膝关节弥漫性色素沉着绒毛结节性滑膜炎的联合治疗

目的 探讨联合疗法治疗膝关节弥漫性色素沉着绒毛结节性滑膜炎的临床效果.方法 对18例影像学及病理确诊的患者,采用关节镜切除关节内病变,有限切开辅助性开放性手术切除关节外病变,术后结合放疗.术后随访3-67个月,平均36个月.结果 除1例患者术后23个月复发外,其余患者膝关节活动度为0°～140°,患膝关节未出现复发症状,部分患者复查MRI未发现有复发迹象.术前Lysholm膝关节功能平均评分为（36.2±4）分,术后为（89±3.4）分.结论 关节镜联合有限切开辅助性开放性手术对弥漫型病变的切除较好,结合术后辅助放疗,可取得较好治疗效果.

The combined treatment against diffuse pigmented villonodular synovitis of the knee

Objective To investigate the efficacy of the combined treatment against diffuse pigmented villonodular synovitis （PVNS） of the knee. Methods 18 patients, radiologically and pathologically diagnosed with PVNS, were involved in this study. They all underwent arthroscopic resection of intra-articular lesion, limited open adjuvant excision of extra-articular lesion, and post-operative radiotherapy. The mean follow-up period was 36 months, （range, 3-67 months）. Results Only 1 case sustained post-operative recurrence in 23 months. For all the other patients（n=17）, their range of motion were from 0 degrees to 140 degrees, and no recurrence of symptoms were found in their knees. Some of the patients took MRI in the follow-up appointments, which showed no evidence of recurrence. According to the Lysholm Knee Scoring Scale, the mean preoperative score was （36.2±4）, while the postoperative score was （89±3.4）. Conclusions The arthroscopic resection combined with limited open adjuvant excision has a relatively good outcome against diffuse lesions. In combination with postoperative radiotherapy, good efficacy can be expected.