Complications After Total Knee Arthroplasty in Patients With Pigmented Villonodular Synovitis

Casp, Aaron; Browne, James A.; Durig, Nicole E.; Werner, Brian C.

doi:10.1016/j.arth.2018.08.041

Cited by 17 publications

(24 citation statements)

References 26 publications

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“…It is generally known that TKA is the most effective treatment for end-stage PVNS in patients who have severe OA due to PVNS progression, and the recurrence and revision rate of PVNS are lower than that with simple synovectomy [9]. The long-term results of TKA treatment with PVNS have been well recorded, and some studies have reported excellent long-term survival of TKA in patients with PVNS [9,10]. However, it is still controversial to retain or substitute the PCL in TKA when treated with the patients with PVNS, and due to limited case studies of the knee PVNS, there is currently little data on the results of CR TKA in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…According to some articles, the survival rate of prosthesis ranges from 80 to 85% in patients with PVNS who have been followed up for more than 10 years [9]. In addition, the incidence of postoperative complications of TKA also provided acceptable results in a large number of patients diagnosed with PVNS [10]. However, it is still controversial to retain or substitute posterior cruciate ligament (PCL) in TKA when treated with patients with PVNS.…”

Section: Introductionmentioning

confidence: 99%

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Pigmented villonodular synovitis does not influence the outcomes following cruciate-retaining total knee arthroplasty: a case-control study with minimum 5-year follow-up

et al. 2020

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Background Pigmented villonodular synovitis (PVNS) is a rare synovial disease with benign hyperplasia, which has been successfully treated with total knee arthroplasty (TKA). The purpose of this study was to investigate the middle-term follow-up outcomes of cruciate-retaining (CR) TKA in patients with PVNS. Methods From January 2012 to December 2014, a retrospective study was conducted in 17 patients with PVNS who underwent CR TKA as PVNS group. During this period, we also selected 68 patients with osteoarthritis who underwent CR TKA (control group) for comparison. The two groups matched in a 1:4 ratio based on age, sex, body mass index, and follow-up time. The range of motion, Knee Society Score, revision rate, disease recurrence, wound complications, and the survivorship curve of Kaplan-Meier implant were assessed between the two groups. Results All patients were followed up at least 5 years. There was no difference in range of motion and Knee Society Score between the two groups before surgery and at last follow-up after surgery (p > 0.05). In the PVNS group, no patients with the recurrence of PVNS were found at the last follow-up, one patient underwent revision surgery due to periprosthetic fracture, and three patients had stiffness one year after surgery (17.6% vs 1.5%, p = 0.005; ROM 16–81°), but no revision was needed. At 7 years, the implant survivorship was 90.0% in the PVNS group and 96.6% in the control group (p = 0.54). Conclusions This study demonstrated that the function of patients with PVNS who underwent CR TKA had been significantly improved, and the survival rate of implants in these patients was similar to the patients with OA. Consequently, the patients with PVNS who underwent CR TKA might be an achievable option. However, these patients should pay more attention to the occurrence of postoperative stiffness complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pigmented villonodular synovitis does not influence the outcomes following cruciate-retaining total knee arthroplasty: a case-control study with minimum 5-year follow-up

et al. 2020

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“…The studies included 552 TKAs; however, only 98 patients (99 TKAs) had reported functional outcomes. Among the 552 TKAs, 83 patients (84 TKAs) had D-PVNS and 15 had L-PVNS, while the remaining 453 patients from the study by Casp et al were not characterized by the disease subtype [12]. The mean patient age of the four studies was 61 years (range 33-94).…”

Section: Cohort Characteristicsmentioning

confidence: 97%

“…The four studies included were small to medium retrospective case series (n = 10-48 patients, 11-48 TKAs) describing the outcome of TKA in patients with PVNS. Our largest study was by Casp et al (n = 453 TKAs) [12] and we decided to include this study as it was a large study that reported on the complications after TKA in patients with PVNS even though the study did not report on the pre-operative and post-operative functional outcomes. The range of follow-up in these studies was from 0.2 to 35 years.…”

Section: Quality Assessmentmentioning

confidence: 99%

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Systematic review: total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS)

Tan

Tsitskaris

2021

Knee Surg & Relat Res

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Background To determine the functional outcomes, complications and revision rates following total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS). Materials and methods We conducted a systematic review of the literature. Five studies with a total of 552 TKAs were included for analysis. The methodological quality of the articles was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) scale. Functional outcomes, complications and revision rates were assessed. The mean age was 61 years (range 33–94 years) and the mean follow-up period was 61.1 months (range 0.2–35 years). Results All the studies reported improvement in knee function following TKA. Post-operative stiffness was the most frequently reported complication, affecting 32.7% (n = 32) of patients in our review. Symptomatic recurrence of PVNS, component loosening, tibial-component fracture, instability and periprosthetic infection were the main factors leading to the need for revision TKA. Conclusion The findings of this review support the use of TKA to alleviate the functional limitations and pain due to knee degeneration in patients with PVNS. The operating surgeon should be aware of the increased risk of post-operative stiffness, as well as a potentially higher risk of infection. Implant survival should also be considered inferior to the one expected for the general population undergoing TKA.

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Pigmented Villonodular Synovitis of the Knee

Charalambous

2021

The Knee Made Easy

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Complications After Total Knee Arthroplasty in Patients With Pigmented Villonodular Synovitis

Cited by 17 publications

References 26 publications

Pigmented villonodular synovitis does not influence the outcomes following cruciate-retaining total knee arthroplasty: a case-control study with minimum 5-year follow-up

Pigmented villonodular synovitis does not influence the outcomes following cruciate-retaining total knee arthroplasty: a case-control study with minimum 5-year follow-up

Systematic review: total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS)

Pigmented Villonodular Synovitis of the Knee

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