J Knee Surg 2019; 32(05): 427-433
DOI: 10.1055/s-0038-1646929
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Arthroscopic Treatment of Diffuse Pigmented Villonodular Synovitis of the Knee: Complete Synovectomy and Septum Removal—Midterm Results

Sohrab Keyhani
1  Department of Orthopedic Surgery, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Seyyed Morteza Kazemi
2  Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Jin Hwan Ahn
3  Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
René Verdonk
4  Department of Orthopedics and Traumatology, Ghent University, Ghent, Belgium
Mehran Soleymanha
5  Department of Orthopaedics, Orthopaedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
› Author Affiliations
Funding None.
Further Information

Publication History

15 January 2018

20 March 2018

Publication Date:
04 May 2018 (online)


The purpose of this study was to evaluate and describe the clinical results of complete arthroscopic synovectomy through the four arthroscopic portals in the knees affected by diffuse pigmented villonodular synovitis (DPVNS). Between 2009 and 2012, 21 patients (15 men and 6 women) with the diffuse form of PVNS of the knee were enrolled in the study after qualification. The clinical diagnosis was confirmed by magnetic resonance imaging and postsurgical pathologic examination. All patients underwent complete synovectomy through posteromedial, posterolateral, anteromedial, and anterolateral portals. Each patient was evaluated before treatment and followed up for a minimum of 5 years (range: 60–79 months) using the Lysholm score and International Knee Documentation Committee (IKDC) score. Both Lysholm score and IKDC scores were significantly improved in all study participants. No cases of clinical recurrence, infection, joint stiffness, or neurovascular lesions were observed. This study showed that an attentive arthroscopic synovectomy is a safer alternative with better clinical outcomes, with no clinical recurrences.

Authors' Contributions

S.K.: Developing the original idea and the protocol, and definition of intellectual content; R.V. and J.H.A.: Study supervision; M.S. and S.M.K.: Contribution to the development of the protocol; M.S.: Preparation and drafting of the article. All authors read and approved the final article.


This study was approved by the Akhtar Hospital Research Ethic Committee in Tehran, Iran (No. 9820). Informed consent was obtained from all individual participants included in the study.