Purpose
To analyze mid-term outcomes after arthroscopic synovectomy of both diffuse and nodular
hip pigmented villonodular synovitis (PVNS).
Methods
This is a retrospective case series of patients that underwent hip arthroscopy for
hip PVNS with a single senior surgeon between 2007 and 2016. Inclusion criteria were
magnetic resonance imaging evidence, arthroscopic visualization, and/or histologic
confirmation of PVNS; and a minimum of 3 years of follow-up. Concomitant pathology
such as femoroacetabular impingement also was treated at the time of surgery. Primary
outcome measures were recurrence of hip PVNS and the rate of revision hip surgery.
Secondary outcomes were complications, visual analog scale pain score, pain relief,
and patient satisfaction, and 6 patient-reported outcome measures were collected at
latest follow-up.
Results
In a case series of 14 patients consisting of 6 (42.9%) male and 8 (57.1%) female
patients, the mean operative age was 32.69 ± 12.73 years with a mean follow-up was
6.66 ± 1.87 years. PVNS type was determined intraoperatively: 5 (35.7%) patients had
diffuse hip PVNS and 9 (64.3%) had nodular type. There was only 1 case (7.14%) of
recurrence that was treated arthroscopically and no cases (0%) progressed to revision
open synovectomy or arthroplasty. Mean patient-reported outcome measure scores were
notable for a modified Harris Hip Score of 74.08 ± 16.84. The mean visual analog scale
pain score decreased by 4.9 ± 1.7, which was significant with a P < .001, with a larger decrease in patients with localized type.
Conclusions
This study presents a large case series of hip PVNS managed arthroscopically with
mid-term follow-up of slightly over 6.5 years. The survival rate was 93%, with only
1 (7%) recurrence and 0 (0%) progression to revision open synovectomy or arthroplasty
with 0 (0%) complications. We conclude that arthroscopic synovectomy is a reliable
and effective treatment of hip PVNS.
Level of Evidence
Case Series, Level IV.
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Article info
Publication history
Published online: February 13, 2020
Accepted:
January 31,
2020
Received:
September 13,
2019
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Research performed with support of the Conine Family Fund for Joint Preservation. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
ISAKOS 2019, Cancun, Mexico, Poster Presentation, Abstract #17575.
This study was performed at the Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, U.S.A.
Identification
Copyright
© 2020 by the Arthroscopy Association of North America
