Ogilvie-Harris D J, McLean J, Zarnett M E
Toronto Hospital Arthritis Centre, Toronto Western Hospital, Ontario.
J Bone Joint Surg Am. 1992 Jan;74(1):119-23.
Twenty-five patients who had had a diagnosis of pigmented villonodular synovitis of the knee were followed for an average of four and one-half years (range, two to ten years) after arthroscopic treatment. Five patients had had localized lesions and had been managed with local resection; all five had improvement, with no apparent recurrence. The remaining twenty patients had had diffuse disease. Of these twenty, eleven had had a complete arthroscopic synovectomy. All eleven had definite improvement in pain and function, and almost all had a decrease in synovitis and an increase in the range of motion of the knee; the disease recurred in only one. The other nine patients had had a partial arthroscopic synovectomy. Although most had some improvement in function and range of motion and a decrease in pain and synovitis, the disease recurred in five of the nine. Thus, in the patients who had had diffuse pigmented villonodular synovitis, the rate of recurrence was lower in those who had had a complete arthroscopic synovectomy than in those who had had a partial arthroscopic synovectomy (p = 0.01).
25例被诊断为膝关节色素沉着绒毛结节性滑膜炎的患者在接受关节镜治疗后平均随访了4.5年(范围为2至10年)。5例患者为局限性病变,接受了局部切除术治疗;所有5例均有改善,无明显复发。其余20例患者为弥漫性疾病。在这20例患者中,11例行完全关节镜下滑膜切除术。所有11例患者的疼痛和功能均有明显改善,几乎所有患者的滑膜炎均减轻,膝关节活动范围增加;仅1例复发。另外9例患者行部分关节镜下滑膜切除术。虽然大多数患者的功能和活动范围有所改善,疼痛和滑膜炎减轻,但9例中有5例复发。因此,在患有弥漫性色素沉着绒毛结节性滑膜炎的患者中,完全关节镜下滑膜切除术患者的复发率低于部分关节镜下滑膜切除术患者(p = 0.01)。