Chen Xi, Li Ping, Zhang Wenhui, Yin Xiaopeng, Ma Qunying, Wang Kun
Orthopedics department, Affiliated Hospital of Xizang Minzu University, Xianyang 712000, China; Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
Int J Surg Case Rep. 2022 Nov;100:107720. doi: 10.1016/j.ijscr.2022.107720. Epub 2022 Oct 1.
Pigmented Villonodular Synovitis (PVNS) is a kind of extremely rare and not easily diagnosed disease, while the occurrence following the anterior cruciate ligament (ACL) rupture is comparably high.
Here we reported 2 patients presenting knee swelling, pain, and giving away symptoms following a rupture of ACL history. Clinical and radiological findings were supportive of ACL rupture and PVNS, prompting the patient to undergo surgery. The synovium was completely removed with the help of an arthroscope. Reconstruction of the ruptured ACL was carried out a few months later. At the last follow-up visit, both the patients were doing well with no recurrence of pain, swelling, or give way sensation.
The diagnosis of PVNS is often difficult because in the early stages, symptoms are often non-specific and pathological examination remains the gold standard for the diagnosis of PVNS. We have reviewed some of the previously reported literature on PVNS, suggesting that joint instability may be an important risk factor for PVNS and summarizing the treatment options for PVNS.
More attention should be paid to the incidence of PVNS in patients with joint instability, particularly in patients with cruciate ligament injuries. Early and reliable stabilization of the joint may significantly prevent PVNS and ensure a better clinical outcome.
色素沉着绒毛结节性滑膜炎(PVNS)是一种极为罕见且不易诊断的疾病,而在前交叉韧带(ACL)断裂后发生的情况相对较多。
在此我们报告2例有ACL断裂病史后出现膝关节肿胀、疼痛及打软症状的患者。临床和影像学检查结果支持ACL断裂和PVNS,促使患者接受手术。在关节镜辅助下彻底切除滑膜。数月后对断裂的ACL进行重建。在最后一次随访时,两名患者情况良好,无疼痛、肿胀或打软感复发。
PVNS的诊断往往困难,因为在早期症状通常不具特异性,病理检查仍是PVNS诊断的金标准。我们回顾了一些先前报道的关于PVNS的文献,提示关节不稳可能是PVNS的一个重要危险因素,并总结了PVNS的治疗选择。
应更多关注关节不稳患者中PVNS的发生率,尤其是在交叉韧带损伤患者中。早期且可靠的关节稳定可能显著预防PVNS并确保更好的临床结果。