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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2018

10.04.2018 | Knee

Distinct extra-articular invasion patterns of diffuse pigmented villonodular synovitis/tenosynovial giant cell tumor in the knee joints

verfasst von: Dong-Eun Kim, Jong-Min Kim, Bum-Sik Lee, Nam-Ki Kim, Sang-Hoon Lee, Seong-Il Bin

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 11/2018

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Abstract

Purpose

Pigmented villonodular synovitis (PVNS)/tenosynovial giant cell tumor (TGCT) is a benign, proliferative lesion of the synovium, the bursa, and the tendon sheath. Little is known about the anatomical distribution pattern of diffuse extra-articular PVNS/TGCT around the knee joint. In this retrospective study, anatomical distribution of PVNS/TGCT using magnetic resonance imaging (MRI) and arthroscopy was analyzed.

Methods

This study was designed as a retrospective, observational cross-sectional study based on MRI and arthroscopy. Twenty-four PVNS/TGCT patients (24 knees) who underwent arthroscopic or posterior open surgery between 2009 and 2016 were enrolled. Of these, eight intra-articular and 16 diffuse extra-articular PVNS/TGCT of the knee were classified. The anatomical locations of the PVNS/TGCT masses were determined with a newly devised mapping scheme. Analysis was performed on the prevalence of each compartment and agreement rates between each compartment.

Results

The point prevalence of intra-articular posterior compartment was higher in diffuse extra-articular PVNS/TGCT group compared with intra-articular PVNS/TGCT group. The point prevalence of diffuse PVNS/TGCT was most prevalent in the extra-articular posterolateral compartment (12 out of 16 diffuse extra-articular PVNS/TGCT patients, 75%) and second most common in the below to joint capsule compartment (11 out of 16, 68.8%). The agreement rate was the highest between intra-articular posterolateral and extra-articular posterolateral compartments (75%).

Conclusion

Extra-articular invasion of diffuse PVNS/TGCT occurred in specific patterns in the knee joint. Extra-articular lesions were always accompanied by lesions in intra-articular compartments. In particular, lesions in the intra-articular posterior compartments were observed in all of the diffuse extra-articular PVNS/TGCT patients. The point prevalence of diffuse extra-articular PVNS/TGCT for each compartment was the highest [12 out of 16 (75%)] in extra-articular posterolateral compartment. In contrast, invasion to the extra-articular posteromedial side was less frequent [5 out of 16 (31.3%)] than to the extra-articular posterolateral side. Knowing where the lesions frequently occur may provide important information for deciding the timing, method, and extent of surgery.

Level of evidence

Level IV.
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Metadaten
Titel
Distinct extra-articular invasion patterns of diffuse pigmented villonodular synovitis/tenosynovial giant cell tumor in the knee joints
verfasst von
Dong-Eun Kim
Jong-Min Kim
Bum-Sik Lee
Nam-Ki Kim
Sang-Hoon Lee
Seong-Il Bin
Publikationsdatum
10.04.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 11/2018
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-4942-2

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