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J Knee Surg 2025; 38(04): 180-187
DOI: 10.1055/s-0044-1793939
Original Article

Patient-Reported Outcomes after Surgery for Pigmented Villonodular Synovitis in the Knee: A Cohort Study

Ryan J. Lashgari
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Bruce W. Chen
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Dominic J. Ventimiglia 
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Leah E. Henry
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Matthew P. Kolevar 
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Natalie L. Leong 
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Sean J. Meredith
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Jonathan D. Packer
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
R. Frank Henn  III
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
› Author Affiliations Funding This work was supported by a grant from the James Lawrence Kernan Hospital Endowment Fund Inc. (BL1941007WS) and in part by Career Development Award Number IK2 BX004879 from the U.S. Department of Veterans Affairs Biomedical Laboratory R&D (BLRD) Service.
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Abstract

Pigmented villonodular synovitis (PVNS) is a rare neoplastic proliferation of large joints, including the knee, with both localized PVNS (LPVNS) and diffuse PVNS (DPVNS) types. DPVNS is known to recur at a higher rate following resection; however, there is little evidence comparing patient-reported outcomes (PROs) between the two types. The purpose of this study was to compare PROs between patients with LPVNS and DPVNS involving the knee 2 years after surgical resection. We hypothesized that DPVNS would have worse 2-year PROs than LPVNS.

Sixteen patients who underwent arthroscopic resection of pathology-confirmed PVNS involving the knee were enrolled in a prospective registry. Several PROs, including six Patient-Reported Outcomes Measurement Information System (PROMIS) domains and the International Knee Documentation Committee (IKDC) Subjective Knee Form, were assessed at baseline and at 2 years postoperatively. Mean scores between LPVNS and DPVNS groups were compared using a Wilcoxon exact test, while categorical variables were compared using a Fisher's exact test.

Eleven patients (seven LPVNS and four DPVNS) completed both the baseline and 2-year PRO surveys. There were no significant differences in the demographic variables between groups, including age, body mass index, or prior surgical history (p < 0.05). There was a trend toward higher mean PRO scores in the DPVNS group at 2 years postoperatively in all measures, despite lower reported baseline levels of activity as measured by Marx Activity Rating Scale (26.3 vs. 76.7, p = 0.02). The DPVNS group also trended toward more improvement in PROMIS Physical Function (9.7 vs. −2.7), PROMIS Pain Interference (−9.0 vs. −2.5), PROMIS Anxiety (−5.4 vs. −4.4), and IKDC (26.7 vs. 18.9). However, these differences did not reach statistical significance (p < 0.05). There were two recurrences in the DPVNS group and none in the LPVNS group.

Patients with knee DPVNS do not report worse outcomes 2 years after arthroscopic resection compared with LPVNS patients.

Keywords

PVNS - patient-reported outcomes - PROMIS - knee


Publication History

Received: 11 April 2024

Accepted: 23 October 2024

Article published online:
28 November 2024

© 2024. Thieme. All rights reserved.

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