Abstract
Purpose:
We report 10 years’ experience in arthroscopic treatment of pigmented villonodular
synovitis (PVNS) of the knee in a series of patients affected by the localized or
diffuse form of the disease. The purpose of the study is to critically examine the
results of arthroscopic synovectomy in the knee affected by PVNS, to determine the
safety and effectiveness of the procedure.
Type of Study:
Retrospective case analysis.
Methods:
The study population consists of 19 patients, with an average follow-up of 60 months
(minimum, 12; maximum, 128). All patients underwent knee arthroscopy. The 3 standard
portals were used; posteromedial and posterolateral portals were added if required.
Four patients were affected by localized PVNS and were subject to partial synovectomy
with excision of the pathologic tissue. The remaining 15 patients presented a diffuse
form of PVNS; 7 of them underwent extended arthroscopic synovectomy and 8 underwent
partial synovectomy. The diagnosis was confirmed by synovial biopsy.
Results:
In the group affected by the localized form of PVNS, the arthroscopic local excision
resulted in a complete and persistent regression of the pathology. Among the patients
affected by the diffuse form of PVNS, clinical results were better and the recurrence
rate was lower in the group treated with extended synovectomy. No relevant complications
were encountered. In particular, no cases of infection, stiffness, or neurovascular
lesions were seen.
Conclusions:
Arthroscopic synovectomy is an appropriate treatment for knee PVNS. Extended synovectomy
must be performed in all cases of diffuse PVNS.
Keywords
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© 2003 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
