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 etiologies. We aimed to 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-watt 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 22–71 years. Median intra-articular 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 3 patients and a third session for 1. Functional disability and pain scores were improved significantly (median score from 9 to 1, p< 0.00001, in both). In magnetic resonance imaging, follow-up significant regression in synovial hypertrophy size was shown especially after 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.

中文翻译：

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微波消融治疗复发性单关节炎滑膜肥大：扩展队列和长期随访的结果


目标 复发性单关节炎（RM）是许多风湿性疾病的主要挑战。消融是治疗不同病因的良性或恶性病变的众所周知的技术。我们的目的是调查微波消融 (MWA) 作为辅助治疗在一组难治性 RM 患者中的成功性和安全性。方法纳入伴有不同炎症性疾病的 RM 患者。在用 15 或 20 瓦功率和不同持续时间测量滑膜肥大的大小后进行 MWA，直到出现表明坏死的微泡。记录临床和放射学数据。结果 我们对年龄在 22-71 岁之间的 10 名女性和 12 名男性患者总共 24 个膝关节应用了 MWA。 MWA 之前最后 6 个月的中位关节内抽吸 (IAA) 需求为 5 (0–15)。中位随访时间为 10 (3-16) 个月。 MWA 前最后 6 个月（总计 144 个月）的 IAA 总数为 129，MWA 后总计 226 个月减少至 7（每月 0.89 vs 0.03，p< 0.001）。 3 名患者需要进行第二次 MWA 治疗，1 名患者需要进行第三次 MWA 治疗。功能障碍和疼痛评分显着改善（两者中位评分从 9 到 1，p< 0.00001）。磁共振成像显示，滑膜肥大尺寸的后续显着消退尤其是在第 6 个月后。在手术或随访过程中未观察到并发症。结论 与手术方法相比，MWA 治疗滑膜肥大是一种侵入性较小的技术，在 RM 安全方面显示出显着的临床改善。 MWA 作为 RM 管理的候选治疗方案似乎很有前景。