关节镜下滑膜切除联合放疗治疗弥漫型踝关节色素绒毛结节性滑膜炎

Arthroscopic Synovectomy Combined with Radiotherapy for the Treatment of Diffuse Pigmented Villonodular Synovitis of the Ankle

目的:探讨关节镜下滑膜切除联合放疗治疗弥漫型踝关节色素绒毛结节性滑膜炎的临床疗效。方法:本组包括8例踝关节色素绒毛结节性滑膜炎患者。术前根据症状、体征和核磁共振检查诊断。踝关节镜下经前方和后方入路行滑膜切除,同时处理伴发的关节软骨损伤和骨性撞击。术后病理检查确定色素绒毛结节性滑膜炎的诊断后,行外照射放疗。结果:所有患者术后获得随访,无手术相关并发症,术后平均随访50个月。术前美国足踝外科学会评分(American Orthopaedic Foot&Ankle Society,AOFASankle hindfoot scale)为59分,末次随访时AOFAS评分为86分(P=0.001)。所有患者疗效优良,术后无复发。结论:关节镜下滑膜切除联合放疗治疗弥漫型踝关节色素绒毛结节性滑膜炎临床疗效良好。

Objective To evaluate the clinical outcome of treating patients with diffuse pigmented vil-lonodular synovitis（PVNS） of the ankle using the arthroscopic synovectomy combined with the externalbeam radiotherapy. Methods Eight patients diagnosed as PVNS according to their signs, symptoms andthe magnetic resonance imaging were chosen as the subjects. Combined anterior and posterior approach-es to the ankle were used to perform the arthroscopic synovectomy, with the concomitant chondral inju-ry and bony impingement dealt with simultaneously. The external beam radiotherapy was given afterthe diagnosis of PVNS was confirmed by pathological examination results. Results All patients were fol-lowed up with a mean period of 50 months. There were no complications resulting from the operation.The average American Orthopaedic Foot Ankle Society ankle hindfoot scale score improved from 59 before the operation to 86 after the operation（P=0.001）. All the patients had good or excellent resultsand no recurrence appeared. Conclusion Arthroscopic anterior-and posterior-approach synovectomycombined with external beam radiotherapy is of good effect in treating diffuse PVNS of the ankle.