Simultaneous anterior and posterior synovectomies for treating diffuse pigmented villonodular synovitis

Area of Science:

• Orthopedic Surgery
• Oncology
• Radiotherapy

Background:

• Current treatments for diffuse pigmented villonodular synovitis (PVNS) include arthroscopic or staged open synovectomies.
• The efficacy of simultaneous anterior and posterior synovectomies for local control and functional recovery in PVNS remains unclear.

Purpose of the Study:

• To evaluate the recurrence rate and functional outcomes in patients with diffuse PVNS treated with simultaneous anterior and posterior synovectomies and adjuvant radiotherapy.

Main Methods:

• Retrospective review of 19 patients with diffuse knee PVNS treated between 2001 and 2007.
• Assessment of local recurrence via MRI and functional recovery using Tegner-Lysholm scores.
• Minimum follow-up of 42 months (median 98 months).

Main Results:

• Postoperative MRI showed residual tumor in 5/19 patients; 3 had no disease progression.
• Two recurrences occurred within 9 months, with good knee scores at long-term follow-up.
• Mean Tegner-Lysholm score improved from 59 to 93; range of motion significantly improved.

Conclusions:

• Simultaneous anterior and posterior synovectomies combined with postoperative radiotherapy offer comparable local control and functional recovery rates to staged synovectomies for diffuse PVNS.
• This surgical approach provides a viable option for managing diffuse PVNS.