Oncological and functional outcomes of modified arthroscopic resection for intra-articular tenosynovial giant cell tumor of the knee using multiple portals

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 31; no. 3; p. 10225536231220413
• Main Authors: Higa, Kotaro, Uehara, Fuminari, Azuma, Chinatsu, Oshiro, Hiromichi, Tome, Yasunori, Nishida, Kotaro
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-09-2023; SAGE Publishing
• Subjects: Arthroscopy; Giant Cell Tumor of Tendon Sheath - diagnostic imaging; Giant Cell Tumor of Tendon Sheath - surgery; Humans; Knee Joint; Retrospective Studies; Synovectomy; Synovitis, Pigmented Villonodular; pigmented villonodular synovitis; arthroscopic synovectomy; tenosynovial giant cell tumor; intra-articular; arthroscopic resection; range of motion
• ISSN: 1022-5536; 2309-4990
• DOI: 10.1177/10225536231220413

Background
Arthroscopic resection of tenosynovial giant cell tumor (TS-GCT) presents favorable outcomes. However, there are reportedly higher recurrence rates in patients who had incomplete resection. To minimize incomplete resection, we established a multiple portal approach depending on the location of the disease. In this study, we aimed to retrospectively evaluate the clinical outcomes of arthroscopic resection for both localized and diffuse types of TS-GCT of the knee.
Methods
From 2009 to 2019, 13 patients who underwent arthroscopic synovectomy of the knee and were histologically diagnosed with TS-GCT were included in this study. The pre- and postoperative range of motion (ROM) of the knee was measured. The Japanese Orthopaedic Association (JOA) score and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were assessed at the final follow-up examination. Magnetic resonance imaging was performed to detect incomplete resection or local recurrence.
Results
Among the 13 patients, seven and six had localized and diffuse type TS-GCT, respectively. Regarding the knee ROM, preoperative knee flexion in patients with the localized type was limited compared with that in those with the diffuse type. However, the ROM was significantly improved in patients with both types postoperatively. The JOA score and KOOS of patients with both types at the final follow-up were favorable, and there were no significant differences between both types. There was neither recurrence nor incomplete resection in any patient for both types.
Conclusion
All patients, regardless of the TS-GCT type, achieved favorable outcomes after arthroscopic surgery; especially, the failure rate was 0%.