Arthroscopic synovectomy in pigmented villonodular synovitis of the knee: clinical series and outcome

Abstract

Purpose The aim of this study was to evaluate the long-term results of arthroscopic excision of pigmented villonodular synovitis (PVNS) of the knee joint. Methods We retrospectively assessed the results of arthroscopic excision of PVNS done in 40 patients from 1987 to 2012 by the senior author (JVS). No radiotherapy was given to any patient. All patients were followed for a mean of seven years. At follow-up functional assessment was done using the Lysholm score. Recurrence-free survival and recurrence-free survival probability were calculated. Results No recurrence was noted in the localised variety. In the diffuse variety the five year recurrence-free survival probability was 57 %. Twelve patients developed recurrences between three months and two years. No recurrence was noted after two years. The mean recurrence interval was 6.25 months. Conclusions We concluded from this series that arthroscopic excision is an effective treatment for localised as well as diffuse PVNS. Recurrences can also be successfully dealt with by arthroscopic excision with excellent functional outcome.

Intramuscular Cysts at the Proximal Calf: Two Case Reports and a Systematic Review of Literature

“…MRI is the best imaging method for diagnosis, but definitive diagnosis can only be confirmed by pathological biopsy. The management of PVNS includes open surgical excision and arthroscopic synovectomy, which have been reported to have a high rate of recurrence [48,49]. Extra-articular spread of PVNS in the knee joint has scarcely been reported.…”

Review Article: Open versus Arthroscopic Synovectomy for Pigmented Villonodular Synovitis of the Knee

“…10 studies (including 270 patients) specifically on this topic were analysed (Table 1); all were retrospective case reports, and thus level of evidence was low. [1][2][3][4][5][6][7][8][9][10] PVNS was confined to the anterior compartment in 2 studies, 2,5 and affected both anterior and posterior compartments in 7 studies. 1,3,4,6,7,9,10 One study did not report the site of PVNS and the follow-up period.…”

“…8 The mean follow-up period of the other 9 studies was 6.9 (range, 3.3-8.6) years. [1][2][3][4][5][6][7]9,10 Only 2 studies 7,8 reported the approach used for open synovectomy: one used both anterior and posterior approaches 8 ; another used the posterior approach, with additional subtotal arthroscopic synovectomy. 7 Only one study reported the number of portals used in arthroscopic synovectomy: 2 to 3 portals for PVNS confined to the anterior compartment, and 5 portals for PVNS affecting the anterior and posterior compartments.…”

A case series of intra-articular diffuse pigmented villonodular synovitis of the knee: Prognosis of complete synovectomy under arthroscopic surgery

“…Partial synovectomy has been demonstrated to be effective in LPVNS with either an open procedure or arthroscopy. [11][12][13] However, the optimal method for complete synovectomy in DPVNS remains controversial. Even with an open method, the prognosis is unsatisfactory with recurrence rates as high as 33%.…”