Perka C, Labs K, Zippel H, Buttgereit F
Department of Orthopaedics and. Department of Rheumatology and Clinical Immunology, Charité University Hospital, Humboldt University, Schumannstrasse 20/21, 10117 Berlin, Germany.
Rheumatology (Oxford). 2000 Feb;39(2):172-8. doi: 10.1093/rheumatology/39.2.172.
The localized form of pigmented villonodular synovitis of the knee joint is a rare disease with limited alteration of the synovial membrane, the pathogenesis of which is the subject of controversial discussion.
Eighteen cases have been documented in our hospital since 1976. All of the patients had additional cartilage or meniscus damage. Treatment consisted of excision of the lesion and the adjacent synovial membrane, as well as therapy of the additional damage.
The patients who had received such therapy were followed for 3-9 yr, without any clinical, sonographic or magnetic resonance tomographic signs of recurrence. In addition to the lack of a tendency towards recurrence, none of the cases displayed any further characteristics of the diffuse form of villonodular synovitis, such as invasiveness or malignant transformation.
We therefore suggest that pigmented villonodular synovitis of the knee joint should be classified more strictly than before into a potentially neoplastic (diffuse) form and a reactive granulomatous (local) form. From the cases observed, we conclude that degenerative joint lesions may be the cause of the reactive granulomatous form.
膝关节色素沉着绒毛结节性滑膜炎的局限性形式是一种罕见疾病，滑膜改变有限，其发病机制是有争议的讨论主题。
自1976年以来我院记录了18例。所有患者均伴有额外的软骨或半月板损伤。治疗包括切除病变及相邻滑膜，以及对额外损伤的治疗。
接受该治疗的患者随访3至9年，无任何临床、超声或磁共振断层扫描复发迹象。除了没有复发倾向外，所有病例均未表现出弥漫性绒毛结节性滑膜炎的任何其他特征，如侵袭性或恶性转化。
因此，我们建议膝关节色素沉着绒毛结节性滑膜炎应比以前更严格地分为潜在肿瘤性（弥漫性）形式和反应性肉芽肿性（局限性）形式。从观察到的病例中，我们得出结论，退行性关节病变可能是反应性肉芽肿性形式的病因。
