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Jun-Cheol Choi, Woo-Suk Song
, Chan-Woong Byun, Jin Kim, Eun-Mee Han*
, Chan-Woong Byun, Jin Kim, Eun-Mee Han*
Abstract
Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving the synovial membranes. Complete excision with a total synovectomy is important for diffuse type PVNS because of its high recurrence rate. In the ankle, complete excision of diffuse type PVNS is difficult due to the anatomical structure of the ankle joint. This paper reports the author's experience of surgical treatment with combined open and arthroscopic synovectomy. In this manner, it is expected that the complications of the open procedure and the recurrence rate of arthroscopic procedure can be reduced.
Figures and Tables
Figure 1
Magnetic resonance imaging of left ankle. T1-, T2-weighted fat suppressed sagittal (A) and axial (B) images show large sized mass of low signal intensity in anterior and posterior aspect of ankle (arrows).
Figure 2
Anterior arthroscopic approach findings. (A) Diffuse synovial hypertrophy was found. (B) Diffuse hemosiderin deposition and hemorrhagic lesion were found. (C) Bony erosion of talar neck was found.
Figure 3
Posterior approach showing a pigmented villonodular synovitis mass (A) after through debridement (B).
References
1. Myers BW, Masi AT. Pigmented villonodular synovitis and tenosynovitis: a clinical epidemiologic study of 166 cases and literature review. Medicine (Baltimore). 1980; 59:223–238. DOI: 10.1097/00005792-198005000-00004.
2. Granowitz SP, Mankin HJ. Localized pigmented villonodular synovitis of the knee. Report of five cases. J Bone Joint Surg Am. 1967; 49:122–128. DOI: 10.2106/00004623-196749010-00010.
3. Jaffe HL, Lichtenstein L, Sutro CJ. Pigmented villonodular synovitis, bursitis and tenosynovitis: a discussion of the synovial and bursal equivalents of the tenosynovial lesion commonly denoted as xanthoma, xanthogranuloma, giant cell tumor or myeloplaxoma of the tendon sheath, with some consideration of this tendon sheath lesion itself. Arch Pathol. 1941; 31:731–765. DOI: Arch Pathol. 1941;31:731-65.
4. Byers PD, Cotton RE, Deacon OW, Lowy M, Newman PH, Sissons HA, et al. The diagnosis and treatment of pigmented villonodular synovitis. J Bone Joint Surg Br. 1968; 50:290–305. DOI: 10.1302/0301-620X.50B2.290.
5. Ushijima M, Hashimoto H, Tsuneyoshi M, Enjoji M. Pigmented villonodular synovitis. A clinicopathologic study of 52 cases. Acta Pathol Jpn. 1986; 36:317–326. DOI: 10.1111/j.1440-1827.1986.tb01022.x.
6. Saxena A, Perez H. Pigmented villonodular synovitis about the ankle: a review of the literature and presentation in 10 athletic patients. Foot Ankle Int. 2004; 25:819–826. DOI: 10.1177/107110070402501112.
7. Flandry FC, Hughston JC, Jacobson KE, Barrack RL, McCann SB, Kurtz DM. Surgical treatment of diffuse pigmented villonodular synovitis of the knee. Clin Orthop Relat Res. 1994; (300):183–192. DOI: 10.1097/00003086-199403000-00024.
8. Chin KR, Barr SJ, Winalski C, Zurakowski D, Brick GW. Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee. J Bone Joint Surg Am. 2002; 84:2192–2202. DOI: 10.2106/00004623-200212000-00011.
9. Stephan SR, Shallop B, Lackman R, Kim TW, Mulcahey MK. Pigmented villonodular synovitis: a comprehensive review and proposed treatment algorithm. JBJS Rev. 2016; 4:01874474-201607000-00005. DOI: 10.2106/JBJS.RVW.15.00086.
10. Brien EW, Sacoman DM, Mirra JM. Pigmented villonodular synovitis of the foot and ankle. Foot Ankle Int. 2004; 25:908–913. DOI: 10.1177/107110070402501211.
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