[Prognostic factors in pigmented villonodular synovitis]

By means of the diagnostic register, all of the patients in the County of Funn with the diagnosis pigmented villonodular synovitis (PVS) during the years 1973 to 1987 were localized. Out of 22 patients, 19 were followed-up clinically and radiologically. Fifteen patients had PVS in a knee, 63% were women. The diagnosis was established late. Repeated punctures of the knee with dark aspirate without relevant trauma should raise the suspicion of PVS. The clinical course of the disease could not be related to the radiographic findings or the histology but depended rather on the localization. In some patients, PVS ran a more aggressive course and arthroses were observed electively in patients treated early. The prognosis in cases diagnosed early was not better but, as treatment yielded considerable relief of symptoms, early treatment was considered to be of value. This consists of local resection of the nodular PVS elements and as radical synovectomy as possible in the diffuse cases. Treatment of recurrences should depend on the symptoms and the degree of possible arthrosis. One patient who had had three recurrences received irradiation with good results. Restricted joint mobility after synovectomy is treated effectively with brisement.