Pigmented villonodular synovitis: a retrospective study of seventy five cases (eighty one joints)
Pigmented villonodular synovitis: a retrospective study of seventy five cases (eighty one joints)
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DOI：
10.1007/s00264-013-1858-9
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发表时间：
2013-06-01
影响因子：
2.7
通讯作者：
Jin, Wentao
中科院分区：
文献类型：
--
作者：
Ma, Xiaomei;Shi, Guodong;Jin, Wentao
色素沉着绒毛结节性滑膜炎（PVNS）是一种相对罕见的大关节滑膜良性增生性病变，但关于该病的病因、临床病史、鉴别诊断、治疗和长期影响的信息并不多。我们对75例PVNS患者（81个关节）的临床资料进行了分析，这些患者接受了单纯滑膜切除术或滑膜切除加关节成形术，所有病例的病理检查均证实了PVNS的诊断。男女比例为27：48，患者平均年龄为46岁（范围：15-80岁）。病变位于膝关节、髋关节或踝关节，疼痛和肿胀是主要症状。在75例患者中，42例有关节创伤史。41例患者（43个关节）单独接受了滑膜切除术，34例患者（38个关节）接受了滑膜切除术和关节成形术。在75例患者中，61例有完整的随访数据。12例患者的复发军团检测病理检查，4例患者有两个以上的复发。此外，5例患者在关节成形术后发生PVNS，PVNS最常发生于中年女性，最常累及膝关节，其次是髋关节和踝关节。该病的病因是多种多样且不清楚的。手术切除或关节成形术是一种有效的治疗方法，但复发率高。
Pigmented villonodular synovitis (PVNS) is a relatively rare, benign proliferation lesion of the synovium of large joints, but there is not much information available about the disease's aetiology, clinical history, differential diagnosis, treatment, and long-term effects. We conducted a study to analyse these aspects of PVNS.We reviewed all clinical data for 75 patients with PVNS (81 joints) who were treated either by synovectomy alone or synovectomy plus arthroplasty.In all cases, the diagnosis of PVNS was confirmed by pathological examination. The ratio of males to females was 27:48, and the average age of patients was 46 years (range, 15-80 years). Lesions were located in the knee, hip, or ankle, and pain and swelling were the main symptoms. Of 75 patients, 42 had a history of trauma to the involved joint. Forty-one patients (43 joints) underwent synovectomy alone, and 34 patients (38 joints) underwent synovectomy and arthroplasty together. Of the 75 patients, 61 had full follow-up data. Twelve patients had recurrent legions detected by pathological examinations; four patients had more than two recurrences. Moreover, five patients developed PVNS after arthroplasty.PVNS occurs most often in middle-aged women and most frequently involves the knee, followed by the hip and ankle. The disease's etiology is varied and unclear. Surgical excision alone or with arthroplasty is an effective treatment, but there is a high rate of recurrence.