Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2020 May-Jun;64(3):199-205. doi: 10.1016/j.recot.2019.12.001. Epub 2020 Jan 21.
Tenosynovial giant cell tumour (TGCT) is locally aggressive entity affecting young people (around 4 decade of life) and can cause joint destruction. It could be nodular or diffuse. These two varieties are histological and genetically similar, but present a different prognosis. The aim of this study is to identify risk factors for local recurrence and predisposing factors for the development of early osteoarthritis in patients with TGCT.
We conducted a retrospective study of 35 patients with an anatomopathological diagnosis of TGCT in our Institution from 1991 to 2017. The mean follow-up was 8.2 years. Demographic variables, characteristics of the primary tumor and its evolution were collected to assess the risk factors for local recurrence and early osteoarthritis.
The diffuse type was identified as a risk factor for the development of osteoarthritis (p=0.01) and for local recurrence (p=0.015). Osteoarthritis was more frequent in the hip and ankle than in the knee (p=0.03). A difference of 16 months in the duration of symptoms prior to diagnosis between those who developed osteoarthritis and those who did not was observed (p=0.05).
The diffuse type is more aggressive than the nodular type; it is associated with a higher risk of osteoarthritis and local recurrence. The hip and ankle present a higher risk of osteoarthritis than other joints. The time of evolution of the symptoms before diagnosis and adequate treatment, negatively influences the development of osteoarthritis.
腱鞘巨细胞瘤（TGCT）是一种局部侵袭性肿瘤，主要影响年轻人（40 岁左右），可导致关节破坏。它可以是结节性或弥漫性。这两种类型在组织学和遗传学上相似，但预后不同。本研究的目的是确定 TGCT 患者局部复发的危险因素和发生早期骨关节炎的易患因素。
我们对 1991 年至 2017 年在我院接受 TGCT 解剖病理学诊断的 35 例患者进行了回顾性研究。平均随访时间为 8.2 年。收集了人口统计学变量、原发性肿瘤的特征及其演变情况，以评估局部复发和早期骨关节炎的危险因素。
弥漫型被认为是发生骨关节炎的危险因素（p=0.01）和局部复发的危险因素（p=0.015）。髋关节和踝关节比膝关节更容易发生骨关节炎（p=0.03）。发生骨关节炎和未发生骨关节炎的患者在诊断前症状持续时间上存在 16 个月的差异（p=0.05）。
弥漫型比结节型更具侵袭性；它与更高的骨关节炎和局部复发风险相关。髋关节和踝关节比其他关节更容易发生骨关节炎。诊断前症状的演变时间和适当的治疗会对骨关节炎的发展产生负面影响。
