Long-term success in the treatment of diffuse pigmented villonodular synovitis of the knee with subtotal synovectomy and radiotherapy.

Abstract

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.

• Authors: Lúcio Honório de Carvalho Jr, Luiz Fernando Machado Soares, Matheus Braga Jacques Gonçalves, Eduardo Frois Temponi, Otávio de Melo Silva Jr
• Journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (Arthroscopy) Vol. 28 Issue 9 Pg. 1271-4 (Sep 2012) ISSN: 1526-3231 [Electronic] United States
• PMID: 22554472 (Publication Type: Journal Article)
• Copyright: Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Arthroscopy
• Female
• Follow-Up Studies
• Humans
• Knee Joint (radiation effects, surgery)
• Male
• Middle Aged
• Radiotherapy, Adjuvant
• Synovectomy
• Synovitis, Pigmented Villonodular (diagnosis, radiotherapy, surgery)
• Treatment Outcome