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

Isart Torruella, Anna; Gelber, Pablo-Eduardo; Besalduch, Marina; Pelfort López, Javier; Erquicia, Juan Ignacio; Tey Pons, Marcos; Monllau García, Juan Carlos

doi:http://dx.doi.org/10.1016/j.recot.2015.05.006

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

Citation

Isart A, Gelber PE, Besalduch M, Pelfort X, Erquicia JI, Tey-Pons M. et al. High recurrence and good functional results after arthroscopic resection of pigmented villonodular synovitis. Rev Esp Cir Ortop Traumatol. 2015 Nov-Dec;59(6):400-405. doi: 10.1016/j.recot.2015.05.006.

Abstract

INTRODUCTION: Pigmented 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 METHODS: Twenty-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. RESULTS: There 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. DISCUSSION: Pigmented 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.