EFFECTIVENESS OF ARTHROSCOPIC SYNOVECTOMY IN TREATMENT OF PIGMENTED VILLONODULAR SYNOVITIS OF KNEE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DONG Peilong , TANG Xiaobo , WANG Jian.

Department of Orthopedics, Jianhu Hospital, Nantong University, Yancheng Jiangsu, 224700, P.R.China. Corresponding author: TANG Xiaobo, E-mail: txb5122@sina.com;

Corresponding author：

Keywords：

Pigmented villonodular synovitis; Knee; Arthroscope; Synovectomy

DOI：

10.7507/1002-1892.20130257

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Objective To explore the effectivness of arthroscopic synovectomy in the treatment of pigmented villonodular synovitis (PVNS) of the knee. Methods A retrospective analysis was conducted on 13 patients with PVNS of the knee treated with arthroscopic synovectomy between June 2008 and December 2011, including 8 left knees and 5 right knees. There were 9 males and 4 females, aged 25-45 years (mean, 33 years). Of 13 patients, 5 had a history of trauma, and 8 had no history of trauma. The disease duration ranged from 4 months to 80 months (mean, 44 months). The preoperative Lysholm score was 45.3 ± 4.2, and International Knee Documentation Committee (IKDC) 2000 score was 46.8 ± 4.9. All patients underwent arthroscopic synovectomy and postoperative radiotherapy. Results The pathological examination proved PVNS in all cases. All incisions obtained healing by first intention after operation. There was no neurovascular injury or knee infection. The average follow-up period was 21.8 months (range, 12-30 months). The Lysholm score was 90.2 ± 7.4, and IKDC2000 score was 87.8 ± 3.8 at last follow-up, showing significant differences when compared with preoperative scores (t=22.64, P=0.00; t=24.32, P=0.00). No recurrence was observed during follow-up. Conclusion Arthroscopic synovectomy can be effective in the treatment of PVNS of the knee, and it has the merits of minimal invasion, rapid function recovery of the knee joint, and satisfactory results. So it is a safe, promising, and minimal invasive procedure in treatment of PVNS.

Citation： DONG Peilong,TANG Xiaobo,WANG Jian.. EFFECTIVENESS OF ARTHROSCOPIC SYNOVECTOMY IN TREATMENT OF PIGMENTED VILLONODULAR SYNOVITIS OF KNEE. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(10): 1171-1174. doi: 10.7507/1002-1892.20130257 Copy

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2.	Koh KH, Lim KS, Yoo JC. Arthroscopic treatment of pigmented villonodular synovitis involving bilateral shoulders. Orthopedics, 2010, 33(6): 442.
3.	Lauger J, Palmer J, Rosón N, et al. Pigmented villonodular synovitis and giant cell tumors of tendon sheath: radiologic and pathologic feature. AJR Am J Roentgenol, 1999, 172(4): 1087-1091.
4.	徐洪港, 徐斌. 膝关节镜治疗色素绒毛结节性滑膜炎20例疗效分析. 中国内镜杂志, 2012, 18(5): 497-500.
5.	王洪, 孟春庆, 王小红, 等. 关节镜滑膜切除术联合放射治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎. 中国骨肿瘤骨病, 2011, 10(6): 543-546.
6.	Finis K, Sültmann H, Ruschhaupt M, et al. Analysis of pigmented villonodular synovitis with genomewide complementary DNA microarray and tissue array technology reveals insight into potential novel therapeutic approaches. Arthritis Rheum, 2006, 54(3): 1009-1019.
7.	Murphey MD, Rhee JH, Lewis RB, et al. Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics, 2008, 28(5): 1493-1518.
8.	陈玉章. 色素沉着绒毛结节性滑膜炎X线表现. 中华中西医学杂志, 2005, 3(2): 68-69.
9.	颜有霞, 徐香玖, 金新安, 等. 膝关节色素沉着绒毛结节性滑膜炎影像学表现. 实用放射学杂志, 2011, 27(8): 1227-1229.
10.	宗敏, 娄鉴娟, 祁鸣, 等. 膝关节色素沉着绒毛结节性滑膜炎X线与MR诊断. 实用放射学杂志, 2010, 26(8): 1158-1161.
11.	马春波, 魏友平, 王汝龄, 等. 膝关节色素沉着绒毛结节性滑膜炎的MRI诊断. 苏州大学学报: 医学版, 2011, 31(6): 1002-1003.
12.	McCarthy EF, Frassica FJ. Pathology of bone and joint disorders with clinical and radiographic correlation. Philadelphia: Saunders, 1998: 760.
13.	Kramer DE, Frassica FJ, Frassica DA, et al. Pigmented villonodular synovitis of the knee: diagnosis and treatment. J Knee Surg, 2009, 22(3): 243-254.
14.	赵金忠. 膝关节弥漫性色素沉着绒毛结节性滑膜炎的关节镜治疗. 中华骨科杂志, 2004, 24(3): 162-166.
15.	刘宇, 王静成, 施晓明, 等. 关节镜治疗膝关节色素沉着绒毛结节性滑膜炎的疗效分析. 中华全科医师杂志, 2011, 10(8): 600-601.
16.	刘东, 李棋, 蒋勰, 等. 关节镜下和/或切开治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎疗效分析. 中国修复重建外科杂志, 2012, 26(5): 518-521.
17.	吴萌, 高莉, 汉华, 等. 关节镜下空心钉内固定治疗陈旧性胫骨髁间嵴撕脱性骨折的临床观察. 中华显微外科杂志, 2010, 33(6): 509-510.
18.	彭伟, 黄迅悟, 关长勇, 等. 关节镜手术辅助放射治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎的疗效分析. 军事医学, 2011, 35(2): 139-141.
19.	刘宁, 赵承斌. 髋关节色素沉着绒毛结节性滑膜炎的诊断与治疗研究进展. 中国矫形外科杂志, 2010, 18(19): 1622-1625.

1. Bouali H, Deppert EJ, Leventhal LJ, et al. Pigmented villonodular synovitis: a disease in evolution. J Rheumatol, 2004, 31(8): 1659-1662.
2. Koh KH, Lim KS, Yoo JC. Arthroscopic treatment of pigmented villonodular synovitis involving bilateral shoulders. Orthopedics, 2010, 33(6): 442.
3. Lauger J, Palmer J, Rosón N, et al. Pigmented villonodular synovitis and giant cell tumors of tendon sheath: radiologic and pathologic feature. AJR Am J Roentgenol, 1999, 172(4): 1087-1091.
4. 徐洪港, 徐斌. 膝关节镜治疗色素绒毛结节性滑膜炎20例疗效分析. 中国内镜杂志, 2012, 18(5): 497-500.
5. 王洪, 孟春庆, 王小红, 等. 关节镜滑膜切除术联合放射治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎. 中国骨肿瘤骨病, 2011, 10(6): 543-546.
6. Finis K, Sültmann H, Ruschhaupt M, et al. Analysis of pigmented villonodular synovitis with genomewide complementary DNA microarray and tissue array technology reveals insight into potential novel therapeutic approaches. Arthritis Rheum, 2006, 54(3): 1009-1019.
7. Murphey MD, Rhee JH, Lewis RB, et al. Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics, 2008, 28(5): 1493-1518.
8. 陈玉章. 色素沉着绒毛结节性滑膜炎X线表现. 中华中西医学杂志, 2005, 3(2): 68-69.
9. 颜有霞, 徐香玖, 金新安, 等. 膝关节色素沉着绒毛结节性滑膜炎影像学表现. 实用放射学杂志, 2011, 27(8): 1227-1229.
10. 宗敏, 娄鉴娟, 祁鸣, 等. 膝关节色素沉着绒毛结节性滑膜炎X线与MR诊断. 实用放射学杂志, 2010, 26(8): 1158-1161.
11. 马春波, 魏友平, 王汝龄, 等. 膝关节色素沉着绒毛结节性滑膜炎的MRI诊断. 苏州大学学报: 医学版, 2011, 31(6): 1002-1003.
12. McCarthy EF, Frassica FJ. Pathology of bone and joint disorders with clinical and radiographic correlation. Philadelphia: Saunders, 1998: 760.
13. Kramer DE, Frassica FJ, Frassica DA, et al. Pigmented villonodular synovitis of the knee: diagnosis and treatment. J Knee Surg, 2009, 22(3): 243-254.
14. 赵金忠. 膝关节弥漫性色素沉着绒毛结节性滑膜炎的关节镜治疗. 中华骨科杂志, 2004, 24(3): 162-166.
15. 刘宇, 王静成, 施晓明, 等. 关节镜治疗膝关节色素沉着绒毛结节性滑膜炎的疗效分析. 中华全科医师杂志, 2011, 10(8): 600-601.
16. 刘东, 李棋, 蒋勰, 等. 关节镜下和/或切开治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎疗效分析. 中国修复重建外科杂志, 2012, 26(5): 518-521.
17. 吴萌, 高莉, 汉华, 等. 关节镜下空心钉内固定治疗陈旧性胫骨髁间嵴撕脱性骨折的临床观察. 中华显微外科杂志, 2010, 33(6): 509-510.
18. 彭伟, 黄迅悟, 关长勇, 等. 关节镜手术辅助放射治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎的疗效分析. 军事医学, 2011, 35(2): 139-141.
19. 刘宁, 赵承斌. 髋关节色素沉着绒毛结节性滑膜炎的诊断与治疗研究进展. 中国矫形外科杂志, 2010, 18(19): 1622-1625.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF ARTHROSCOPIC SYNOVECTOMY IN TREATMENT OF PIGMENTED VILLONODULAR SYNOVITIS OF KNEE

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