Surgical Treatment of Venous Malformations of the Knee: Treatment Outcomes for 35 Patients. Issue 6 (July 2018)

• Record Type: Journal Article
• Authors: Laurian, Claude; Masonni, Claudine; Wassef, Michel; Houdart, Emmanuel; Toni, Francesca; Marteau, Veronique; Paraskevas, Nikos; Lenck, Stephanie; Bisdorff, Annouk
• Is Part Of: Journal of pediatric orthopaedics. Volume 38:Issue 6(2018)
• Publication Date: 2018-07
• Subjects: venous malformation -- knee arthropathy -- surgical synovectomy; Pediatric orthopedics -- Periodicals; 618.927
• DOI: 10.1097/BPO.0000000000001150
• Languages: English
• ISSNs: 0271-6798

Abstract

Abstract : Background: The place of open surgery in venous malformations (VMs) of knee joint is still discussed. The aim of this study was to evaluate the benefits of surgery in terms of pain, function, and quality of life. Design: This was a retrospective observational study. Methods: Thirty-five consecutive young patients undergoing surgery for VMs of the knee between 2011 and 2014 were included. Data collection was performed using a prospective database by reviewing patient records. Pain, mobility of the joint, residual VMs as seen by magnetic resonance imaging, and quality of life were the main outcome endpoints for this study. Results: Thirty-five patients (22 females and 13 males, with a median age of 15 y, range of 5 to 20 y) were included. Twenty-seven VMs were localized in and around the knee joint, of which 8 were extensive. Indication for surgery was intermittent or permanent pain. Details of the surgical excisions of the VM are as follows: suprapatellar area in 57%, suprapatellar and infrapatellar area in 29%, infrapatellar area in 2%, limited in the femoropatellar area in 12%. Partial resection of a vastus muscle or patellar retinaculum was necessary for 19 patients. The median duration of the surgery was 4 hours (range: 2 to 7 h). The median hospital stay was 5 days; full-time physiotherapy was systematic for 2 to 3 weeks. After 6 months, 74% had no longer pain, the mobility of the joint was normal for 60%. Of the 33 patients who had a magnetic resonance imaging at 6 months, 86% (28 patients) had no residual intra-articular VMs, and 14% had focal residual VMs. At the last follow-up, 77% (27 patients) had no longer pain, 23% experienced intermittent pain with unusual activities, and 91% (32 patients) had normal mobility of the joint. Quality of life was increased significantly due to the pronounced impact on pain. Conclusion: Extensive surgical excision of knee VMs is a safe procedure with good outcomes in terms of pain, function, and quality of life. Level of Evidence: Level II—retrospective observational monocentric study.