SURGICAL-TREATMENT OF DIFFUSE PIGMENTED VILLONODULAR SYNOVITIS OF THEKNEE

Twenty-five cases of diffuse pigmented villonodular synovitis of the k nee in 23 patients were reviewed to determine the results of surgical treatment. All the cases met strict histologic criteria for diagnosis. Long-term clinical follow-up data (average, 58 months) were available for all patients. One case for a patient who was treated by marginal excision recurred within one year. All other cases (initial and recurr ent) were treated by total synovectomy, preserving the functional inte grity of the knee. Proximal extensor realignments were performed in pa tients in which chronic distention had caused a redundancy of retinacu lar tissues. Adhesions, an early complication in eight patients, respo nded well to closed manipulation and did not adversely affect long-ter m functional outcome. The outcome was excellent in seven and good in 1 6 the patients. Two of the patients have had recurrences but have not had another operation. Using this technique, the recurrence rate (8%) and morbidity are significantly lower than those reported previously.