Diffuse pigmented villonodular synovitis in knee joint: diagnosis and treatment

Area of Science:

• Orthopedics
• Rheumatology
• Oncology

Background:

• Pigmented villonodular synovitis (PVNS) is a rare, benign proliferative condition affecting the synovium.
• While PVNS can occur in any joint, the knee is the most frequently involved site.
• The diffuse form of monoarticular PVNS is more common and associated with a high recurrence rate.

Purpose of the Study:

• To review the management strategies for pigmented villonodular synovitis.
• To discuss the efficacy of different surgical and adjuvant treatments.
• To highlight the heterogeneity in reporting functional outcomes.

Main Methods:

• Review of literature on pigmented villonodular synovitis management.
• Comparison of open surgery, arthroscopic synovectomy, and combined approaches.
• Evaluation of adjuvant therapies like radiation.

Main Results:

• Open surgery is a classical treatment; arthroscopic synovectomy offers advantages for intra-articular cases.
• A combined approach is recommended for extra-articular involvement.
• Adjuvant radiation may decrease recurrence rates in diffuse PVNS.

Conclusions:

• Synovectomy, regardless of approach, may prevent secondary osteoarthritis and joint replacement.
• There is significant heterogeneity in reported functional results, precluding definitive conclusions.
• Individualized patient management is crucial for optimal outcomes in PVNS.