Clinical study of diffuse pigmented villonodular synovitis arthroscopic using simple knee arthroscopy operation combined with post-operation radiotherapy

Abstract

Objective To explore the clinical efficacy and safety of using simple arthroscopic operation combined with post-operative radiotherapy in the treatment of knee joint diffuse pigmented villonodular synovitis (DPVNS). Methods A total of 30 cases with knee DPVNS in Wuhan Central Hospital and General Hospital of Beijing Military Region from January 2009 to January 2014 were enrolled, including 18 males and 12 females with average age of 42.5 years (28-64 years). The average duration was 35.6 months(4-121 months). According to the decision of the patients, 16 cases treated with operation combined with postoperative radiotherapy and the other 14 cases with operation alone. The treatment group accepted arthroscopic synovial excision and received local radiotherapy, the total dose of radiotherapy was 40 Gy, 2 Gy/fraction. While the control group received arthroscopic operation alone. Patients were followed up, which the average time of 38.7 months (12-72 months). The recurrence rate, clinical KSS score and function score were compared between the two groups. Results The efficiency of treatment group (14/16) was significantly higher than the control group (11/14) (χ2=9.87, P<0.05), and the recurrence rate of the former(1/16) was significantly lower than that latter (3/14)(χ2=1.83, P<0.05). Furthermore the KSS clinical score and function score were improved significantly in the treatment group(χ2=15.00, 15.78, P<0.05). The main side effect of radiation therapy were leucopenia, limb edema, skin pigmentation and so on, meanwhile the treatment group was well tolerated. Conclusions Arthroscopic operation combined with postoperative radiotherapy is safe and effective in treatment of DPVNS, and it is worthy of clinical application. Key words: Diffuse; Pigmented villonodular synovitis; Radiation therapy; Knee joint; Arthroscopic operation