Objective To explore the technique of arthroscopic treatment of local ized pigmented villonodular synovitis of the knee and to evaluate its cl inical results. Methods From February to December 2006, 22 cases of local ized pigmented villonodular synovitis of the knee were treated by arthroscopic excision of the focus and partial synovectomy. There were 8 males and 14 females, with an average age of 24 years old (16 to 35 years old). Eight patients had a trauma history, the others had no obvious inducement. The disease course was from 1 month to 30 months with an average of 10 months. The Lysholm score was 68.5 ± 8.2, and the International Knee Documentation Committee (IKDC) score was 72.7 ± 5.2 before operation. MRI showed that 20 knees had definite focuses and 2 had no ones. In all the cases, routine arthroscopic approach combined with assistant approach adjacent to the focus was used. Results All the patients were diagnosed as having local ized pigmented villonodular synovitis of the knee by pathological examination. The incisions healed at stage I. No compl ications occurred after operation. All patients were followed up 18-28 months (average 22 months). The angle of genuflex was less than 90° in 2 cases after 6 weeks, and the range of motion of the knee was recovery after manipulation release. At last followup, MRI showed no recurrence was found in 19 patients. The IKDC score was 92.8 ± 2.4, and the Lysholm score was 94.5 ± 3.5, respectively, indicating significant differences when compered with before operation (P lt; 0.01). Conclusion Local ized pigmented villonodular synovitis of the knee can be effectively treated by arthroscopic excision of the focus along with a rim of surrounding healthy synovium with most minimal invasive and best knee function.
Objective To evaluate the primary cl inical results of double-bundle anterior cruciate l igament reconstruction (ACLR) with semitendinosus allografts. Methods From March 2006 to October 2006, 33 patients underwent double-bundle ACLR with semitendinosus allografts. The complete followed-up data of 31 patients was analyzed retrospectively. There were 24 males and 7 females aged 18-35 years old (average 25 years old). The injury was caused by sports accidents in 23cases and traffic accidents in 8 cases, involving the left knee in 18 cases and the right knee in 13 cases. Anterior cruciate l igament rupture were confirmed by MRI and arthroscopy in all the patients, without lateral collateral l igaments injuries and posterior cruciate l igament injuries. The time from injury to operation was 1-43 months (average 11 months). The knee was fixed at 0° position after operation for 2 weeks and got knee joint rehabil itation exercises gradually. Results The incision of 2 patients showed effusion 4 and 7 days after operation, respectively, and healed after symptomatic treatment. The incision of 29 patients healed by first intention. There were no compl ications such as stiffness of knee joint, neurovascular injuries and joint infections. All the patients were followed up for 24-29 months (average 26 months). MRI displayed the anterior cruciate l igament grafts presented with good connection and signal similar to the normal 2 years after operation. There was significant difference between the preoperational value and the final follow-up value in terms of bilateral knee joint difference of prior laxity, Lachman test, and pivot shift test (P lt; 0.05 ). The circumference difference between the injured and the normal was (11.6 ± 7.9) mm before operation and (5.0 ± 3.1) mm at the final follow-up (P lt; 0.05). The Tegner score, Lysholm score, and International Knee Documentation Committee score was 3.83 ± 1.15, 64.38 ± 6.81, and 41.42 ± 6.30, respectively, before operation, and 6.29 ± 0.64, 94.45 ± 3.03, and 95.72 ± 3.10, respectively, at the final follow-up. There was a significant difference between before and after operation (P lt; 0.05). Conclusion The primary cl inical results of double-bundle ACLR with semitendinosus allografts are satisfactory and the allogeneic semitendinosus are good grafts for double-bundle ACLR.