High recurrence and good functional results after arthroscopic resection of pigmented villonodular synovitis

• Published in: Revista española de cirugía ortopédica y traumatología 2015-11, Vol.59 (6), p.400-405
• Main Authors: Isart, A, Gelber, P E, Besalduch, M, Pelfort, X, Erquicia, J I, Tey-Pons, M, Monllau, J C
• Format: Article
• Language: Spanish
• ISSN: 1988-8856
• DOI: 10.1016/j.recot.2015.05.006

INTRODUCTIONPigmented villonodular synovitis (PVS) is a synovial proliferation disorder of uncertain aetiology, with some controversy as regards its proper treatment. The purpose of the study was to evaluate the functional outcome and recurrence rate in a series of patients diagnosed with both the diffuse and the localised type of PVS and treated by arthroscopic resection.MATERIAL AND METHODSTwenty-four patients diagnosed with PVS were retrospectively assessed. There were 11 cases with the diffuse type, and 13 cases with the localised type of PVS. They were followed-up for a median of 60 months (range, 34-204). They underwent arthroscopic synovectomy, and were functionally evaluated with IKDC, WOMET, and Kujala scores.RESULTSThere was recurrence in 8 out of 13 (61.5%) cases with the diffuse type of PVS. Two of these patients were treated with radiation. One patient underwent surgical resection with an open procedure due to extra-articular involvement. The remaining 5 patients underwent a second arthroscopic resection, and no recurrence was subsequently observed. Cases with localised PVS did not recur after a single arthroscopic resection. IKDC, WOMET and Kujala scores improved by 30.6, 37.4 and 34.03 points, respectively.DISCUSSIONPigmented villonodular synovitis treated by arthroscopic resection showed good functional results at mid-term follow-up. A single arthroscopic resection was sufficient to treat the localised PVS, whereas the diffuse type of PVS required a second arthroscopic resection in most cases, due to its high rate of recurrence.