Oliva Francesco, Frizziero Antonio
Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata" School of Medicine, Viale Oxford 81, Rome, Italy.
Muscles Ligaments Tendons J. 2011 Oct 30;1(1):36-9. Print 2011 Jan.
Pigmented villonodular synovitis is a proliferative disease involving joints, bursas and tendon sheaths with typical histological changes in the synovial tissue. A local and diffuse form are described. Aetiology is uncertain, MRI is helpful to establish the diagnosis, which is confirmed with by biopsy. Treatment is based on the principles of tumor resection: arthroscopically in the local form, or by a open synovectomy in the diffuse form, often followed by adjuvant radiotherapy. The rate of recurrence is high, but differs in consideration of the treatment chosen. We report a 35 year old soccer player with diffuse pigmented villonodular synovitis with a history of chronic swelling knee. The patient underwent a one step open synovectomy without adjuvant therapy, with the conservation of the heads of gastrocnemius muscle. At five years of follow-up, the patient had no sign of recurrence of the condition. One step open synovectomy in this patient showed an excellent outcome with the return to his previous sport. The short follow-up and the neoplastic characteristic of the disease cannot exclude the risk of recurrence.
色素沉着绒毛结节性滑膜炎是一种累及关节、滑囊和腱鞘的增殖性疾病，滑膜组织有典型的组织学改变。该病分为局限性和弥漫性两种类型。病因尚不明确，磁共振成像（MRI）有助于确诊，确诊需通过活检。治疗基于肿瘤切除原则：局限性类型采用关节镜手术，弥漫性类型采用开放性滑膜切除术，术后常需辅助放疗。复发率较高，但因治疗方式不同而有所差异。我们报告一名35岁的足球运动员，患有弥漫性色素沉着绒毛结节性滑膜炎，有慢性膝关节肿胀病史。该患者接受了一期开放性滑膜切除术，未进行辅助治疗，保留了腓肠肌头。随访五年，患者病情无复发迹象。该患者接受的一期开放性滑膜切除术效果极佳，患者恢复了之前的运动。随访时间短以及疾病的肿瘤特性不能排除复发风险。
