Evaluation of patients with diffuse pigmented villonodular synovitis of knee with functional scoring systems after surgery and radiosynovectomy

Abstract

Aim: To evaluate the symptoms and functional status of patients with pigmented villonodular synovitis (PVNS) of the knee using the modified Marshall scoring system and musculoskeletal tumor society (MSTS) rating scale before therapy and six months after radiosynovectomy (RS). Materials and methods: Evaluation was made of 29 knee joints of 29 patients with DPVNS. Arthroscopic synovectomy was applied to all patients and additional posterior open synovectomy to five. Yittrium-90 (Y-90) citrate colloid was used in the RS procedure. RS was performed 11.8±13.3 weeks after the operation. In the six months after RS, patients were evaluated with the modified Marshall scoring system and MSTS rating scale. Results: The patients were 17 females and 12 males with a mean age of 31.8±12.9 years years (range: 13-54 years). The preoperative modified Marshall score was poor in 24 patients and fair in five patients. In the follow-up period, the scores were excellent in 17 patients, good in 10 patients and fair in two patients. The mean modified Marshall scores increased after the operation and RS from 12.93±2.93 to 25.52±2.90 (p<0.001). The mean MSTS scores increased from 17.52±4.82 to 26.86 ±2.46 (p<0.001). In one of four patients with a score of 22 and three patients with a score of 24, maximum scores were obtained in the follow-up period with the effect of surgery and RS. Conclusion: RS with Y-90 citrate colloid after surgical excision in the treatment of PVNS is a reliable and efficient treatment method for the increase of functional capacity and decrease of symptoms.