Lashgari Ryan J, Chen Bruce W, Ventimiglia Dominic J, Henry Leah E, Kolevar Matthew P, Leong Natalie L, Meredith Sean J, Packer Jonathan D, Henn R Frank
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland.
J Knee Surg. 2025 Mar;38(4):180-187. doi: 10.1055/s-0044-1793939. Epub 2024 Nov 28.
Pigmented villonodular synovitis (PVNS) is a rare neoplastic proliferation of large joints, including the knee, with both localized PVNS (LPVNS) and diffuse PVNS (DPVNS) types. DPVNS is known to recur at a higher rate following resection; however, there is little evidence comparing patient-reported outcomes (PROs) between the two types. The purpose of this study was to compare PROs between patients with LPVNS and DPVNS involving the knee 2 years after surgical resection. We hypothesized that DPVNS would have worse 2-year PROs than LPVNS.Sixteen patients who underwent arthroscopic resection of pathology-confirmed PVNS involving the knee were enrolled in a prospective registry. Several PROs, including six Patient-Reported Outcomes Measurement Information System (PROMIS) domains and the International Knee Documentation Committee (IKDC) Subjective Knee Form, were assessed at baseline and at 2 years postoperatively. Mean scores between LPVNS and DPVNS groups were compared using a Wilcoxon exact test, while categorical variables were compared using a Fisher's exact test.Eleven patients (seven LPVNS and four DPVNS) completed both the baseline and 2-year PRO surveys. There were no significant differences in the demographic variables between groups, including age, body mass index, or prior surgical history ( < 0.05). There was a trend toward higher mean PRO scores in the DPVNS group at 2 years postoperatively in all measures, despite lower reported baseline levels of activity as measured by Marx Activity Rating Scale (26.3 vs. 76.7, = 0.02). The DPVNS group also trended toward more improvement in PROMIS Physical Function (9.7 vs. -2.7), PROMIS Pain Interference (-9.0 vs. -2.5), PROMIS Anxiety (-5.4 vs. -4.4), and IKDC (26.7 vs. 18.9). However, these differences did not reach statistical significance ( < 0.05). There were two recurrences in the DPVNS group and none in the LPVNS group.Patients with knee DPVNS do not report worse outcomes 2 years after arthroscopic resection compared with LPVNS patients.
色素沉着绒毛结节性滑膜炎（PVNS）是一种累及膝关节等大关节的罕见肿瘤性增生，分为局限性PVNS（LPVNS）和弥漫性PVNS（DPVNS）两种类型。已知DPVNS切除术后复发率较高；然而，几乎没有证据比较这两种类型患者报告的结局（PROs）。本研究的目的是比较手术切除2年后膝关节LPVNS和DPVNS患者的PROs。我们假设DPVNS患者术后2年的PROs比LPVNS患者差。16例经关节镜切除病理确诊的膝关节PVNS患者被纳入前瞻性登记研究。在基线和术后2年评估了多项PROs，包括六个患者报告结局测量信息系统（PROMIS）领域和国际膝关节文献委员会（IKDC）主观膝关节量表。使用Wilcoxon精确检验比较LPVNS组和DPVNS组的平均得分，使用Fisher精确检验比较分类变量。11例患者（7例LPVNS和4例DPVNS）完成了基线和术后2年的PRO调查。两组间人口统计学变量无显著差异，包括年龄、体重指数或既往手术史（P<0.05）。尽管根据马克思活动评分量表测量，DPVNS组报告的基线活动水平较低（26.3对76.7，P=0.02），但在术后2年的所有测量中，DPVNS组的平均PRO得分有升高趋势。DPVNS组在PROMIS身体功能（9.7对 -2.7）、PROMIS疼痛干扰（-9.0对 -2.5）、PROMIS焦虑（-5.4对 -4.4）和IKDC（26.7对18.9）方面也有更大改善趋势。然而，这些差异未达到统计学意义（P<0.05）。DPVNS组有2例复发，LPVNS组无复发。与LPVNS患者相比，膝关节DPVNS患者在关节镜切除术后2年报告的结局并不更差。
