Arthroscopic treatment of diffused pigmented villonodular synovitis of the knee / 中华骨科杂志

ABSTRACT

Objective To explore the technique of arthroscopic treatment of diffused pigmented villonodular synovitis, and to evaluate its clinical results. Methods 32 cases of diffused pigmented villonodular synovitis were treated by arthroscopic total synovectomy, using routine anterior approach, combined with posteromedial, posterolateral and trans-posterior-septal approach. There were 23 males and 9 females with an average of 31 years (range, 11 to 57 years). The history lasted from 9 to 39 months (mean, 27 months). 12 of the patients had been operated and recurred. Debridement of the synovium in the posteromedial and posterolateral chambers, and excision of the lesion outside the joint were emphasized. Systematic rehabilitation program were followed. The patients were followed up for 13 to 47 months, and were evaluated for pain, swelling, effusion, range of motion, and function of the whole leg. Results One year after operation, there was slight pain in 2 cases and slight swelling in 1, but no effusion was found. The range of motion was 143??5.1? on average. At the last follow-up, 23 cases received MR examination. No recurrence was found in all cases but one suspected beneath the posterior horn of the medial meniscus without symptoms. According the International Knee Documentation Committee(IKDC)criteria, subjective knee score was 63.4?5.1 and 87.9?4.9, and the Lysholm score were 35.6?4.7 and 86.3?5.6 respectively before surgery and at the last follow-up. 3 cases with postoperative knee instability were subjected to anterior cruciate ligament reconstruction because of its deficiency 3-5 months after synovectomy. Conclusion In case of diffused pigmented villonodular synovitis of the knee joint, arthroscopical total synovectomy is able to prevent recurrence and to assure the good surgical results. The procedure is minimally invasive, and useful to restore knee function.