Treatment of Primary Intra-Articular Pigmented Villonodular Synovitis of the Knee by Using Complete Arthroscopic Synovectomy and Postoperative Low-Dose Radiotherapy

Abstract

BackgroundPigmented villonodular synovitis (PVNS) is a locally aggressive, proliferative synovial tissue disorder, the optimal treatment regimen for diffuse PVNS is still undefined. The aim of this study was to evaluate the long-term clinical outcome of the treatment of complete arthroscopic synovectomy combined with low-dose external radiotherapy in the knee affected by primary intra-articular diffuse PVNS.MethodsA series of 18 patients diagnosed with primary diffuse PVNS by clinical and pathological examination were enrolled in this study from May 2009 to January 2016. All patients underwent complete arthroscopic synovectomy and postoperative local low-dose (20 Gy) external radiotherapy, and were evaluated before treatment and final follow-up using the criteria of Ogilvie-Harris and International Knee Documentation Committee (IKDC) score.ResultsThe patients were followed-up for a mean of 68 months (35 to 120 months). No recurrence was found. No surgical and radiation-related complications were observed. The mean score according to Ogilvie-Harris criteria was 3.19 which rated as poor, and the IKDC function score was 37.1±3.8 before treatment. At the final follow-up, the mean score of Ogilvie-Harris was 8.79 which rated as good, and the IKDC score was 83.9±11.3 (p<0.05).ConclusionTreatment for primary intra-articular diffuse PVNS in the knee with complete arthroscopic synovectomy and postoperative low-dose external radiotherapy had good clinical outcome with no complication and recurrence.