Stephan Stephen R, Shallop Brandon, Lackman Richard, Kim Tae Won B, Mulcahey Mary K
Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
Cooper University Hospital, Camden, New Jersey.
JBJS Rev. 2016 Jul 19;4(7). doi: 10.2106/JBJS.RVW.15.00086.
Evidence now exists suggesting a neoplastic origin for pigmented villonodular synovitis, including a thorough description of the translocations involved. Arthroscopic excision for localized pigmented villonodular synovitis allows for both minimal recurrence and morbidity when compared with open excision; however, open excision still plays an important role in treating posterior compartment nodules. The optimal surgical treatment for diffuse pigmented villonodular synovitis is still a matter for debate, with combined anterior arthroscopic and open posterior excision being considered the preferred method. Radiation therapy has re-emerged as an additional treatment method for pigmented villonodular synovitis; however, the potential for serious toxicity makes it a questionable option, especially for such a benign condition. Small molecule and monoclonal antibody targeted therapies are being investigated as novel treatment methods for pigmented villonodular synovitis, with promising results.
目前有证据表明色素沉着绒毛结节性滑膜炎起源于肿瘤，包括对相关易位的详尽描述。与开放性切除相比，关节镜下切除局限性色素沉着绒毛结节性滑膜炎复发率低且并发症少；然而，开放性切除在治疗后室结节方面仍发挥着重要作用。弥漫性色素沉着绒毛结节性滑膜炎的最佳手术治疗方法仍存在争议，关节镜下前路联合开放性后路切除被认为是首选方法。放射治疗再次成为色素沉着绒毛结节性滑膜炎的一种额外治疗方法；然而，其严重毒性的可能性使其成为一个有问题的选择，尤其是对于这样一种良性疾病。小分子和单克隆抗体靶向治疗正在作为色素沉着绒毛结节性滑膜炎的新型治疗方法进行研究，结果令人鼓舞。
