• Title/Summary/Keyword: Total synovectomy

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Arthroscopic Treatment of Synovial Chondromatosis (활액막 연골종증의 관절경적 치료)

  • Bae Dae Kyung;Kwon Oh Soo;Lee Jeong Heui;Lim Chan Teak
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.43-48
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    • 2002
  • Purpose : We evaluated the results of the arthroscopic treatment of nine cases of synovial chondromatosis in the knee joints. Materials and Methods : From June 1989 to September 1999, eight patients nine cases with synovial chondromatosis involving knee joints underwent arthroscopic total synovectomy and removal of loose bodies. There were 6 females and 2 males. The average age at surgery was 44.1 years(range, 20-57 years). The average follow-up period was 5.9 years (range, 2.5-7.3 years). All cases had pain and swelling and two cases had locking preoperatively. Flexion contracture was found in three cases. Results : Pathologic finding revealed Milgram I in one case, Milgram II in six cases and Milgram III in two cases. There were six cases of generalized synovial hypertrophy and one case of localized type. All patients had symptomatic relief by arthroscopic total synovectomy and loose body removal. Second arthoroscopic surgery was performed in one patient due to recurred lesions 11 months after the primary surgery. Conclusion : Clinical results of the synovial chondromatosis with arthroscopic total synovectomy and loose body removal were satisfactory. Arthroscopic total synovectomy was also effective for the recurred case.

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Surgical Treatment for Diffuse Pigmented Villonodular Synovitis of the Ankle by A Combined Open and Arthroscopic Synovectomy: A Case Report (발목관절의 미만형 색소 융모 결절성 활액막염에서 관절경적 및 개방적 활액막 절제술을 이용한 수술적 치료: 증례 보고)

  • Choi, Jun-Cheol;Song, Woo-Suk;Byun, Chan-Woong;Kim, Jin;Han, Eun-Mee
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.3
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    • pp.139-142
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    • 2019
  • 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.

Outcomes of Diffuse-Type Pigmented Villonodular Synovitis (PVNS) after Open Total Synovectomy (미만형 색소 융모 결절성 활액막염의 관혈적 활막 전 절제술 후 경과)

  • Lee, Mo-Ses;Lee, Soo-Hyun;Suh, Jin-Suck;Yang, Woo-Ik;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.27-36
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    • 2010
  • Purpose: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. Materials and Methods: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. Results: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. Conclusion: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.

Pigmented Villonodular Synovitis in Forefoot (A Case Report) (전족부에 발생한 색소 융모 결절성 활액막염 (1례 보고))

  • Kim, Jun Beom;Song, In Soo;Chon, Je Gyun;Kim, Tae In;Sun, Dong Hyuk;Lee, Kyung Tai
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.1
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    • pp.64-67
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    • 2013
  • Pigmented villonodular synovitis (PVNS) is a slowly, progressive, proliferative disorder of synovial tissue characterized by villous or nodular changes of synovial-lined joints, bursae, and tendon sheaths and most frequently affects the large joints, with the knee and hip. A few studies have been reported that occurred PVNS in small joint, but mainly in hands. It is a very rare condition that occurs in the small joints of the forefoot. We have experienced the case, which developed in small joint of the forefoot, and performed total synovectomy. After the operation, there was no recurrence. We report a case of PVNS in forefoot with a review of the literature.

Combined Arthroscopic Gross Total Synovectomy and Radiotherapy for Diffuse Pigmented Villonodular Synovitis of the Knee: A Report of 2 Cases (무릎관절의 미만형 색소 융모 결절성 활액막염에서 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료: 증례보고)

  • Chang, Sei-Kyung;Kim, Jae-Hwa;Ha, Doo-Hoe;Kang, Hae-Youn;Chong, So-Young;Shin, Hyun-Soo
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.201-206
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    • 2006
  • Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.

Total Ankle Replacement in Pigmented Villonodular Synovitis of Ankle Joint (A Case Report) (색소 융모결절종 환자에 시행한 족관절 인공관절 치환술(1예 보고))

  • Ha, Jung-Min;Choi, Sun-Jin;Lee, Chang-Bum;Ha, Jeong-Han;Park, Hyung-Taek
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.101-104
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    • 2010
  • Pigmented villonodular synovitis (PVNS) is a rare proliferative disease affecting joint synovium, tendon sheaths, bursae. The usual treatment for PVNS is a surgical excision. If destructive joint lesions have occurred, complete resections must be performed followed by arthrodesis or arthroplasty. We report a case of a pigmented villonodular synovitis involving an ankle joint which was treated by total ankle replacement for recurrence after simple synovectomy.

Arthroscopic Treatment of Pigmented Villonodular Synovitis of the Shoulder - A Case Report - (견관절 색소 융모 결절성 활막염의 관절경적 치료 - 증례 보고 -)

  • Lee, Seoung-Joon;Yoo, Jae-Chul;Lim, Kyung-Sub
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.140-145
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    • 2007
  • Pigmented villonodular synovitis(PVNS) is a benign proliferative lesion, involving synovial tissue in joints, tendon sheaths, and bursae. Pigmented villonodular synovitis is a rare and usually monoarticular condition and primarily affects the knee joint and hand. Polyarticular PVNS appears in less than 1% of all case and its occurrence in the shoulder is rare(<2%). We present a 64-year-old male who had pigmented villonodular synovitis of both shoulder joints, which was treated by arthroscopic total synovectomy.

Diffuse Pigmented Villonodular Synovitis of Knee Presenting as a Popliteal Cyst - One case report - (슬와 낭종을 형성한 슬관절의 미만성 색소 융모 결절성 활액막염 - 1례 보고 -)

  • Kim, Myung Ku;Ko, Suk Myun;Oh, In Suk;Kim, Ryuh Sup;Shin, Jin Ho
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.48-50
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    • 1999
  • Pigmented villonodular synovitis most commonly occurs in the knee joint and rarely extends into the popliteal space, which not only has mimicked Baker's cyst but also has been misdiagnosed as malignant tumor. We report a case of a diffuse pigmented villonodular synovitis of knee joint which is extended into the popliteal space as like a popliteal cyst. We treated this case by arthroscopic total synovectomy and excision of cyst. There was no recurrence during more than one year after operation.

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Pigmented Villonodular Synovitis of the Ankle and Subtalar Joint Treated by Surgical Excision and Ligament Reconstructions: A Case Report

  • Shin, Jae-Hyuk;Lee, Byung Hoon;Kim, Gab-Lae;Kim, Kwon
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.192-195
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    • 2016
  • Diffuse pigmented villonodular synovitis (PVNS) involving ankle joint needs complete mass excision and total synovectomy to reduce recurrence rate, while surrounding ligaments can be easily damaged. So the concurrent ligament reconstruction should be considered for post-excisional instability in subtalar joint as well as lateral ankle joint. We describe our experience in the management of a diffuse type PVNS, invades lateral talocrural joint extended to subtalar joint and introduce a new technique of all-in-one reconstruction for anterior talofibular,calcaneofibular and cervical ligament. Our new reconstruction technique applying modified Chrisman and Snook technique is useful in stabilization for deficiencies of the ligament complexafter PVNS excisionat lateral ankle and subtalar joint.

Treatment of Pyogenic Arthritis of the Knee Using Drainage Tube Insertion in the Posterior Compartment through the Posterior Transeptal Portal after an Arthroscopic Synovectomy (관절경적 활액막 절제술 후 후격막 삽입구를 통한 배액관의 후방 거치를 이용한 무릎의 화농성 관절염 치료)

  • Kim, Tae Ho;Yu, Chang Eon;Shin, Chung Shik
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.269-275
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    • 2019
  • Purpose: This study analyzed the treatment effects of drain insertion in the posteromedial portal after an arthroscopic synovectomy and posterior septum resection for pyogenic arthritis. Materials and Methods: From June 2005 to December 2016, 56 cases (55 patients, 1 case of bilateral knee) were diagnosed with pyogenic arthritis and arthroscopic treatment was performed. Fourteen patients (25.0%) were identified with causative organisms. The average follow-up period was 12.3 months, and the mean age was 67.8 years old. Twenty-four cases were males and 31 cases were females. Kellgrene-Lawrence grade (K-L grade) I was 6 patients, II was 20 patients, III was 11 patients, and IV was 18 patients. Surgery was performed through six portal. The posterior septum was removed and a drainage tube was inserted from the posterior medial side to the posterior side of the joint. The Lysholm score was used after surgery for a functional evaluation. The K-L grade at the time of admission and at the last follow-up were compared for a radiological evaluation. Results: The mean normalization period of the C-reactive protein was 59.8 days (6-164 days). Intravenous antibiotics were used for an average of 37.1 days. The results of the functional evaluation revealed a mean Lysholm score of 64.5 (30-98) in a total of 56 cases. Two reoperations was performed, but the treatment was completed with same method in all patients. The K-L grade was similar at the time of surgery and at the last follow-up (p>0.05). Conclusion: The method of drain insertion in the posteromedial portal after arthroscopic synovectomy and posterior septum resection for pyogenic arthritis is an effective technique that can obtain satisfactory results by inducing proper exudate discharge.