Assessment of patients with diffuse pigmented Villonodular Synovitis of Knee before and after radio-synovectomy

Full text of publication follows. Aim: the aim of this study was to evaluate subjective and objective findings of patients with diffuse pigmented villonodular synovitis (DPVNS) of knee before and after treatment with Yttrium-90 (Y-90) radio-synovectomy. Materials and methods: between years 2005 and 2013, 23 patients, 15 female and 8 male, who had adjuvant radio-synovectomy after arthroscopic surgery were included to our study. 5 mCi of Y-90 radiocolloid was administered under local anesthesia at least 6 weeks after arthroscopic surgery. The patients were reevaluated 6 months after radio-synovectomy. All the patients were assigned a Lysholm knee score prior to surgery, prior to radio-synovectomy and 6 months after radio-synovectomy. Lysholm score was calculated according to patients' pain, swelling, instability, locking, limping, support, climbing the stairs, squatting and the highest evaluation score was 100. In addition modified Marshall scoring system was calculated according to objective and subjective findings of the patients prior to surgery and six months after radio-synovectomy. The highest evaluation score was 30 in modified Marshall scoring system where 19 points were provided by objective findings and 11 points were provided by subjective findings. Scores higher than 26 were defined as very good, between 21-25 was good, between 16-20 was medium, and values less than 16 points are considered to be poor. The obtained points using scoring systems were evaluated statistically. Results: the mean age was (31.7 ± 13.2) years. The average time period between the operation and radio-synovectomy was (12.8 ± 8.14) weeks. The calculated Lysholm scores prior to surgery, prior to radio-synovectomy and 6 months after radio-synovectomy were (38.8 ± 4.1), (60.0 ± 4.4) and (82.9 ± 6.5), respectively (p <0.001). Modified Marshall scores prior to surgery, and 6 months after radio-synovectomy, was (12.4 ± 2.7) and (25.5 ± 3.1) respectively (p <0.001). Conclusion: we conclude that Y-90 therapy in patients with DPVNS of knee is efficient in treatment of objective and subjective symptoms. In addition both scoring systems are reliable predictors of effectiveness of the Y-90 therapy. (authors)