Unusual presentation of anterior knee pain in elite female athletes: report of two cases

Abstract

Two elite female athletes presented with anterior knee pain with range of motion and reproducible tenderness to palpation. Diagnostic arthroscopy was performed in both cases resulting in excision of a nodular pigmented villonodular synovitis (PVNS) in the first patient and scar tissue in the second patient. Correct diagnosis of anterior knee pain in the elite female athlete can present a challenge to clinicians. Although patellofe-moral pain is the most common diagnosis, other uncommon causes include PVNS and residual scar formation in patients with a history of surgery or trauma. Magnetic resonance imaging (MRI) images are helpful in confirming the diagnosis, however, in a subset of patients, the physician must rely on clinical suspicion and physical exam to make the proper diagnosis. Given the possibility of a false negative MRI images, patients with persistent anterior knee pain with a history of knee surgeries and focal tenderness reproducible on physical exam may benefit from a diagnostic arthroscopy.

Higher incidence of diffuse Pigmented Villonodular Synovitis in patients with ruptured cruciate ligament: A case report

“…While due to the high recurrence of diffuse PVNS, finding more effective therapies for PVNS remains a theme of dispute. In a retrospective review of the patients who accepted surgical treatment between 1990 and 2022 [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , the results exhibit that higher recurrence rate of arthroscopic synovectomy compared with open synovectomy, However, the arthroscopic therapy is a minimally aggressive surgical operation that could narrow the scope of operation, lessen tissue trauma, and promote early functional exercise, allowing the earlier return to the daily life [24] . The combined anterior arthroscopic and posterior open synovectomy in the knee could be a good option because some researches have shown that the recurrence rate of it is lower than arthroscopic synovectomy and open synovectomy.…”