High recurrence and good functional results after arthroscopic resection of pigmented villonodular synovitis

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• 作者：A. Isart^a ; ^{isartanna@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; P.E. Gelber^a ; ^b ; M. Besalduch^b ; X. Pelfort^a ; J.I. Erquicia^a ; M. Tey-Pons^a ; J.C. Monllau^a ; ^c
• 关键词：Villonodular synovitis ; Knee ; Arthroscopy
• 刊名：Revista Española de Cirugía Ortopédica y Traumatología
• 出版年：2015
• 出版时间：November-December 2015
• 年：2015
• 卷：59
• 期：6
• 页码：400-405
• 全文大小：843 K

文摘

Pigmented villonodular synovitis (PVS) is a synovial proliferation disorder of uncertain aetiology, with some controversy as regards its proper treatment. The purpose of the study was to evaluate the functional outcome and recurrence rate in a series of patients diagnosed with both the diffuse and the localised types of PVS and treated by arthroscopic resection.

Material and methods

Twenty-four patients diagnosed with PVS were retrospectively assessed. There were 11 cases with the diffuse type, and 13 cases with the localised type of PVS. They were followed-up for a median of 60 months (range, 34–204). They underwent arthroscopic synovectomy, and were functionally evaluated with IKDC, WOMET, and Kujala scores.

Results

There was recurrence in 8 out of 13 (61.5%) cases with the diffuse type of PVS. Two of these patients were treated with radiation. One patient underwent surgical resection with an open procedure due to extra-articular involvement. The remaining 5 patients underwent a second arthroscopic resection, and no recurrence was subsequently observed. Cases with localised PVS did not recur after a single arthroscopic resection. IKDC, WOMET and Kujala scores improved by 30.6, 37.4 and 34.03 points, respectively.

Discussion

Pigmented villonodular synovitis treated by arthroscopic resection showed good functional results at mid-term follow-up. A single arthroscopic resection was sufficient to treat the localised PVS, whereas the diffuse type of PVS required a second arthroscopic resection in most cases, due to its high rate of recurrence.