Pigmented villonodular synovitis does not influence the outcome following cementless total hip arthroplasty using ceramic-on-ceramic articulation: a case-control study with middle-term follow-up

Abstract

BackgroundPigmented villonodular synovitis (PVNS) is a relatively rare, locally aggressive, and potentially recurrent synovial disease of large joints. The purpose of this study was to investigate (1) the disease recurrence rate and (2) the treatment outcomes including Harris hip scores, complications, and revision following cementless total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) articulation in patients with PVNS.MethodsTwenty-two patients (14 females and 8 males) with histologically confirmed PVNS underwent cementless THA using CoC bearings between 2000 and 2013. Three patients with less than 5-year follow-up were excluded. The mean age was 35.2 years (range, 22–58 years) with a mean follow-up of 8.6 years (range, 6.9–10.8 years). A control group was matched in a 2:1 ratio with the PVNS group for age, sex, body mass index (BMI), year of surgery, and American Society of Anesthesiologists score (ASA). Postoperative outcome variables included disease recurrence, Harris Hip Scores (HHS) at the latest follow-up, complications (dislocation, squeaking, ceramic fracture), and any-cause revision. A Kaplan-Meier implant survivorship curve with 95% confidence interval (CI) of the two groups was generated.ResultsNo recurrence of PVNS was noted in the follow-up period. The HSS in the PVNS group was 92.6 ± 5.5, which was similar to the control group (93.4 ± 4.6, p = 0.584) at the last follow-up visit. No patients sustained dislocation, osteolysis, or any ceramic fracture within the study duration. One patient in the PVNS group had a complication of squeaking, but did not require revision. Another patient in the PVNS group underwent revision surgery due to aseptic loosening. There was no significant difference in revision rates between the two groups (p = 1.000). The implant survivorship free of any revision was 90.0% (95% CI, 73.2% to 100%) in the PVNS group and 92.5% (95% CI, 82.6% to 100%) in the control group at 10 years (p = 0.99).ConclusionsFor young and active patients with end-stage PVNS of the hips, cementless THA using CoC bearing has similar functional outcome scores, a low complication rate, and similar implant survivorship compared to the control group.

Open or Arthroscopic Synovectomy Is the Preferred Management Option in Pigmented Villonodular Synovitis of the Hip Joint Without Evidence of Degeneration: A Systematic Review of 20 Studies

“…Six of these studies described the indication for arthroplasty, in which most of them was performed for joint space narrowing. 32,33,36,39,40 One study by Verspoor et al performed arthroplasty for three of its five included patients due to extensive disease. 41 Six studies The largest study we have included was a case control study by Ardeljan et al of 1,240 participants with hip PVNS.…”

“…33 However, another study by Xu et al used cementless hip arthroplasty with ceramic-onceramic bearing surfaces, due to the relatively younger ages of this patient cohort and the need to optimize component survivorship, demonstrated good survivorship in this small case series. 39 In terms of overall outcomes, Harris Hip Score was reported in four studies with a mean improvement between 30 and 48.2 points. Recurrence rates were displayed in 7 studies, ranging from 0 to 20%, of which there were two cases of recurrence (Fig 4).…”

Hip Tenosynovial Giant Cell Tumor without Recurrence in a 9-Year Follow-Up

“…There might be 8-56% chance of recurrence which might entail adjuvant radiation therapy in some cases [18][19][20]. TGCT of the hip joint is a comparatively rare condition, as the hip is affected in 15% of total cases [16,21]. Here, we aim to introduce a case of the hip TGCT without recurrence postoperatively in a 9-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

“…It is characterized by mechanical symptoms, local recurrence, and knee stiffness which can lead to severe joint destruction [3]. PVNS mainly affects young people aged 30-40, and there is no difference in gender preference [4]. The knee is the most common diseased joint [5,6].…”