Purpose: The purpose of this study was to present the long-term results of treatment of localized pigmented villonodular synovitis (LPVNS) comparing two operative procedures of excision of the lesion-the arthroscopic and the arthroscopically assisted mini-open. We hypothesized that the latter approach allowed for treatment of LPVNS with acceptable recurrence rates, complication rates and functional outcomes.
Methods: Between 1990 and 2006, 21 patients with LPVNS were treated with partial synovectomy through an arthroscopically-assisted mini open technique (group A), and 23 patients were treated with an arthroscopic excision of the lesion (group B). All patients were clinically examined at one, three, and 12 months post-operatively and graded by the Lysholm knee score and the Ogilvie-Harris score.
Results: The mean Lysholm score was improved from 58.7 ± 9 to 94.2 ± 7 for group A (p < 0.05) and from 57.4 ± 9.1 to 95.5 ± 8 for group B (p < 0.05). The mean Ogilvie-Harris score was improved from 7.2 ± 2 to 11.2 ± 0.9 for group A and from 7.1 ± 2 to 11.75 ± 0.5 for group B (p < 0.05). We encountered two cases of CRPS and one case of recurrence of the lesion in group A and no complications for group B.
Conclusions: Arthroscopically-assisted mini open partial synovectomy is a safe alternative treatment, especially for surgeons without extended experience in arthroscopic techniques. The arthroscopic localization of the precise position of the lesion and its subsequent mini-open excision is a safe and effective technique with very low morbidity and recurrence rate and equivalent functional outcome to fully arthroscopic excision due to limited incision.
Level Of Evidence: Retrospective comparative study, Level III.
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