Prospective Clinical Evaluation of Intra-Articular Injection of Tin-117m ((117m)Sn) Radiosynoviorthesis Agent for Management of Naturally Occurring Elbow Osteoarthritis in Dogs: A Pilot Study

PURPOSE: To evaluate the clinical effects of an intra-articular injection of (117m)Sn-colloid for management of canine grade 1 or 2 elbow osteoarthritis (OA). PATIENTS AND METHODS: This was a prospective study in 23 dogs with grade 1 or 2 elbow OA. An orthopedic examination and elbow radiographs were performed to confirm the presence of OA. Dogs were randomly assigned to receive unilateral intra-articular (IA) injection of low-dose (LD: 1.0mCi, n =8), medium-dose (MD: 1.75mCi, n =6), or high-dose (HD: 2.5mCi, n =9) of (117m)Sn-colloid. The primary outcome measure was peak vertical force (PVF) from force-plate gait analysis and secondary outcome measures included the Canine Brief Pain Inventory score (CBPI) and elbow goniometry. The CBPI was evaluated at pretreatment and then monthly post treatment for 1 year, and goniometry and PVF were evaluated at pretreatment, and at 1, 3, 6, 9 and 12 months post treatment. RESULTS: PVF improved at 3, and 9 months compared to pretreatment values in the HD group. CBPI scores improved at most of the time points in all dose groups. There was no significant difference in elbow goniometry between treated and untreated elbows. There were no self-reports of any adverse effects of the injection by the owners and none were noted by the examining veterinarian at the time of regularly scheduled re-evaluations. CONCLUSION: (117m)Sn IA injection was free of any obvious adverse effects, improved CBPI scores, and increased weight bearing in limbs with elbow OA providing preliminary evidence that (117m)Sn may be beneficial in the management of elbow OA in dogs. Although (17m)Sn appeared to be effective for management of elbow OA in these dogs, this pilot study has inherent limitations; therefore, future studies with larger numbers and with placebo group are needed.