Cheng You-Hung, Lin Yi-Hsuan, Tseng I-Chuan, Chan Yi-Sheng
Department of Orthopaedic Surgery, 38014Chang Gung Memorial Hospital at Linkou, Guishan District, Taoyuan City.
J Orthop Surg (Hong Kong). 2021 May-Aug;29(2):23094990211022042. doi: 10.1177/23094990211022042.
The purpose of this study is to evaluate the outcome and prognosis of complete synovectomy performed under arthroscopic surgery in the treatment of diffuse pigmented villonodular synovitis (DPVNS) of the knee.
We retrospectively reviewed 7 cases (6 female and 1 male) diagnosed with diffuse pigmented villonodular synovitis (DPVNS) of knee from 2013 to 2017. All of these cases were treated with knee arthroscopy-assisted complete synovectomy. The follow-up period ranged from 36 months to 60 months (average: 48.0 months). The pain score, range of motion and functional outcome of the knee joint were evaluated after surgery. Symptoms and signs were monitored and magnetic resonance imaging (MRI) were routinely requested to note for possible recurrence during clinical follow up.
During and after the surgeries of complete synovectomy under arthroscope by the same surgeon, no complications were noted in the ward or the clinic. Significant improvements were achieved in terms of the range of motion and Lysholm knee function score. There was no recurrence of DPVNS observed in our patients during a follow-up of 4 years.
Intra-articular DPVNS of the knee can successfully be treated by complete synovectomy under arthroscope. This case series emphasized the technique of multiple portals and cycling different shavers to achieve satisfactory outcomes.
本研究旨在评估关节镜手术下行完全滑膜切除术治疗膝关节弥漫性色素沉着绒毛结节性滑膜炎(DPVNS)的疗效及预后。
我们回顾性分析了2013年至2017年诊断为膝关节弥漫性色素沉着绒毛结节性滑膜炎(DPVNS)的7例患者(6例女性,1例男性)。所有病例均接受膝关节镜辅助下的完全滑膜切除术治疗。随访时间为36个月至60个月(平均48.0个月)。术后评估膝关节的疼痛评分、活动范围及功能结果。在临床随访期间,监测症状和体征,并常规进行磁共振成像(MRI)检查以观察是否可能复发。
在同一位外科医生进行关节镜下完全滑膜切除术的手术过程及术后,病房及门诊均未发现并发症。膝关节活动范围及Lysholm膝关节功能评分有显著改善。在4年的随访期间,我们的患者未观察到DPVNS复发。
膝关节内DPVNS可通过关节镜下完全滑膜切除术成功治疗。本病例系列强调了采用多个入路及交替使用不同刨削器的技术以获得满意疗效。