title: Pigmented villonodular synovitis diagnosed during revision total knee arthroplasty for flexion instability and patellar fracture.
abstract: Occurring in either a localized or diffuse form, pigmented villonodular synovitis (PVNS) is a disease of unknown etiology that typically presents with insidious onset of pain, swelling, stiffness, or mechanical symptoms as a result of synovial tissue proliferation. PVNS preferentially affects large joints, most commonly the knee. Currently there is no known association with PVNS and total knee arthroplasty (TKA), and to date, there are only a few cases reported in the orthopedic literature in which PVNS was diagnosed after primary TKA. To our knowledge, this is the first case of diffuse PVNS that was discovered at the time of revision TKA for flexion instability and patellar fracture. In this patient, with no known history of PVNS, the diagnosis of diffuse PVNS was made at the time of surgery. She underwent revision TKA, partial patellectomy, and extensive synovectomy. Level of evidence: V, Case Report.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 200 First St., SW, Rochester, MN 55905, USA. Electronic address: camp.christopher@mayo.edu.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Camp
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 200 First St., SW, Rochester, MN 55905, USA.
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Yuan
authors.affiliation: Department of Anatomical and Clinical Pathology, Mayo Clinic, 200 First St., SW, Rochester, MN 55905, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Wood
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 200 First St., SW, Rochester, MN 55905, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Lewallen
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010329:Patella / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D016059:Range of Motion, Articular; D012086:Reoperation; D013583:Synovial Membrane / Q000000981:diagnostic imaging; D013586:Synovitis, Pigmented Villonodular / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery
keywords: Flexion instability; Patella fracture; Pigmented villonodular synovitis; Revision total knee arthroplasty; Total knee arthroplasty