Prognosis of Advanced Tenosynovial Giant Cell Tumor of the Knee Diagnosed During Total Knee Arthroplasty.
Tenosynovial giant cell tumor (TGCT) is a relatively rare disease often misdiagnosed as osteoarthritis. Synovectomy or arthroplasty is the recommended treatment option, but recurrence is common after surgery. This study aimed to determine the prognosis of patients with advanced TGCT that was diagnosed incidentally during total knee arthroplasty (TKA) for osteoarthritis and treated by synovectomy.



From January 2008 to July 2011, TGCT was diagnosed incidentally in 10 patients (a total of 11 individual knees) undergoing posterior-stabilized TKA for an initial diagnosis of osteoarthritis. TGCT was confirmed by histopathology of biopsy specimens. Partial synovectomy was performed for localized-type TGCT (3 knees, 3 patients) and total synovectomy for diffuse-type TGCT (8 knees, 7 patients).



All patients were female with a mean age of 61.7 ± 6.6 (range 50-70) years. No postoperative infection, nerve injury, or deep venous thrombosis occurred. All patients were followed up for a mean period of 60.9 ± 6.6 (39-83) months, and no recurrence of TGCT occurred. X-ray imaging showed no apparent radiolucent lines around the prosthesis, and no prosthetic loosening, subsidence, or osteolysis. The joints were stable, with a significantly improved range of motion following surgery (109.5° ± 8.8° vs 80.5° ± 16.8°, P < .01). The Knee Society scores for knee joint (90.0 ± 4.1 vs 40.5 ± 8.1) and knee function (81.8 ± 7.5 vs 35.0 ± 13.8) were both significantly improved after surgery (P < .01).



Inactive TGCT could not be diagnosed preoperatively. TKA combined with synovectomy is effective in the treatment of advanced TGCT with degenerative lesions.
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Pengfei
P
Lei
Department of Orthopaedics, The Six Affiliated Hospital, Xinjiang Medical University, Urumchi, People's Republic of China.
Rongxin
R
Sun
Program of Biology and Biomedical Sciences, Division of Medical Sciences, Harvard Medical School, Harvard University, Cambridge, Massachusetts.
Hao
H
Liu
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Jianxi
J
Zhu
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Ting
T
Wen
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Yihe
Y
Hu
D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D000070779:Giant Cell Tumor of Tendon Sheath / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D033162:Incidental Findings; D007717:Knee / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D016059:Range of Motion, Articular; D016896:Treatment Outcome
knee joint; partial synovectomy; prognosis; tenosynovial giant cell tumor; total knee arthroplasty; total synovectomy