S Radha Plot No: 20, Road No: 1, Alakapuri, Hyderabad – 35 India
Source of Support: None, Conflict of Interest: None
Background: Pigmented villonodular synovitis is a rare disorder affecting joints.
Methods : We reviewed 19 cases of pigmented villonodular synovitis out of 481 arthroscopic synovial biopsies over a period of ten years. A common presenting symptom was locking. Both diffuse and localized forms were diagnosed. Duration of symptoms varied from 5 months to3 years. We report our experience of patients treated by arthroscopic excision for localized villonodular synovitis and arthroscopic synovectomy for diffuse villonodular synovitis followed by intraarticular Yttrium.
Results : In diffuse villonodular synovitis arthroscopic total synovectomy was done a using special angular and straight motorized shaver through different portals to reach all corners of the joint. Localized variety was treated by excising the pedicle attached to the synovium. In our series none of the patients with localized villonodular synovitis showed recurrence till date. Three cases of diffuse variety presented with effusion and swelling three to six months after treatment and were managed by arthoscopic synovial shaving. Two cases who showed recurrence after one year were subjected to intraarticular 90Y isotope injection.
Conclusion : Arthroscopic synovectomy helps in reducing morbidity. Radiation and intraarticular Injection of 90 Y are alternative modes of treatment.