Radiation Therapy for the Treatment of Osteoarthritis.

Osteoarthritis is a common cause of pain and disability in the United States. Many patients experience pain that is refractory or unable to be treated by traditional treatments such as exercise, physical therapy, nonsteroidal anti-inflammatory drugs, and/or cyclooxygenase-2 inhibitors. For patients with medically refractory disease, intra-articular corticosteroid therapy, hyaluronic acid, or surgery can be considered. However, for many older patients with significant impairment in quality of life related to osteoarthritis, radiation therapy is a noninvasive treatment option that has a long history of global use. In this topic discussion, we review the clinical evidence supporting treatment of osteoarthritis, as well as considerations for how to select which patient and joint to treat. We discuss technical considerations for treatment including dose and immobilization, assessment of treatment response, and the role of retreatment.