Aljuhani Wazzan, Alamri Amal, Altorbak Byan, Alabbasi Jawad, Ahmed Faris
Department of Surgery, Ministry of the National Guard - Health Affairs, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Department of Surgery, Ministry of the National Guard - Health Affairs, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, Riyadh, SAU.
Cureus. 2024 Aug 30;16(8):e68248. doi: 10.7759/cureus.68248. eCollection 2024 Aug.
Introduction Pigmented villonodular synovitis (PVNS) is a proliferative disorder that affects synovial joints. PVNS, also known as tenosynovial giant cell tumor (TGCT), is a broad term that refers to a variety of diseases, both localized and diffuse. The current study aims to describe the outcomes of PVNS in patients in King Abdulaziz Medical City (KAMC) Riyadh, Saudi Arabia especially after surgical resection, highlighting radiological and pathological evidence of disease recurrence and symptom progression. The study is also concerned with comparison between patients who had adjuvant radiotherapy versus patients who underwent surgery only in addition to comparison between patients who underwent arthroscopic surgery versus those who underwent open surgery. Objective Pigmented villonodular synovitis is a disorder that occurs in the synovial joints with the highest incidence rates in the third and fourth decades. PVNS is categorized into localized and diffuse. The current study aims at defining the recurrence rate and outcomes of PVNS in patients in KAMC between 2008 and 2019. Design A retrospective study that comprises patients with proven PVNS of the knee, hip, and elbow for a minimum follow-up duration of two years. Data was collected from the KAMC database, National Guard Health Affairs, Riyadh, Saudi Arabia. Results Nearly a third of patients reported a prior history of trauma. The knee joint was most frequently involved followed by the ankle followed by the hip. Diffuse PVNS was more common than localized disease with more affection on the right side. The most common presenting symptoms were pain and swelling followed by decreased range of motion (ROM). About one-fifth of patients had undergone prior surgery. 30.8% received adjuvant radiotherapy. Post-operative stiffness or decreased ROM were noted in 23.1% of cases. Half of the patients received follow-up for more than 24 months. Overall recurrence rate was 19.2%. Recurrence rates were significantly higher in patients with left-sided lesions and those with prior surgery but it did not reach statistical significance. Non-statistically significant trends for increased recurrences were also seen with older age, diffuse type PVNS, and knee involvement. Conclusions In summary, this study reports the outcomes of PVNS after surgical resection in patients in King Abdulaziz Medical City. The study showed recurrence rates being significantly higher in patients with left-sided lesions than those with prior surgery. Also, non-statistically significant trends for increased recurrences were also seen with older age, diffuse type PVNS, and knee involvement.
引言 色素沉着绒毛结节性滑膜炎（PVNS）是一种影响滑膜关节的增殖性疾病。PVNS，也称为腱鞘巨细胞瘤（TGCT），是一个广义术语，指各种局限性和弥漫性疾病。本研究旨在描述沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城（KAMC）患者中PVNS的治疗结果，尤其是手术切除后的结果，突出疾病复发和症状进展的影像学和病理学证据。该研究还关注接受辅助放疗的患者与仅接受手术的患者之间的比较，以及接受关节镜手术的患者与接受开放手术的患者之间的比较。
目的 色素沉着绒毛结节性滑膜炎是一种发生于滑膜关节的疾病，在第三和第四个十年发病率最高。PVNS分为局限性和弥漫性。本研究旨在确定2008年至2019年期间KAMC患者中PVNS的复发率和治疗结果。
设计 一项回顾性研究，纳入经证实患有膝关节、髋关节和肘关节PVNS且至少随访两年的患者。数据从沙特阿拉伯利雅得国民警卫队卫生事务部的KAMC数据库中收集。
结果 近三分之一的患者报告有既往创伤史。膝关节受累最为常见，其次是踝关节，然后是髋关节。弥漫性PVNS比局限性疾病更常见，右侧受累更多。最常见的症状是疼痛和肿胀，其次是活动范围（ROM）减小。约五分之一的患者曾接受过手术。30.8%的患者接受了辅助放疗。23.1%的病例术后出现僵硬或ROM减小。一半的患者接受了超过24个月的随访。总体复发率为19.2%。左侧病变患者和既往接受过手术的患者复发率显著更高，但未达到统计学意义。年龄较大、弥漫型PVNS和膝关节受累的患者复发率也有非统计学意义的上升趋势。
结论 总之，本研究报告了阿卜杜勒阿齐兹国王医疗城患者手术切除后PVNS的治疗结果。研究表明，左侧病变患者的复发率显著高于既往接受过手术的患者。此外，年龄较大、弥漫型PVNS和膝关节受累的患者复发率也有非统计学意义的上升趋势。
