High recurrence and good functional results after arthroscopic resection of pigmented villonodular synovitis

© 2014 SECOT. Introduction: Pigmented villonodular synovitis (PVS) is a synovial proliferation disorder ofuncertain aetiology, with some controversy as regards its proper treatment. The purpose ofthe study was to evaluate the functional outcome and recurrence rate in a series of patientsdiagnosed with both the diffuse and the localised type of PVS and treated by arthroscopicresection.Material and methods: Twenty-four patients diagnosed with PVS were retrospectively assessed.There were 11 cases with the diffuse type, and 13 cases with the localised type of PVS. Theywere followed-up for a median of 60 months (range, 34-204). They underwent arthroscopicsynovectomy, and were functionally evaluated with IKDC, WOMET, and Kujala scores.Results: There was recurrence in 8 out of 13 (61.5%) cases with the diffuse type of PVS. Twoof these patients were treated with radiation. One patient underwent surgical resection withan open procedure due to extra-articular involvement. The remaining 5 patients underwenta second arthroscopic resection, and no recurrence was subsequently observed. Cases withlocalised PVS did not recur after a single arthroscopic resection. IKDC, WOMET and Kujalascores improved by 30.6, 37.4 and 34.03 points, respectively.Discussion: Pigmented villonodular synovitis treated by arthroscopic resection showed goodfunctional results at mid-term follow-up. A single arthroscopic resection was sufficient to treatthe localised PVS, whereas the diffuse type of PVS required a second arthroscopic resection inmost cases, due to its high rate of recurrence.