Purpose
The objective of this study was to evaluate the effectiveness and long-term outcome
of the treatment of patients with diffuse pigmented villonodular synovitis (PVNS)
of the knee with subtotal arthroscopic and open synovectomy and subsequent external-beam
radiotherapy.
Methods
Eight patients diagnosed with diffuse PVNS by clinical and magnetic resonance imaging
were treated surgically with subtotal arthroscopic synovectomy and an additional posterior
incision for extra-articular lesions, followed by local adjuvant radiotherapy. These
patients were followed up for a mean of 8.6 years to monitor remaining lesions and
to detect new occurrences of the condition.
Results
None of the patients presented with major postoperative complications or have had
radiotherapeutic late effects. In no case was radiographic arthritis progression detected.
Three patients exhibited late minor complications (peripatellar pain, articular effusion,
and persistent quadricipital muscle atrophy). Only 1 patient (12.5%) presented with
recurrence of the disease during the follow-up period.
Conclusions
On the basis of our limited study, subtotal arthroscopic and open synovectomy with
subsequent local external-beam radiotherapy had a recurrence rate of 12.5% at 8.6
years of follow-up for the treatment of diffuse PVNS of the knee joint.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: May 04, 2012
Received in revised form:
February 2,
2012
Received:
July 18,
2011
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2012 Published by Elsevier Inc. All rights reserved.
