Abstract
Aim The aim of this study was to identify the presentation, management and outcomes this rare disease using the large series of patients treated at our unit
Material and Methods We reviewed the medical records and x-rays of all the patients who were referred – treated for PVNS around the knee joint between 1990 and 2002
Results 42 patients totally were treated or had second opinion for PVNS disease. 37 have been analysed in detail.
Their mean age was 33 years old and 11 patients were below 17 years of age. There was a predilection for females with 22 (59.5%) out of 37 patients.
There was average 3.3 years period of time with swelling/knee symptoms before diagnosis .
The MRI scan was the cornerstone for the patient’s assessment. It has proved useful in recurrent disease and posterior ”Bakers cyst” disease.
2 of the patients had been managed with arthroscopic synovectomy alone, 10 patients have undergone simultaneous arthroscopic synovectomy combined with open excision of any “Bakers cyst” disease.
10 had “open synovectomy”. 3 patients have had radiotherapy .3 patients have had TKR Complications included 3 superficial wound infections, 1 DVT, 1 PE, 1 stress fracture after radical bone curettage, common temporary/refractory stiffness (needing physio/ MUAs). Recurrence was high and managed with repeat arthroscopic synovectomy.
Conclusion PVNS is a rare disorder with typical mono-articular involvement affecting most commonly the knee joint. MRI and biopsy is the gold standard for the establishment of diagnosis and often needs a combined approach with arthroscopic and open posterior cyst excision. Radiotherapy is helpful in aggressive cases. TKR is suggested when there is associated articular erosion. The patient should be warned about the long course of treatment and often multiple procedures because of high recurrence rates.
The abstracts were prepared by Mr Roger Smith. Correspondence should be addressed to him at the British Association for Surgery of the Knee, c/o BOA, Royal College of Surgeons of England, 35–43 Lincoln’s Inn Fields, London WC2A 3PN.
