Microsurgical Management of Pigmented Villonodular Synovitis of the Knee / 中国微创外科杂志

ABSTRACT

Objective To investigate the value of microsurgical management for the diagnosis and treatment of pigmented villonodular synovitis(PVNS)of the knee.Methods Thirty-eight patients with PVNS of the knee that were confirmed by arthroscopy were treated in our unit between January 2002 and April 2006.Among the patients,5 were referred from other hospitals because of postoperative recurrence.Villusectomy was performed in each of the patients by using arthroscopy.In the cases with larage extra-articular lesions,small auxiliary incision was made for complete resection.All the resected masses were examined pathologically after the surgery,and the patients received intra-anticular drainage,local ice therapy,and functional exercises afterwards.Results Unilateral surgery was performed on this group of patients.Under an arthroscope,the synovium showed characteristic yellow-brown color.Patholgocial examination confirmed PVNS in all the cases,including 20 cases of local PVNS and 18 diffused lesions.Open surgery was performed on 6 patients owing to large lesion at the popliteal fossa.According to the International Knee Documentation Committee(IKDC)Scoring Forms,the mean IKDC score increased from 60.4?6.1 to 89.3?7.2 in one year after the operation.The 38 patients were followed up for 1 to 4 years(mean 2.1 years),none of them had recurrence during this period.Two of the patients,who had been treated by open surgery and then were referred to our hospital,could not flex their knees to 90? after the microsurgery.Whereas,all the others achieved normal knee flexion.Conclusions Arthroscopy is reliable for the diagnosis and treatment of PVNS.For large extra-articular lesions,open surgery using small auxiliary incision is necessary for complete resection and avoidance of recurrence.