Surgical Treatment of Pigmented Villonodular Synovitis of the Hip

Vastel, L.; Lambert, Patrick; Pinieux, Gonzague de; Charrois, O.; Kerboull, M.; Courpied, Jean-Pierre

doi:10.2106/jbjs.c.01297

Cited by 92 publications

(62 citation statements)

References 15 publications

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“…The goals of surgery for patients with diffuse intraarticular PVNS are to restore function of the joint and to prevent the destruction of articular cartilage by completely resecting the diseased synovium (64). The majority of literature that discusses the surgical management of diffuse intraarticular PVNS describes the approach to the knee (63).…”

Section: Treatment and Prognosismentioning

confidence: 99%

Pigmented Villonodular Synovitis: Radiologic-Pathologic Correlation

Rhee²,

et al. 2008

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Pigmented villonodular synovitis (PVNS) represents an uncommon benign neoplastic process that may involve the synovium of the joint diffusely or focally (PVNS) or that may occur extraarticularly in a bursa (pigmented villonodular bursitis [PVNB]) or tendon sheath (pigmented villonodular tenosynovitis [PVNTS]). Pathologic specimens of the hypertrophic synovium may appear villous, nodular, or villonodular, and hemosiderin deposition, often prominent, is seen in most cases. The knee, followed by the hip, is the most common location for PVNS or PVNB, whereas PVNTS occurs most often in the hand and foot. PVNTS is also referred to as giant cell tumor of the tendon sheath (GCTTS). PVNTS is the most common form of this disease by a ratio of approximately 3:1. Radiographs reveal nonspecific features of a joint effusion in PVNS, a focal soft-tissue mass in PVNB or PVNTS, or a normal appearance. Extrinsic erosion of bone (on both sides of the joint) may also be seen and is most frequent with intraarticular involvement of the hip (>90% of cases). Cross-sectional imaging reveals diffuse involvement of the synovium (PVNS), an intimate relationship to the tendon (PVTNS), or a typical bursal location (PVNB), findings that suggest the diagnosis. However, the magnetic resonance (MR) imaging findings of prominent low signal intensity (seen with T2-weighting) and "blooming" artifact from the hemosiderin (seen with gradient-echo sequences) are nearly pathognomonic of this diagnosis. In addition, MR imaging is optimal for evaluating lesion extent. This information is crucial to guide treatment and to achieve complete surgical resection. Recurrence is more common with diffuse intraarticular disease and is difficult to distinguish, both pathologically and radiologically, from the rare complication of malignant PVNS. Recognizing the appearances of the various types of PVNS, which reflect their pathologic characteristics, improves radiologic assessment and is important for optimal patient management.

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Section: Treatment and Prognosismentioning

confidence: 99%

Pigmented Villonodular Synovitis: Radiologic-Pathologic Correlation

Rhee²,

et al. 2008

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“…Open or arthroscopic synovectomy (9,12,(16)(17)(18)(19)(20), external beam radiation therapy (RT) (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), and intra-articular radionuclid application (40)(41)(42)(43) have been shown to be effective for the primary treatment and the management of recurrent disease, either alone or in various combinations. Nevertheless, there is a wide consensus that surgical synovectomy and curettage of bony lesions is the treatment of choice for the primary management of PVNS (4).…”

Section: Introductionmentioning

confidence: 99%

Radiation Therapy for Treatment of Pigmented Villonodular Synovitis: Results of a National Patterns of Care Study

Heyd¹,

Micke

Berger

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…Die chirurgische Synovektomie ist ein etabliertes Verfahren in der Behandlung der primären synovialen Chondromatose [3,4,5,6] und der pigmentierten villonodulären Synovialitis (PVNS; [7,8,9]). Anders als bei der Synovialitis auf dem Boden einer rheumatischen Erkrankung lässt sich bei einer synovialen Chondromatose oder einer PVNS eine ursächliche Behandlung nur chirurgisch durchführen.…”

Section: Vorbemerkungenunclassified

“…Auch ohne ein Rezidiv können durch den fortschreitenden Verschleiß erneute Operationen bis hin zum endoprothetischen Gelenkersatz erforderlich werden. Nach offener chirurgischer Synovektomie werden für die synoviale Chondromatose zwischen 4,8% (1 von 21 Hüften) und 25% (2 von 8 Hüften) Reoperationen mit einem Hüftgelenkersatz angegeben [3,12], für die PVNS 25% (4 von 16 Hüften) [8]. Die Rate für ein Rezidiv der synovialen Erkrankung nach offener Synovektomie liegt bei der synovialen Chondromatose zwischen 0% (0 von 8 Hüften) und 9,5% (2 von 21 Hüften, [3,12]).…”

Section: Vorbemerkungenunclassified

“…Die Rate für ein Rezidiv der synovialen Erkrankung nach offener Synovektomie liegt bei der synovialen Chondromatose zwischen 0% (0 von 8 Hüften) und 9,5% (2 von 21 Hüften, [3,12]). Die Rate für ein Rezidiv einer PVNS wird mit 6,3% (1 von 16 Hüften, [8]) angegeben. Untersuchungen an anderen Gelenken mit entsprechend höherer Fallzahl zeigen eine höhere Rezidivrate von 9-30% [16].…”

Section: Vorbemerkungenunclassified

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Arthroskopische Synovektomie des Hüftgelenks

Wunsch

Rühmann

Lipka

et al. 2014

Oper Orthop Traumatol

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From June 2007 to December 2013 a total of 20 patients with specific synovial diseases were treated with hip arthroscopy of which 18 had chondromatosis and 2 had PVNS. A telephone interview was carried out after an average of 40.2 months (range 8-92 months) and revealed a recurrence rate of the synovial disease of 20 %. In two cases (10 %) a second arthroscopy was necessary due to recurrent symptoms but without return of the synovial disease.

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Surgical Treatment of Pigmented Villonodular Synovitis of the Hip

Cited by 92 publications

References 15 publications

Pigmented Villonodular Synovitis: Radiologic-Pathologic Correlation

Pigmented Villonodular Synovitis: Radiologic-Pathologic Correlation

Radiation Therapy for Treatment of Pigmented Villonodular Synovitis: Results of a National Patterns of Care Study

Arthroskopische Synovektomie des Hüftgelenks

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