Pigmented Villonodular Synovitis Of Knee Research Articles

Pigmented villonodular synovitis of knee with concomitant partial tear of anterior cruciate ligament in skeletally immature patient: A case report

Pigmented villonodular synovitis (PVNS) is benign but locally aggressive proliferative disorder that affects synovial joint, tendon sheaths, and bursae. PVNS is rare in child, while concurrent Anterior Cruciate Ligament (ACL) tear in PVNS is uncommon finding. Previous study reported ACL tear might be a risk factor in adult PVNS but lack of record for pediatric PVNS. We report a case of uncommon concomitant ACL partial tear in an already rare pediatric PVNS. A nine-year old female with pain and swelling on left knee, occurred intermittent every 2 months for 1 year prior to surgery. There was moderate knee movement restriction with history of fall from bicycle 1 year before surgery. No history of knee instability was reported. X-ray only denote joint swelling, while MRI shows intraarticular bodies suspected synovial chondromatosis with hyperintense signal sign of partial ACL tear. The patient underwent arthroscopic evaluation which exhibit intraarticular hyperemic and hypertrophic synovium with loosening anteromedial ACL bundle. Arthroscopic synovectomy was then performed followed by range of motion training and muscle strengthening rehabilitation program. Post-operative histopathological result confirms PVNS assessment. 1 year follow up post-surgery shows no recurrence of pain or swelling with free movement of left knee joint and no disturbance or instability while walking. In this case, partial ACL tear may contribute as risk factor of PVNS in child. Arthroscopic synovectomy with physical rehabilitation program shows good functional result with no recurrence at 1-year follow up.

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

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. 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. 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. 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.

Evaluation of patients with diffuse pigmented villonodular synovitis of knee with functional scoring systems after surgery and radiosynovectomy

Evaluation of patients with diffuse pigmented villonodular synovitis of knee with functional scoring systems after surgery and radiosynovectomy

Angiomyomatous Hamartoma of Popliteal Lymph Nodes Occurring in Association with Diffuse Pigmented Villonodular Synovitis of Knee

We report the first case of an angiomyomatous hamartoma (AH) of the popliteal lymph nodes (LNs) occurring in association with diffuse pigmented villonodular synovitis (PVNS) of the knee. AH is a rare benign vascular disease with a predisposition for the LNs of the inguinal region. Twenty-five cases of AH have been reported to date; however, the precise pathogenesis is still undetermined. In the present case, an open synovectomy revealed two of three popliteal LNs in close proximity to the extra-articular component of diffuse PVNS. These LNs demonstrated irregularly distributed thick-walled blood vessels in the hilum. These vessels extended into the medulla and cortex and were associated with haphazardly arranged smooth muscle cells in the sclerotic stroma. These findings are compatible with an AH. Our observations raise the possibility that AH of the popliteal LNs may represent an abnormal proliferative reaction against the inflammatory process caused by PVNS of the knee.

Arthroscopic Treatment of Pigmented Villonodular Synovitis of the Knee

Purpose : To evaluate the efficacy of arthroscopic synovectomy through the direct posteriorposterior approach in pigmented villonodular synovitis (PVNS) of the knee. Materials and Methods : Between January 1997 and May 2004, twenty-one patients underwent an arthroscopic synovectomy for PVNS of knee. The mean follow-up period was 35 months. The arthroscopic and MRI findings revealed the localized form of PVNS in six patients and the diffuse form in fifteen patients. All patients underwent an arthroscopic examination and synovectomy through the direct posterior-posterior approach. The clinical results were evaluated by the range of motion, Lysholm knee score, and the knee pain score using the visual analogue scale (minimum 0-maximum 10). Results : Among the fifteen cases with the diffuse form, three cases (14%) recurred and had secondary arthroscopic total synovectomy. One cases recurred again. Therefore, radiation therapy was performed. The Lysholm knee score improved from 62.5 to 87.3, and the VAS score improved from 5.9 to 1.8. Three patients had a mild limitation in knee motion. However, the others had full range of motion of the knee at the last follow-up. Conclusion : Arthroscopic synovectomy through the direct posterior-posterior approach could be a useful method for the treatment of PVNS of the knee, and can be used as an effective therapeutic tool particularly in posteromedial or posterolateral lesions.

Localized Pigmented Villonodular Synovitis of Knee Encircling the lnfrapatellar Tendon: Report of a Case and Paper Review

A 30 year-old female presented with a mass lesion over her right infrapatellar region. The lesion was a painful, soft, movable, well-defined lesion which measured about 3 cm × 3 cm × 3 cm. Magnetic resonance imagings (MRI) of the right knee joint revealed a localized pigmented villonodular synovitis, encircling the infrapatella tendon. Excision of the mass lesion was performed arthroscopically. Histological examination confirmed the diagnosis. Radiotherapy was arranged postoperatively. She was followed for about one and half years without recurrence. Localized pigmented villonodular synovitis is very rare. It is curable with arthroscopy and has a low recurrence rate. ( Mid Taiwan J Med 2002;7:65-9)