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Pigmented villonodular synovitis of the knee joint in a 5-year-old girl treated with combined open and arthroscopic surgery: a case report

Jha, Subash Chandra; Nishisho, Toshihiko; Matsuura, Tetsuya; Takeuchi, Makoto; Miyagi, Ryo; Takao, Shoichiro; Suzue, Naoto; Toki, Shunichi; Nagamachi, Akihiro; Sairyo, Koichi

Journal of Pediatric Orthopaedics B: November 2016 - Volume 25 - Issue 6 - p 564–569
doi: 10.1097/BPB.0000000000000293

Pigmented villonodular synovitis is an extremely rare disease in skeletally immature patients. Erosive destruction of the involved joint leads to early arthritis, and its high recurrence rate makes treatment challenging. Multiple surgical approaches exist, but it is unclear as to which among them achieves the lowest possible recurrence rate and morbidity. We report the case of a 5-year-old girl with left knee pain and swelling who was diagnosed with diffuse pigmented villonodular synovitis of the left knee based on MRI findings. Combined open and arthroscopic surgery was performed to completely remove the tumor. Postoperative histopathological examination confirmed the diagnosis of diffuse pigmented villonodular synovitis. The postoperative course was uneventful, with a gradual improvement in symptoms. There were no signs of recurrence on postoperative MRI performed at the 8-month follow-up, with neither knee pain nor limitation of range of motion. The favorable outcome in this case suggests that combined open and arthroscopic surgery may be an effective method for treating pigmented villonodular synovitis in skeletally immature patients.

aDepartment of Orthopedics

bDepartment of Radiologic and Technology, Division of Health Sciences, Institute of Biomedical Sciences, Tokushima University Graduate School

cDepartment of Orthopedics, Tokushima Municipal Hospital, Tokushima

dDepartment of Orthopedics, Kochi Red Cross Hospital, Kochi

eDepartment of Orthopedics, Mitoyo General Hospital, Kagawa, Japan

Correspondence to Toshihiko Nishisho, MD, PhD, Department of Orthopedics, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan Tel: +81 88 633 7240; fax: +81 88 633 0178; e-mail:

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