title: Pigmented villonodular synovitis: a retrospective multicenter study of 237 cases.
abstract: OBJECTIVE
  To review clinical characteristics of pigmented villonodular synovitis (PVNS) in China.
  
  
  METHODS
  Electronic medical records (EMR) of four Chinese institutes were queried for patients with histologically proven PVNS between January 2005 and February 2014. Their data were collected including gender, age at diagnosis, clinical presentation, affected site, symptom duration, comorbidities, treatment strategy, recurrence and routine laboratories.
  
  
  RESULTS
  A total of 237 patients with biopsy-proven PVNS were investigated. The gender ratio was 1.35 for a female predominance (101 males and 136 females). The average age was 36 years (range, 2 to 83 years). The median delay from initial clinical symptom to diagnosis was 18 months. Main affected areas were the knee (73.84%) and the hip (18.14%). Forty patients had a clear history of joint trauma. Six patients were concurrently diagnosed with PVNS and avascular necrosis (AVN). Five patients suffered from PVNS following implantation of orthopaedic devices including artificial prosthesis, plate and wire. One hundred and twenty-nine patients underwent arthroscopic synovectomy and 108 open synovectomy. Altogether 48 patients (26 males and 22 females) had recurrence of disease. The relapse rate was 24% (knee) and 6.98% (hip), 20.93% (open surgery) and 19.44% (arthroscopy), respectively. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) rate were elevated in 45.83% and 38.41% of the patients respectively.
  
  
  CONCLUSIONS
  To our knowledge, this study is the largest sample size of PVNS patients reported as well as the largest sample of PVNS with concurrent AVN reported to date. Our outcomes suggest that PVNS shows a female predominance, occurs mostly between 20-40 years and favors the knee and hip. Recurrence is frequent, particularly in the knee. Serum ESR and CRP may be elevated in some patients. Additionally, the present study supports the theory of an association between PVNS and orthopedic surgery, which is not limited to joint replacement.
authors: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China; Key laboratory of Bone and Cartilage Regenerative Medicine of Guangdong Province, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China.
authors: Guo-ping
authors: GP
authors: Xie
authors: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China.
authors: Nan
authors: N
authors: Jiang
authors: Department of Orthopaedics, Guangdong General Hospital, Guangzhou, Guangdong, PR China.
authors: Chang-xiang
authors: CX
authors: Liang
authors: Department of Third Orthopaedics, The First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, PR China.
authors: Jian-chun
authors: JC
authors: Zeng
authors: Department of Overseas Chinese Patients, General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, PR China.
authors: Zhi-yuan
authors: ZY
authors: Chen
authors: Department of Health Statistics, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, PR China.
authors: Qian
authors: Q
authors: Xu
authors: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China.
authors: Rui-zhen
authors: RZ
authors: Qi
authors: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China.
authors: Yi-rong
authors: YR
authors: Chen
authors: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China; Key laboratory of Bone and Cartilage Regenerative Medicine of Guangdong Province, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China.
authors: Bin
authors: B
authors: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006615:Hip / Q000473:pathology*; D006801:Humans; D007717:Knee / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012737:Sex Factors; D013586:Synovitis, Pigmented Villonodular / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult