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Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a mean follow-up of 4 years: introducing a novel technique
Background: Pigmented villonodular synovitis (PVNS) is characterized by the presence of inflammation and hemosiderin deposition in the synovium. Two forms of PVNS distinguished in the literature are diffused and localized involvements. There are controversies in the literature about the surgical man...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Iran University of Medical Sciences
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4313448/ https://www.ncbi.nlm.nih.gov/pubmed/25679002 |
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author | Jabalameli, Mahmoud Jamshidi, Khodamorad Radi, Mehran Hadi, Hosseinali Bagherifard, Abolfazl |
author_facet | Jabalameli, Mahmoud Jamshidi, Khodamorad Radi, Mehran Hadi, Hosseinali Bagherifard, Abolfazl |
author_sort | Jabalameli, Mahmoud |
collection | PubMed |
description | Background: Pigmented villonodular synovitis (PVNS) is characterized by the presence of inflammation and hemosiderin deposition in the synovium. Two forms of PVNS distinguished in the literature are diffused and localized involvements. There are controversies in the literature about the surgical management of PVNS. We report our experience in the management of knee PVNS at a mean follow-up of 4 years. We also introduce our preferred method of treatment for these patients. Methods: A number of 26 patients (26 knees) with histologically proven PVNS of the knee in the pathology department at Shafa Yahyaeyan hospital were identified between January 1996 and February 2012. Annual clinical follow-up was conducted in all patients and a follow-up MRI scans was ordered for symptomatic cases. All patients were examined according to the Knee Society Score (KSS) in which the knees were graded from excellent to poor. Results: Mean age of the patients was 28.08±12.5. A number of 15 patients (58%) had diffused involvement of the knee joint and 11 (42%) had a localized form of involvement. Mean follow up was 4 years. The mean duration of symptoms prior to presentation was 44.40±38.69 months. In five cases (23%) subtotal synovectomy and in 21 cases (77%) total synovectomy was performed. Two cases (7.7%) had recurrence. In a comparison between new methods vs. routine methods, after adjusting the pre-operation KSS scores, there was a significant difference between both methods in their post-op results. There were no complications in the form of knee instability, infection or neurovascular injury. Conclusion: The PVNS of knee joint; especially the diffused form should be carefully observed and managed using appropriate investigations. Staged open total synovectomy with a posterior and then an anterior approach seems to be a superior method for surgical treatment of diffused forms. |
format | Online Article Text |
id | pubmed-4313448 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Iran University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-43134482015-02-12 Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a mean follow-up of 4 years: introducing a novel technique Jabalameli, Mahmoud Jamshidi, Khodamorad Radi, Mehran Hadi, Hosseinali Bagherifard, Abolfazl Med J Islam Repub Iran Original Article Background: Pigmented villonodular synovitis (PVNS) is characterized by the presence of inflammation and hemosiderin deposition in the synovium. Two forms of PVNS distinguished in the literature are diffused and localized involvements. There are controversies in the literature about the surgical management of PVNS. We report our experience in the management of knee PVNS at a mean follow-up of 4 years. We also introduce our preferred method of treatment for these patients. Methods: A number of 26 patients (26 knees) with histologically proven PVNS of the knee in the pathology department at Shafa Yahyaeyan hospital were identified between January 1996 and February 2012. Annual clinical follow-up was conducted in all patients and a follow-up MRI scans was ordered for symptomatic cases. All patients were examined according to the Knee Society Score (KSS) in which the knees were graded from excellent to poor. Results: Mean age of the patients was 28.08±12.5. A number of 15 patients (58%) had diffused involvement of the knee joint and 11 (42%) had a localized form of involvement. Mean follow up was 4 years. The mean duration of symptoms prior to presentation was 44.40±38.69 months. In five cases (23%) subtotal synovectomy and in 21 cases (77%) total synovectomy was performed. Two cases (7.7%) had recurrence. In a comparison between new methods vs. routine methods, after adjusting the pre-operation KSS scores, there was a significant difference between both methods in their post-op results. There were no complications in the form of knee instability, infection or neurovascular injury. Conclusion: The PVNS of knee joint; especially the diffused form should be carefully observed and managed using appropriate investigations. Staged open total synovectomy with a posterior and then an anterior approach seems to be a superior method for surgical treatment of diffused forms. Iran University of Medical Sciences 2014-10-29 /pmc/articles/PMC4313448/ /pubmed/25679002 Text en © 2014 Iran University of Medical Sciences http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly. |
spellingShingle | Original Article Jabalameli, Mahmoud Jamshidi, Khodamorad Radi, Mehran Hadi, Hosseinali Bagherifard, Abolfazl Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a mean follow-up of 4 years: introducing a novel technique |
title | Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a mean follow-up of 4 years: introducing a novel technique |
title_full | Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a mean follow-up of 4 years: introducing a novel technique |
title_fullStr | Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a mean follow-up of 4 years: introducing a novel technique |
title_full_unstemmed | Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a mean follow-up of 4 years: introducing a novel technique |
title_short | Surgical outcomes of 26 patients with pigmented villonodular synovitis (PVNS) of the knee at a mean follow-up of 4 years: introducing a novel technique |
title_sort | surgical outcomes of 26 patients with pigmented villonodular synovitis (pvns) of the knee at a mean follow-up of 4 years: introducing a novel technique |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4313448/ https://www.ncbi.nlm.nih.gov/pubmed/25679002 |
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