scholarly journals Arthroscopic Management of Pigmented Villonodular Synovitis of the Hip in Children and Adolescents

2018 ◽  
Vol 6 (3) ◽  
pp. 232596711876311 ◽  
Author(s):  
S. Clifton Willimon ◽  
Tim Schrader ◽  
Crystal A. Perkins
Keyword(s):  
Pediatric Patients ◽  
Case Reports ◽  
Pediatric Population ◽  
Case Series ◽  
Pigmented Villonodular Synovitis ◽  
Villonodular Synovitis ◽  
Arthroscopic Synovectomy ◽  
Duration Of Symptoms ◽  
Pigmented Villonodular

Background: Pigmented villonodular synovitis (PVNS) is a benign proliferative synovial disorder most commonly described to affect the knee in adults. Literature describing PVNS in the pediatric population is limited to 2 small case series and a handful of single-patient case reports. Within these studies, only 2 patients with PVNS of the hip are described. Purpose: To describe the presentation, management, and outcomes of a single-center series of pediatric patients with PVNS of the hip treated with arthroscopic synovectomy. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of consecutive pediatric patients treated for PVNS at a single institution was performed. Inclusion criteria consisted of patients younger than 19 years with surgically treated PVNS of the hip. Results: Five pediatric patients with a mean age of 11.0 years were treated for PVNS of the hip from 2011 to 2016. The mean duration of symptoms from onset to surgical treatment was 247 days (range, 3-933 days). Upon review of magnetic resonance imaging (MRI) results, radiologists included PVNS in their differential in 3 patients. Seven surgeries were performed in 5 patients. All therapeutic procedures were arthroscopic synovectomies. Nodular PVNS was present in 4 patients, and diffuse disease was present in 1 patient. At a mean 32-month follow-up (range, 12-63 months), all patients were considered to be free of recurrence based on clinical examination and/or follow-up MRI. Four patients were asymptomatic and returned to all of their previous sports activities. Conclusion: Young age at the time of diagnosis is a point to be highlighted in this cohort, and symptoms may be present for many months prior to diagnosis due to the failure to consider PVNS in children. Therefore, for patients with “atypical” presentations or lack of improvement with treatment for rheumatologic, bleeding, or infectious disorders, PVNS should be strongly considered. MRI with gradient echo sequences is the diagnostic imaging study of choice. One patient with diffuse involvement and preoperative degenerative changes showed progressive changes postoperatively. This type of PVNS may have a worse prognosis, but more diffuse cases are needed before the prognosis can be determined. Arthroscopic synovectomy following a timely diagnosis of PVNS produces good outcomes in nodular cases, with no evidence of symptomatic or radiographic disease persistence among these patients.

Functional improvement and low recurrence rate after combined staged synovectomy and external radiotherapy for diffuse pigmented villonodular synovitis of the knee: a minimum 2 years’ follow-up case series

2020 ◽  
Vol 5 (2) ◽  
pp. 69-73
Author(s):  
Mohamed ElAttar ◽  
Hossam Fathi ◽  
Fahmy Samir Fahmy
Keyword(s):  
Range Of Motion ◽  
Case Series ◽  
Pigmented Villonodular Synovitis ◽  
Functional Improvement ◽  
Functional Evaluation ◽  
Villonodular Synovitis ◽  
External Radiotherapy ◽  
Sf 36 ◽  
Pigmented Villonodular

ObjectiveTreatment of diffuse pigmented villonodular synovitis (DPVNS) of the knee is problematic and controversial with a high rate of morbidities and local recurrence. The purpose of this study is functional evaluation of patients with diffuse knee PVNS treated with combined surgical and external radiosynovectomy.MethodsBetween June 2011 and May 2015, twelve patients (four males and eight females) with DPVNS of the knee were treated by staged surgical synovectomy (arthroscopic anterior and open posterior) followed by low-dose external radiation. SF-36, Musculoskeletal Tumor Society (MSTS), Lysholm, International Knee Documentation Committee (IKDC) scores and range of motion (ROM) were assessed preoperatively and at the final follow-up.ResultsAfter a mean follow-up period of 46.7±15 (25–72) months, there were statistically significant improvement of ROM from 72.5±17.6 to 94.2±7.01, Lysholm score from 42.8±5.2 to 78.1±5.1, IKDC from 39.6±8.3 to 75.3±6, MSTS from 5.6±2.7 to 19.7±6.06 and SF-36 score from 29.4±7.5 to 72.3±17.5. Apart from limited range of motion, three mild complications were encountered (superficial wound infection, repeated effusion and transient neuropraxia).ConclusionCombined staged synovectomy and external radiotherapy provide functional improvement of the knee and quality of patients’ lives with low rate of recurrence for knee DPVNS cases.Level of evidenceProspective case series; level IV.

scholarly journals Clinical Outcomes of Endoscopic Synovectomy With Adjuvant Radiotherapy of Pigmented Villonodular Synovitis of The Hip: A Case Series of Single Center

2021 ◽  
Author(s):  
Hao Sun ◽  
XiaoDong Ju ◽  
Hong-Jie Huang ◽  
Xin Zhang ◽  
Jian-Quan Wang
Keyword(s):  
Clinical Outcomes ◽  
Adjuvant Radiotherapy ◽  
Case Series ◽  
Pigmented Villonodular Synovitis ◽  
Villonodular Synovitis ◽  
Outcome Measurements ◽  
Post Operation ◽  
Vas Scores ◽  
Pigmented Villonodular

Abstract Background: Though radiotherapy has been widely used for knee pigmented villonodular synovitis (PVNS), there is few literatures about radiotherapy for the treatment of PVNS hip. Thus, the purpose of this study was to analyze the clinical outcomes of endoscopic synovectomy with/without radiotherapy postoperatively of PVNS hip.Methods: We performed a retrospective study of patients who underwent endoscopy in our hospital from November 2010 to January 2021. Patients with magnetic resonance image (MRI) signs, endoscopic findings and/or histological evidence of PVNS were included. All patients underwent synovectomy endoscopically and were divided into two groups depending on receiving postoperative radiotherapy or not. The primary outcome measurements were the recurrence of PVNS, receiving revision, and/or converting to total hip arthroplasty (THA). The secondary outcome measurements were the patient-reported outcome (PRO) collected at pre- and post-operation, which consist of Hip Outcome Score Activities of Daily Living (HOS-ADL), modified Harris Hip Score (mHHS), International Hip Outcome Tool-12 (IHOT-12), Non-arthritic Hip Scale (NAHS), and visual analog scale (VAS).Results: In a case series of 16 patients (8 cases of male, 50%), 4 (25%) cases were localized type and 12 (75%) cases were diffuse type. The average follow-up was 44.8±38.2 months (range,3 to 110). 8 (50%) cases (6 diffuse cases and 2 localized cases) received radiotherapy postoperatively, and the rest (6 diffuse cases and 2 localized cases) received endoscopic treatment alone. At the latest follow-up, 3 (18.75%) cases (2 diffuse cases and 1 localized case) who did not receive radiotherapy converted to arthroplasty. The preoperative HOS-ADL, mHHS, IHOT-12, NAHS, VAS scores of remaining 13 patients were 63.1±19.1 (range,32.0 to 98.8), 54.8±20.1 (range, 10.0 to 77.0), 50.9±15.4 (range, 31.0 to 76.6) ,51.6±15.9 (range, 20.0 to 84.4), 6.0±1.4 (range,4.0 to 8.0) points, respectively. The latest HOS-ADL, mHHS, IHOT-12, NAHS, VAS scores of the 13 patients were 79.7±10.8 (range, 58.0 to 97.6), 78.6±9.1 (range,55.0 to 87.0), 74.7±9.7 (range, 55.6 to 91.0), 78.9±18.7 (range,20.0 to 92.5), 3.1±1.2 (range,2.0 to 6.0) points respectively. There was a statistically significant difference between pre- and post-operation PRO.Conclusion: Endoscopic synovectomy can achieve satisfactory PRO in PVNS hip patients. Besides, postoperative adjuvant radiotherapy can achieve higher hip survivability than synovectomy alone in this present study.

scholarly journals Radiosynoviorthesis after Surgery in the Treatment of Patients with Ankle Pigmented Villonodular Synovitis: A Case Series

2020 ◽  
Vol 9 (2) ◽  
pp. 597 ◽  
Author(s):  
Ioannis Iakovou ◽  
Panagiotis Symeonidis ◽  
Dimitrios Kotrotsios ◽  
Evanthia Giannoula ◽  
Christos Sachpekidis
Keyword(s):  
Case Series ◽  
Surgical Excision ◽  
Pigmented Villonodular Synovitis ◽  
Histopathological Diagnosis ◽  
Villonodular Synovitis ◽  
Foot Function ◽  
Pre Treatment ◽  
Open Debridement ◽  
Pigmented Villonodular

Pigmented villonodular synovitis (PVNS) of the ankle is a very rare, locally aggressive, proliferative disorder. Although surgical excision represents the standard curative treatment, the PVNS relapse rate is high. We present our study of five young athletes (range 20–36 years) with a histopathological diagnosis of PVNS of the ankle, who were treated by surgery and adjuvant radiosynoviorthesis (RSO). The operation involved either arthroscopic (four patients) or open (one patient) debridement, followed by intraarticular RSO with the radiopharmaceutical erbium-169 (169Er). They were evaluated with the Foot Function Index (FFI) and a visual analog scale (VAS) for pain. At a median follow up period of 47 months (range 36–54 months), all five patients reported marked pain relief with improvements in their daily activities. In particular, the median FFI decreased from 77% (range 71.0%–84.5%) pre-treatment, to 0.5% (range 0%–6%) after treatment. The median VAS score decreased from 4 (range 3–7) to 0 (range 0–1), respectively. Throughout the follow-up period, there were no major complications regarding either therapeutic intervention (arthroscopic or open debridement, RSO). Based on these results, it can be concluded that adjuvant RSO with 169Er following surgical excision is effective and safe in the treatment of PVNS of the ankle.

Postoperative radiotherapy for pigmented villonodular synovitis (PVNS): case series and literature review

2021 ◽  
pp. 1-3
Author(s):  
T. Al-Hajri ◽  
K. Al-Madailwi ◽  
J. Riromar
Keyword(s):  
Postoperative Radiotherapy ◽  
External Beam Radiotherapy ◽  
Three Dimensional ◽  
Case Series ◽  
Disease Recurrence ◽  
Pigmented Villonodular Synovitis ◽  
Villonodular Synovitis ◽  
Arthroscopic Synovectomy ◽  
Oncology Centre ◽  
Pigmented Villonodular

Abstract Purpose: Pigmented villonodular synovitis (PVNS) is a rare benign proliferative disease of the synovium with locally aggressive behaviour. We reviewed our experience using external beam radiotherapy (RT) in the treatment of PVNS. Method: We report five cases of PVNS who underwent Arthroscopic Synovectomy followed by postoperative RT in National Oncology centre in Oman. The total dose RT ranges between 30 and 36 Gray (Gy) Three-dimensional radiotherapy technique. Conclusion: Postoperative RT is effective in preventing disease recurrence and should be offered following maximal cytoreduction to enhance local control in PVNS.

A case series of intra-articular diffuse pigmented villonodular synovitis of the knee: Prognosis of complete synovectomy under arthroscopic surgery

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110220
Author(s):  
You-Hung Cheng ◽  
Yi-Hsuan Lin ◽  
I-Chuan Tseng ◽  
Yi-Sheng Chan
Keyword(s):  
Range Of Motion ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Pigmented Villonodular Synovitis ◽  
Villonodular Synovitis ◽  
Magnetic Resonance Imaging Mri ◽  
Pigmented Villonodular ◽  
Symptoms And Signs ◽  
Score Range

Purpose: The purpose of this study is to evaluate the outcome and prognosis of complete synovectomy performed under arthroscopic surgery in the treatment of diffuse pigmented villonodular synovitis (DPVNS) of the knee. Methods: We retrospectively reviewed 7 cases (6 female and 1 male) diagnosed with diffuse pigmented villonodular synovitis (DPVNS) of knee from 2013 to 2017. All of these cases were treated with knee arthroscopy-assisted complete synovectomy. The follow-up period ranged from 36 months to 60 months (average: 48.0 months). The pain score, range of motion and functional outcome of the knee joint were evaluated after surgery. Symptoms and signs were monitored and magnetic resonance imaging (MRI) were routinely requested to note for possible recurrence during clinical follow up. Results: During and after the surgeries of complete synovectomy under arthroscope by the same surgeon, no complications were noted in the ward or the clinic. Significant improvements were achieved in terms of the range of motion and Lysholm knee function score. There was no recurrence of DPVNS observed in our patients during a follow-up of 4 years. Conclusions: Intra-articular DPVNS of the knee can successfully be treated by complete synovectomy under arthroscope. This case series emphasized the technique of multiple portals and cycling different shavers to achieve satisfactory outcomes.

scholarly journals Pigmented Villonodular Synovitis of the Thoracic Vertebra Presenting with Progressive Spastic Paraparesis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Mustafa Celiktas ◽  
Mehmet Ozan Asik ◽  
Yurdal Gezercan ◽  
Mahir Gulsen
Keyword(s):  
Benign Lesion ◽  
Spastic Paraparesis ◽  
Pigmented Villonodular Synovitis ◽  
Whole Body ◽  
Villonodular Synovitis ◽  
Zygapophyseal Joints ◽  
Insidious Onset ◽  
Short Period ◽  
Pigmented Villonodular

Pigmented villonodular synovitis (PVNS) is a proliferative benign lesion originating from the synovium and commonly affects large joints of the extremities. PVNS can arise from any synovium in the whole body and rarely affects the zygapophyseal joints of the spine. Spinal PVNS is diagnosed mostly after resection of the mass. In our case we present a 22-year-old male patient showing progressive spastic paraparesis with insidious onset of back pain and difficulty of walking in a relatively short period of 1 month. After gross excision of the mass, diagnosis was established through histopathology. Two years of follow-up period reveals complete resolution of the patient’s complaints and no recurrence on radiologic images.

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