Microwave ablation of synovial hypertrophy in recurrent monoarthritis: the results of extended cohort and long-term follow-up


Deniz R., Güzelbey T., Mutlu I. N., Erdim Ç., Karaalioglu B., Özgür D. S., ...More

Rheumatology, vol.64, no.4, pp.1651-1660, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 64 Issue: 4
  • Publication Date: 2025
  • Doi Number: 10.1093/rheumatology/keae348
  • Journal Name: Rheumatology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, International Pharmaceutical Abstracts, MEDLINE
  • Page Numbers: pp.1651-1660
  • Keywords: microwave ablation, musculoskeletal radiology, recurrent monoarthritis, synovectomy, synovial hypertrophy, treatment resistance
  • Marmara University Affiliated: No

Abstract

Objectives: Recurrent monoarthritis (RM) is a major challenge of many rheumatic diseases. Ablation is a well-known technique in the treatment of benign or malign lesions of different aetiologies. We aimed to investigate the success and safety of microwave ablation (MWA) as an adjunctive therapy in a cohort of medical treatment-resistant RM. Methods: Patients with RM associated with different inflammatory diseases were included. MWA was performed after measuring the size of synovial hypertrophy with 15 or 20 W power and different durations until microbubbles were shown, indicating necrosis. Both clinical and radiologic data were recorded. Results: We applied MWA in total of 24 knee joints of 10 female and 12 male patients aged between 22 and 71 years. Median IA aspiration (IAA) need in the last 6 months before MWA was 5 (0–15). The median follow-up was 10 (3–16) months. Overall IAA count in the last 6 months before MWA in total of 144 months was 129, and decreased to 7 in post-MWA in total of 226 months (0.89 vs 0.03 per month, P < 0.001). The second MWA session was needed for three patients and a third session for one. Functional disability and pain scores were improved significantly (median score from 9 to 1, P < 0.00001, in both). In MRI, follow-up significant regression in synovial hypertrophy size was shown especially after the 6th month. No complication was observed during the procedure or follow-up. Conclusion: As a less invasive technique compared with the surgical approach, MWA of synovial hypertrophy showed significant clinical improvement in RM safely. MWA seems promising as a treatment option candidate in the management of RM.