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Pigmented villonodular synovitis

Y S Chang1, M C Ku, K C Hsu

  • 1Department of Orthopaedic Surgery, Taichung Veterans General Hospital, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|August 1, 1993
PubMed
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Pigmented villonodular synovitis (PVNS) is a condition affecting joints and tendons. Surgical excision is the primary treatment, with recurrence rates higher in knee lesions.

Area of Science:

  • Orthopedics
  • Pathology
  • Radiology

Background:

  • Pigmented villonodular synovitis (PVNS) is a rare, benign neoplastic proliferation of the synovium.
  • It can affect joints and tendon sheaths, leading to pain and limited mobility.

Purpose of the Study:

  • To analyze the clinical presentation, diagnosis, treatment, and outcomes of pigmented villonodular synovitis (PVNS).
  • To investigate factors influencing recurrence rates and the potential etiology of PVNS.

Main Methods:

  • Retrospective review of 73 patients diagnosed with PVNS between 1982 and 1990.
  • Analysis of clinical data, imaging (plain roentgenography, arthrography, MRI), surgical procedures, and follow-up data.

Main Results:

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  • PVNS occurred in 55 tendon sheath and 18 synovial joint cases, with an average age of 38.9 years.
  • Clinical presentation included swelling, effusion, and pain; imaging showed soft tissue swelling, erosion, or narrowing.
  • Recurrence rate was 26% overall, higher in knee lesions (33%), with no significant difference in mitotic index between recurrent and non-recurrent groups.

    • Conclusions:

    • Marginal excision for tendon sheath and total synovectomy for intraarticular lesions are standard treatments.
    • Extensive synovectomy with prosthesis replacement can yield good results in elderly patients with extensive cartilage destruction.
    • The findings suggest PVNS may not originate from a tumor, challenging the traditional