Satisfactory functional outcomes and low recurrence rates at a mean 10-year follow-up after combined staged synovectomy and external radiotherapy for diffuse pigmented villonodular synovitis of the knee
Bibliographic record
Abstract
INTRODUCTION: Diffuse pigmented villonodular synovitis (PVNS) of the knee is a locally destructive lesion that tends to recur following surgical synovectomy. This study aims to evaluate the long-term functional outcomes and recurrence rates of combined staged synovectomy and external radiotherapy in managing diffuse PVNS of the knee. METHODS: The data of twenty-three patients who had a diffuse PVNS of the knee between June 2011 and September 2017 were retrospectively collected. The patients underwent combined staged anterior arthroscopic and open posterior synovectomy followed by low-dose external radiotherapy (average 3000 cGy). Functional outcomes were assessed preoperatively and at the final follow-up using the International Knee Documentation Committee (IKDC) score, Musculoskeletal Tumor Society (MSTS) score, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, and SF-36 score, along with the knee motion measurements. Statistical analysis evaluated the changes in functional scores and recurrence rates, with a p-value < 0.05 as the cut-off level of significance. RESULTS: The mean follow-up time was 121.1 ± 20.2 months, with a minimum of 85 months. At the final follow-up, the mean range of motion (ROM) improved from 84.1 ± 16.2° to 110.4 ± 9.7°. The WOMAC score increased significantly from 44.5 ± 5.1 to 81.5 ± 6.3 (p < 0.00001). The IKDC score improved from 43.7 ± 8.1 to 79.1 ± 7.4 (p < 0.00001), MSTS scores from 6.7 ± 2.1 to 20.3 ± 5.7 (p < 0.00001), and SF-36 scores from 28.6 ± 7.4 to 77.4 ± 11.5 (p < 0.00001). Two recurrent cases were documented at the last follow-up visit (8.6%), with a minor complication rate of 21.7%. CONCLUSION: Combined staged synovectomy and external radiotherapy is an effective treatment for diffuse PVNS of the knee. It has demonstrated significant functional improvement and low recurrence rates over extended follow-up periods, supporting its role as a durable and reliable treatment strategy. LEVEL OF EVIDENCE: Level IV, retrospective cohort.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".