Effect van lage dosis radiotherapie bij pijn bij milde heupartrose

Currently, radiotherapy for pain reduction in OA is an accepted and frequently used
treatment in Germany and in Central and Eastern European countries.
(Seegenschmiedt, 2000; Leer, 2007) In the 1960s and 70s, LDRT was also used for
OA in The Netherlands, but it is not commonly practised anymore due to conflicting literature on this topic and fear of tumour induction. Even though some studies show excellent results regarding this treatment, the quality of the available literature is not convincing and level I evidence is still missing. (Seegenschmiedt, 2000 & 2008)

Low-dose radiotherapy (LDRT) is an old but poorly investigated treatment modality for
pain related to degenerative joint pathology such as osteoarthritis. It has been shown
that low-dose radiotherapy can decrease inflammation activity and can thus possibly
reduce local pain sensation. In early osteoarthritis of the hip, synovitis has a prominent
role in pain sensation. Therefore, we will investigate the effect of low-dose
radiotherapy on pain sensation in patients with mild osteoarthritis of the hip.

Our hypothesis is that radiotherapy can achieve a pain-reducing effect of at least
20% after 6 months.

At baseline and subsequent followup will be after 1, 2, 3 and 6 months.

The study design is a prospective, double-blind, randomized trial. We will include 60
patients with early osteoarthritis of the hip, not willing or not able to undergo
surgery. The patients will be recruited in the orthopedic clinic of Orbis MC, after
which they will be included and randomized. The patients will be randomized into
three groups:
1: Irradiation (6x1 Gy) plus standard of care (n=24)
2: Sham (placebo) irradiation plus standard of care (n=24)
3: Standard of care alone (n=12)