Pigmented villonodular synovitis managed by Yttrium 90 after debulking surgery

ABSTRACT

The goal of this study was to evaluate outcome of patients with pigmented villonodular synovitis [PVNS] managed by Yttrium90 [90Y] after debulking surgery. Seven patients [3 males and 4 females] with PVNS were studied retrospectively. Mean follow-up was 47.8 months [range 24-97 months]. Mean age was 44.8 years [range 20-68 years. Debulking surgeries via arthroscopic synovectomy were performed in 4 cases and in 3 cases via mini arthrotomy. After 90Y injection was applied. Magnetic resonance imaging [MRI] included measurement of synovial thickness in preoperative and at last control. Main musculoskeletal tumor society score was 26 [range, 23-29], main MTS rating was 70.4% [range, 38.5-86.2%]. Mean preoperative synovial thickness was 14.9mm range 20-12mm. Synovial thickness was completely disappeared at last MRI examination. There was diffuse joint effusion preoperatively, decreasing at last control. No cases of PVNS recurrence were found. Although we had a small number of cases, we believe that combination of debulking surgery with intra-articular injection of 90Y for PVNS of knee joint is an effective and safe treatment method: