title: Primary arthroscopic synovectomy for pigmented villo-nodular synovitis of the knee: recurrence rate and functional outcomes after a mean follow-up of seven years.
abstract: BACKGROUND
  Pigmented villo-nodular synovitis (PVNS) is an uncommon proliferative condition of the synovial membrane that chiefly affects the knee. Arthroscopic synovectomy may carry lower morbidity rates but higher recurrence rates than open synovectomy. Here, our objective was to evaluate recurrence rates and functional outcomes after primary arthroscopic synovectomy for PVNS of the knee.
  
  
  OBJECTIVE
  Primary arthroscopic synovectomy preserves knee function while producing low recurrence and complication rates.
  
  
  METHODS
  We retrospectively included consecutive patients with histologically documented PVNS managed with primary arthroscopic synovectomy at two centres between 1998 and 2011. Twenty-three patients, 13 men and 10 women with a mean age of 41 ± 12 years, were reviewed including 16 patients with nodular and 7 with diffuse form of this disease. Patients with localized disease underwent partial synovectomy and those with diffuse disease complete synovectomy followed by chemical synovectomy of any residual lesions. The primary outcome measure was recurrence. Secondary outcome measures were the Tegner-Lysholm and Ogilvie-Harris scores.
  
  
  RESULTS
  Follow-up data were obtained after a mean of 7 ± 4 years in 21 patients (14 with nodular and 7 with diffuse disease), of whom 2 had recurrences, after 2 and 5 years, respectively. At last follow-up, neither patient had any evidence of recurrence. The mean Tegner-Lysholm score was significantly improved (from 68 ± 10 to 90 ± 8, P=0.0004) and the mean Ogilvie-Harris score indicated excellent function (11 ± 1).
  
  
  CONCLUSIONS
  Primary arthroscopic synovectomy ensures satisfactory control of PVNS while preserving knee function. A full recovery remains possible even in patients with diffuse disease. In the event of a recurrence, open synovectomy can be performed.
authors.affiliation: Hôpitaux Universitaires Paris Île-de-France Ouest, AP-HP, 92100 Boulogne-Billancourt, France. Electronic address: aureganjc@yahoo.fr.
authors.forename: J C
authors.initials: JC
authors.lastname: Aurégan
authors.forename: Y
authors.initials: Y
authors.lastname: Bohu
authors.forename: N
authors.initials: N
authors.lastname: Lefevre
authors.forename: S
authors.initials: S
authors.lastname: Klouche
authors.forename: J F
authors.initials: JF
authors.lastname: Naouri
authors.forename: S
authors.initials: S
authors.lastname: Herman
authors.forename: P
authors.initials: P
authors.lastname: Hardy
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology; D012008:Recurrence; D012189:Retrospective Studies; D000074402:Synovectomy; D013586:Synovitis, Pigmented Villonodular / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Arthroscopic synovectomy; Knee; Pigmented villo-nodular; Surgery; Synovitis