effective treatment without showing side effects. All analysed subgroups show a good response to radiotherapy for at least 24 months.

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Author information

Authors and Affiliations

  1. Department of Radiotherapy, University of Regensburg, 94042, Regensburg, Germany

    Matthias G. Hautmann MD, Felix Steger MD, Silke Brockmann MD, Marius Treutwein,  Oliver Kölbl MD & Christoph Süß MD

  2. Department of Radiotherapy, Klinikum St. Marien Amberg, Amberg, Germany

    Matthias Hipp MD

  3. MVZ Dr. Neumaier & Kollegen, Regensburg, Germany

    Ulrich Neumaier MD

  4. Department of Trauma Surgery, Klinikum Osnabrück, Osnabrück, Germany

    Antonio Ernstberger MD

  5. Department of Cranio- and Maxillofacial Surgery, University of Regensburg, Regensburg, Germany

    Tobias Ettl MD

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  1. Matthias G. Hautmann MD
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  2. Matthias Hipp MD
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  3. Ulrich Neumaier MD
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  4. Felix Steger MD
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Correspondence to Matthias G. Hautmann MD.

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Conflict of interest

M.G. Hautmann, M. Hipp, U. Neumaier, F. Steger, S. Brockmann, M. Treutwein, A. Ernstberger, T. Ettl, O. Kölbl and C. Süß declare that they have no competing interests.

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Hautmann, M.G., Hipp, M., Neumaier, U. et al. Radiotherapy for osteoarthritis of the ankle and tarsal joints—analysis of 66 joints. Strahlenther Onkol 196, 569–575 (2020). https://doi.org/10.1007/s00066-019-01551-5

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  • DOI: https://doi.org/10.1007/s00066-019-01551-5

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