Institute of Sports Medicine, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.
Knee Surg Sports Traumatol Arthrosc. 2018 Oct;26(10):3118-3123. doi: 10.1007/s00167-017-4488-8. Epub 2017 Apr 7.
The aim of this study was to provide the outcomes and to analyze the recurrence of Pigmented Villonodular Synovitis (PVNS) of the ankle joint treated by surgical synovectomy.
Thirty-one PVNS cases of the ankle, including 5 localized PVNS cases and 26 diffuse PVNS cases, were treated in our institute between 2004 and 2015. The median age was 35 (range 18-63) years. The 5 localized PVNS cases were treated with partial synovectomy (group I); 10 diffuse PVNS cases limited to intra-articular synovium received arthroscopic comprehensive synovectomy (group II); and 16 cases with diffuse PVNS spreading to extra-articular tendon sheaths underwent combined arthroscopic and open synovectomy (group III). Adjuvant radiotherapy was provided in groups II and III. The American Orthopaedic Foot and Ankle Society (AOFAS) score and subjective grading of procedure were used to evaluate the results.
Twenty-seven patients were followed with a median of 54 (range 15-108) months. In the three groups, the average AOFAS score improved from 75 (in all three groups) points preoperatively to 100 (group I), 97 (group II), and 90 points (group III) postoperatively. The rate of good-to-excellent result was 100% in group I and II and 73.3% in group III. Only in group III, recurrence occurred in five cases.
Diffuse PVNS of the ankle can be successfully managed with surgical synovectomy and adjuvant radiotherapy. Radiotherapy is not needed for localized PVNS. The recurrence rate in PVNS patients with extra-articular extension is higher.
IV.
本研究旨在提供结果，并分析经手术滑膜切除术治疗的踝关节色素绒毛结节性滑膜炎（PVNS）的复发情况。
2004 年至 2015 年期间，我院共收治 31 例踝关节 PVNS 患者，其中局限性 PVNS 5 例，弥漫性 PVNS 26 例。患者的平均年龄为 35 岁（18-63 岁）。5 例局限性 PVNS 患者行部分滑膜切除术（I 组）；10 例局限于关节内滑膜的弥漫性 PVNS 患者接受关节镜下全面滑膜切除术（II 组）；16 例弥漫性 PVNS 向关节外肌腱鞘扩散的患者行关节镜和开放滑膜切除术（III 组）。II 组和 III 组均行辅助放疗。采用美国矫形足踝协会（AOFAS）评分和手术主观分级评估疗效。
27 例患者获得随访，平均随访时间为 54 个月（15-108 个月）。三组患者的 AOFAS 评分均从术前的 75 分（三组均为 75 分）提高到术后的 100 分（I 组）、97 分（II 组）和 90 分（III 组）。I 组和 II 组的优良率为 100%，III 组为 73.3%。仅在 III 组中，有 5 例患者复发。
踝关节弥漫性 PVNS 可通过手术滑膜切除术和辅助放疗成功治疗。局限性 PVNS 无需放疗。关节外延伸的 PVNS 患者复发率较高。
IV。
