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Treatment of diffuse pigmented villonodular synovitis of the knee with combined surgical and radiosynovectomy.
MedLine Citation:
PMID:  19096892     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Treatment of extensive diffuse pigmented villonodular synovitis (PVNS) of large joints by isolated surgical resection is unsatisfactory, with high rates of local recurrence. Post-synovectomy adjuvant treatment with external beam radiation therapy or intra-articular injection of radioactive material as yttrium-90 ((90)Y) yielded better results. Between January 2005 and January 2007, 12 patients (eight men and four women aged 19-49 years) with extensive diffuse PVNS of the knee were treated. All patients had an adjuvant post-operative external beam radiation therapy (2,600-3,000 cGy) conventionally fractionated 200 cGy/fraction, five fractions/week, 6-8 weeks after surgery. Mean follow-up time was 27 months (range from 20 to 36 months). All patients were followed up using clinical assessment, magnetic resonance imaging, and plain X-ray. In all patients, neither evidence of disease recurrence nor progression of bone or articular destruction was noted. No complications were noticed after surgery or after post-operative external beam radiation therapy. A combination of debulking surgery using anterior and posterior approach with adjuvant post-operative external beam radiation therapy for extensive diffuse PVNS of the knee joint is a reliable treatment method, with good results in regard to the incidence of local recurrence and functional outcome.
Authors:
Wael A M Nassar; Ayman Abdelaziz Bassiony; Hesham A Elghazaly
Publication Detail:
Type:  Journal Article     Date:  2008-12-19
Journal Detail:
Title:  HSS journal : the musculoskeletal journal of Hospital for Special Surgery     Volume:  5     ISSN:  1556-3316     ISO Abbreviation:  HSS J     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-13     Completed Date:  2010-06-23     Revised Date:  2010-09-23    
Medline Journal Info:
Nlm Unique ID:  101273938     Medline TA:  HSS J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  19-23     Citation Subset:  -    
Affiliation:
Orthopaedic Department, Ain Shams University, Demerdash Hospital, Abbasseia Square, Cairo, Egypt. wgnassar@hotmail.com
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