Comparative Study Of Treating Diffusesd Pigmented Villonodular Synovitis Of The Knee By Arthroscopic Synovectomy And Arthroscopic Synovectomy Associate With Radiotherapy

Objective: To compare the effects of arthroscopic synovectomy associate withradiotherapy with those of only arthroscopic synovectomy in treatment of diffusedpigmented villonodular synovitis of the knee joint.Methods: All the43cases suffered diffused pigmented villonodular synovitis of theknee that were radiologically and pathologically diagnosed got two kinds treatement:20cases treated only for arthroscopic synovectomy,10male and10female,with amean age of (36.80±9.11);23cases treated for arthroscopic synovectomy associatewith radiotherapy,8male and15female, with a mean age of (35.35±8.53).TheLysholm score system and the knee joint ROM(range of motion) were used toevaluate the clinical outcome for all the patients.The Lysholm score and theROM(range of motion) of the diseased knee joints were measured at pre-operationand at the end of follow up.At the end of follow-up,every patient should havePhysical examination and MRI examination and Pathological examination todiagnose the recurrence patients,and compared the recurrence rate between the twogroups. Meanwhile, the complication rate was compared.Result: All the patients got a mean follow-up period（36.4±1.2）months. There wereno statistically differences within the two groups in terms of genders and ages. In thegroup that patients treated with arthroscopic synovectomy:the pre-operation Lysholmscore was41.75±5.85, and86.55±4.22at the end of follow-up,there was significantstatistically differences between the two period（t=29.47,p<0.01）.The same to thegroup that patients treated with arthroscopic synovectomy associate with radiotherapy:pre-operation were39.91±6.52and87.30±4.12at the end of follow-up（t=29.47,p<0.05）.But there were no statistically differences within the two groups onpre-operation Lysholm scores(t=0.97，p>0.05）;The same to the status that at the endof follow-up（t=0.67,p>0.05）.About the knee joint ROM, in the group that patientstreated with arthroscopic synovectomy: the pre-operation was（60.7±13.9）°, and（121.8±11.3）°at the end of follow-up, there was significant statistically differences between the two period（t=15.2，p<0.01）. The same to the group that patients treatedwith arthroscopic synovectomy associate with radiotherapy: pre-operation were（53.8±14.3）°and（123.2±11.1）°at the end of follow-up（t=18.2，p<0.01）.But therewere no statistically differences within the two groups on pre-operation knee jointROM （t=1.60,p>0.05）;The same to the status that at the end of follow-up（t=0.14,p>0.05）. About the recurrent,there were8patients suffered recurrent in thegroup that patients treated with arthroscopic synovectomy. In the group that patientstreated with arthroscopic synovectomy associate with radiotherapy three patientssuffered recurrent. There were significant statistically differences between the twogroup on the recurrence rate（X~2=4.08，p<0.05）.There were1patient underthrowincisional iffection and two patients had slight edema in the group that patientstreated with arthroscopic synovectomy.In the group that patients treated witharthroscopic synovectomy associate with radiotherapy had3patients got skinpigmentation and1patient had slight edema. There was no statistically differenceswithin the two groups on complicants rate（X~2=0.04，p>0.05）.Conclusion: Arthroscopical synovectomy is an effective treatment for diffusepigmented villonodullar synovitis of the knee.But with a combined application ofpostoperative radiotherapy can reduce the rate of recurrence,is a more ideal treatmentmethod.