Arthroscopy in the treatment of pigmented villonodular synovitis of the ankle and subtalar joints: a technique guide and case series. Issue 5 (September 2017)

• Record Type: Journal Article
• Authors: Sweeney, Kyle R.; Slone, Harris S.; Labib, Sameh A.
• Is Part Of: Current orthopaedic practice. Volume 28:Issue 5(2017)
• Publication Date: 2017-09
• Subjects: pigmented -- villonodular -- PVNS -- synovium -- inflammation -- arthroscopic -- ankle -- hindfoot; Orthopedics -- Periodicals; 616.7005
• DOI: 10.1097/BCO.0000000000000542
• Languages: English
• ISSNs: 1940-7041

Abstract

Abstract : Pigmented villonodular synovitis is a proliferative synovial-based inflammatory process that can lead to joint destruction and debilitating pain. Surgical excision is the "gold standard" for treatment of pigmented villonodular synovitis. Given the limited soft tissues surrounding the ankle in conjunction with the ability of arthroscopy to easily access the entire joint, arthroscopic management of ankle pigmented villonodular synovitis allows for successful treatment while minimizing the surgical complications of an open approach. The preoperative planning and surgical technique are described in detail. Additionally, three patients with pigmented villonodular synovitis in the tibiotalar and subtalar joints who were successfully treated with arthroscopically assisted synovectomy are reported.Three patients with pigmented villonodular synovitis in the tibiotalar and subtalar joints underwent arthroscopically assisted synovectomy without adjuvant radiotherapy. With a mean age of 37.7 yr (range 23-52) and mean follow-up of 83 wk (range 19-184), there was no evidence of recurrence. Mean Short Form-12 scores for physical and mental component summaries were, respectively, 49.05±4.76 and 54.57±4.55. The mean Foot and Ankle Disability Index (FDAI) score for the patients was 88.13±9.6. These results suggest good to excellent results. Arthroscopically assisted synovectomy in patients with pigmented villonodular synovitis of the ankle and hindfoot is an effective treatment option, providing adequate visualization for complete excision while minimizing soft-tissue complications related to larger surgical exposures.