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Low-dose Radiation Therapy for Benign Orthopaedic Conditions
Majid M Mohiuddin1, James E Ruffer, Ahmed Siddiqi
1From the Advocate Condell Medical Center, Libertyville, IL (Mohiuddin and Ruffer), the Radiation Oncology Consultants, Park Ridge, IL (Mohiuddin and Ruffer), the Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC (Mohiuddin), the Department of Orthopedic Surgery, WVU Medicine, Princeton, WV (Siddiqi), and the Chicago Medical School, North Chicago, IL (Makda).
None:
Low-dose radiation therapy is increasingly used for benign orthopaedic conditions, including osteoarthritis and enthesopathies, with typical regimens of 0.5 to 1 Gy per fraction and total doses of 3 to 6 Gy. Clinical studies demonstrate notable pain relief and functional improvement, particularly in patients refractory to traditional therapies, with minimal acute and long-term toxicity. Mechanistic insights reveal anti-inflammatory and immunomodulatory effects, supporting its use in degenerative and hyperproliferative musculoskeletal disorders. However, randomized trials and systematic reviews highlight ongoing controversies regarding efficacy and optimal dosing, emphasizing the need for additional high-quality trials. Consensus statements from major radiation societies recommend low-dose radiation therapy as a noninvasive adjunct for many patients, with careful patient selection and multidisciplinary collaboration.
