[ARTHROSCOPIC TREATMENT OF PIGMENTED VILLONODULAR SYNOVITIS OF ANKLE]

To investigate the effectiveness of arthroscopic treatment of pigmented villonodular synovitis (PVNS) of the ankle.

Twelve patients who were initially diagnosed as having PVNS of the ankle were treated between January 2005 and May 2012. There were 6 males and 6 females, aged 20-50 years (mean, 35.4 years). Disease duration ranged from 6 months to 12 years (median, 3.6 years). One case of recurrence was included. The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 55.5 ± 7.6. According to degree and range of the PVNS lesions, 4 cases of local PVNS were treated with arthroscopic debridement, and 8 cases of diffuse PVNS were treated with arthroscopically assisted arthrotomy; and local radiotherapy was given in all patients after operation.

Primary healing of incision was obtained in all patients. The mean follow-up time was 2.8 years (range, 1-6 years). At 12 months after operation, no obvious pain, swelling, and limited range of motion of the ankle were observed. The AOFAS score was increased to 84.3 ± 3.4 at 12 months, and it was significantly higher than that at preoperation (P < 0.05) and at 3 months after operation (82.8 ± 3.8) (P < 0.05). There was no recurrence during follow-up.

Arthroscopic arthrotomy combined with postoperative radiotherapy are recommended for PVNS of the ankle according to the PVNS lesion degree and range. And arthroscopically assisted surgery has many advantages of less traumas and hemorrhage, fast recovery, and less complications.