色素沉着绒毛结节性滑膜炎
医学
滑膜切除术
回顾性队列研究
关节镜检查
外科
膝关节
滑膜炎
内科学
类风湿性关节炎
作者
Kavi H. Patel,Panos Gikas,Robin Pollock,Richard Carrington,Stephen R. Cannon,John Skinner,Twr Briggs,Will Aston
出处
期刊:Knee
[Elsevier]
日期:2017-08-01
卷期号:24 (4): 808-815
被引量:48
标识
DOI:10.1016/j.knee.2017.03.011
摘要
Aims Pigmented villonodular synovitis (PVNS) is a rare, locally aggressive and potentially recurrent synovial disease. We present the largest single-centre experience of knee PVNS. Our aim was to evaluate our tertiary hospital's experience in the management of knee PVNS. Patients and methods Retrospective data collection of consecutive cases of knee PVNS from 2002 to 2015. Results In total, 214 cases of knee PVNS were identified which represented 53.4% of all PVNS (12.1% were recurrent at presentation). 100 were localised PVNS (LPVNS), 114 diffuse PVNS (DPVNS) and two malignant PVNS. Knee PVNS was more likely to occur in females with a mean age of 39. Following surgery, 47.6% had recurrence with DPVNS as opposed to 8.6% with LPVNS. In LPVNS, there was no significant difference in recurrence between open and arthroscopic synovectomy (8.7% vs 9.1%, P > 0.05). However, in DPVNS, there was a significantly higher risk of recurrence with arthroscopic compared to open synovectomy (83.3% vs 44.8%, RR = 1.86 95% CI 1.32–2.62, P = 0.0004). Conclusion PVNS can be difficult to treat. We found no difference in local recurrence rates between open and arthroscopic treatment of LPVNS but significantly increased rates of recurrence for DPVNS following arthroscopic treatment. We would therefore recommend open synovectomy for DPVNS.
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