Iakovou Ioannis, Symeonidis Panagiotis, Kotrotsios Dimitrios, Giannoula Evanthia, Sachpekidis Christos
Academic Department of Nuclear Medicine, School of Medicine, University Hospital AHEPA, 54621 Thessaloniki, Greece.
Department of Nuclear Medicine, Aristotle University of Thessaloniki, Papageorgiou Hospital, 57006 Thessaloniki, Greece.
J Clin Med. 2020 Feb 22;9(2):597. doi: 10.3390/jcm9020597.
Pigmented villonodular synovitis (PVNS) of the ankle is a very rare, locally aggressive, proliferative disorder. Although surgical excision represents the standard curative treatment, the PVNS relapse rate is high. We present our study of five young athletes (range 20-36 years) with a histopathological diagnosis of PVNS of the ankle, who were treated by surgery and adjuvant radiosynoviorthesis (RSO). The operation involved either arthroscopic (four patients) or open (one patient) debridement, followed by intraarticular RSO with the radiopharmaceutical erbium-169 (Er). They were evaluated with the Foot Function Index (FFI) and a visual analog scale (VAS) for pain. At a median follow up period of 47 months (range 36-54 months), all five patients reported marked pain relief with improvements in their daily activities. In particular, the median FFI decreased from 77% (range 71.0%-84.5%) pre-treatment, to 0.5% (range 0%-6%) after treatment. The median VAS score decreased from 4 (range 3-7) to 0 (range 0-1), respectively. Throughout the follow-up period, there were no major complications regarding either therapeutic intervention (arthroscopic or open debridement, RSO). Based on these results, it can be concluded that adjuvant RSO with Er following surgical excision is effective and safe in the treatment of PVNS of the ankle.
踝关节色素沉着绒毛结节性滑膜炎（PVNS）是一种非常罕见的、具有局部侵袭性的增殖性疾病。尽管手术切除是标准的治愈性治疗方法，但PVNS的复发率很高。我们报告了对5名年轻运动员（年龄范围20 - 36岁）的研究，他们经组织病理学诊断为踝关节PVNS，接受了手术及辅助放射性滑膜切除术（RSO）治疗。手术包括关节镜下清创（4例患者）或开放性清创（1例患者），随后使用放射性药物铒 - 169（Er）进行关节内RSO。采用足部功能指数（FFI）和视觉模拟评分量表（VAS）对疼痛进行评估。在中位随访期47个月（范围36 - 54个月）时，所有5名患者均报告疼痛明显缓解，日常活动有所改善。特别是，FFI中位数从治疗前的77%（范围71.0% - 84.5%）降至治疗后的0.5%（范围0% - 6%）。VAS评分中位数分别从4（范围3 - 7）降至0（范围0 - 1）。在整个随访期间，两种治疗干预措施（关节镜或开放性清创、RSO）均未出现重大并发症。基于这些结果，可以得出结论，手术切除后使用Er进行辅助RSO治疗踝关节PVNS是有效且安全的。
