色素沉着绒毛结节性滑膜炎的手术治疗

目的 :探讨色素沉着绒毛结节性滑膜炎的临床症状、诊断和外科治疗方法。方法 :6例关节内的色素沉着绒毛结节性滑膜炎 ,其中膝关节 5例 ,髋关节 1例 ,经手术治疗并病检确诊。结果 :6例术中见关节内滑膜、韧带和关节软骨侵蚀明显 ,5例行全滑膜切除及受侵蚀骨质的刮除 ,1例膝关节PVS行全滑膜切除加关节融合 ,术后随访 6个月～ 6年 ,恢复满意 ,无局部复发。结论 :PVS临床少见且缺乏典型的临床症状和体征 ,术前误诊率高 ;治疗关键是滑膜能否得到彻底的切除 ,对关节软骨下骨侵袭严重的病例 ,可行关节成形或置换术。

Surgical treatment for pigmented villonodular synovitis

Objective Pigmented villonodular synovitis(PVS) is a synovial proliferative disorder that remains a diagnostic difficulty. In this retrospective study we evaluated the diagnostic procedures, clinical symptoms and surgical treatment of PVS. Methods Six surgically treated cases of PVS were evaluated: five of the lesions were located in the knee joint and one in the hip joint. Diagnosis of PVS was confirmed by histological examination. Operation showed characteristic findings of a joint effusion, and synovial proliferation. Results Five cases were treated with complete open total synovectomy, and one case received arthoplasty. The followed up period averaged 3 years and six months (rangeing from 6 months to 6 years). Excellent and good function was seen in all and there was no recurrence. Conclusion PVS diagnosis is frequently delayed due to nonspecific symptoms. Proper treatment includes surgery: extension synovectomy for the diffuse form, and arthoplasty and total joint replacement for the severe bone involvement.