Patient Outcomes After Resection of Pigmented Villonodular Synovitis in Patients in King Abdulaziz Medical City.

Introduction  Pigmented villonodular synovitis (PVNS) is a proliferative disorder that affects synovial joints. PVNS, also known as tenosynovial giant cell tumor (TGCT), is a broad term that refers to a variety of diseases, both localized and diffuse. The current study aims to describe the outcomes of PVNS in patients in King Abdulaziz Medical City (KAMC) Riyadh, Saudi Arabia especially after surgical resection, highlighting radiological and pathological evidence of disease recurrence and symptom progression. The study is also concerned with comparison between patients who had adjuvant radiotherapy versus patients who underwent surgery only in addition to comparison between patients who underwent arthroscopic surgery versus those who underwent open surgery. Objective Pigmented villonodular synovitis is a disorder that occurs in the synovial joints with the highest incidence rates in the third and fourth decades. PVNS is categorized into localized and diffuse. The current study aims at defining the recurrence rate and outcomes of PVNS in patients in KAMC between 2008 and 2019. Design A retrospective study that comprises patients with proven PVNS of the knee, hip, and elbow for a minimum follow-up duration of two years. Data was collected from the KAMC database, National Guard Health Affairs, Riyadh, Saudi Arabia. Results Nearly a third of patients reported a prior history of trauma. The knee joint was most frequently involved followed by the ankle followed by the hip. Diffuse PVNS was more common than localized disease with more affection on the right side. The most common presenting symptoms were pain and swelling followed by decreased range of motion (ROM). About one-fifth of patients had undergone prior surgery. 30.8% received adjuvant radiotherapy. Post-operative stiffness or decreased ROM were noted in 23.1% of cases. Half of the patients received follow-up for more than 24 months. Overall recurrence rate was 19.2%. Recurrence rates were significantly higher in patients with left-sided lesions and those with prior surgery but it did not reach statistical significance. Non-statistically significant trends for increased recurrences were also seen with older age, diffuse type PVNS, and knee involvement. Conclusions In summary, this study reports the outcomes of PVNS after surgical resection in patients in King Abdulaziz Medical City. The study showed recurrence rates being significantly higher in patients with left-sided lesions than those with prior surgery. Also, non-statistically significant trends for increased recurrences were also seen with older age, diffuse type PVNS, and knee involvement.