Arthroscopic treatment of giant cell tumor of tendon sheath in knee joints of adolescents

Abstract

Objective To explore the clinical features and arthroscopic treatment of giant cell tumor of tendon sheath in knee joints of adolescents. Methods From April 2005 to July 2013, 8 patients with giant cell tumor of tendon sheath in knee joints were recruited for arthroscopy. There were 5 males and 3 females with an average age of 15.1 (10-17) years. Lesions were located in left (n=4) and right (n=4) knees. The average disease course was 9.3 (2-18) months. Modified hematological scoring system (HSS) was used for evaluating the postoperative recovery of knee. Results The average follow-up period was 33.1 (12-48) months. At 4 weeks post-operation, swelling and pain of knee joints persisted in all cases, especially after exercises. Swelling and pain significantly decreased after rest. At 8 weeks post-operation, the symptoms were obviously relieved, disappeared or greatly improved as compared with that pre-operation. The preoperative HSS score was 36.0±5.2 points versus 90.0±4.9 points at 8 weeks post-operation. The differences were statistically significant (P<0.001). No recurrence was detected by color Doppler ultrasound or magnetic resonance imaging (MRI) up to the latest follow-up visit. Conclusions Missed diagnosis and misdiagnosis frequently occur for giant cell tumor of tendon sheath in knee joints. And its diagnostic accuracy rate may be improved through careful physical examination, MRI and color Doppler ultrasound. The efficacies of arthroscopy are satisfactory and joint functions recover earlier. Key words: Knee joint; Giant cell tumor of bone; Arthroscope