膝关节色素绒毛结节性滑膜炎的关节镜治疗复发：系统回顾和荟萃分析

IF 2.7 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2025-02-10 DOI:10.1002/jeo2.70169

Sohrab Keyhani, Mehran Soleymanha, Fardis Vosoughi, Ali Nikibakhsh, Ervin Zadgari, Maryam Mousavi, Robert F. LaPrade

{"title":"膝关节色素绒毛结节性滑膜炎的关节镜治疗复发：系统回顾和荟萃分析","authors":"Sohrab Keyhani, Mehran Soleymanha, Fardis Vosoughi, Ali Nikibakhsh, Ervin Zadgari, Maryam Mousavi, Robert F. LaPrade","doi":"10.1002/jeo2.70169","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>The purpose of this study was to assess the efficacy of arthroscopic intervention on the treatment of pigmented villonodular synovitis (PVNS) patients, with a focus on the potential advantages of this approach in lowering the risk of disease recurrence.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We performed a systematic review and meta-analysis following the PRISMA 2020 protocol. Our search encompassed five databases, namely PubMed, Embase, Scopus, Web of Science and Cochrane Library. Statistical analysis was conducted on the extracted data by using the R ver. 4.4.0 software. This study included English-language observational studies (case series and cohort studies) published up to 31 March 2024, focusing on in vivo human subjects with at least 2 years of follow-up. Studies with less than 2 years of follow-up, non-arthroscopic treatment methods or addressing PVNS in structures other than the knee were excluded.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We identified 24 articles, comprising 7 case series and 17 cohort studies, based on title, abstract, and quality assessments. Approximately 16% (95% confidence interval [CI]: 10.4%–24.75%) of knees that underwent arthroscopic surgery were found to be at risk of recurrence. In line with our expectations, sub-group analysis comparing recurrence rates among different subtypes of PVNS found that the diffuse subtype exhibited a higher recurrence rate of 19.4% (95% CI: 10.01%–34.15%), compared to the local subtype, which had a recurrence rate of 9.5% (95% CI: 4.47%–19.01%). Based on the meta-regression analysis, no significant association was found between the recurrence rate and the publication year or patient mean age. However, there was a noticeable rise in the recurrence rate with a longer follow-up period, indicating a probable correlation between extended follow-up and increased recurrence rates.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Our findings suggest that arthroscopic surgery for PVNS, particularly for the diffuse subtype, results in a higher recurrence rate compared to the localized subtype. However, the inherent challenges in achieving complete resection through arthroscopy, particularly in cases with extensive disease involvement, may contribute to the observed recurrence rates.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level III systematic review and meta-analysis.</p>\n </section>\n </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70169","citationCount":"0","resultStr":"{\"title\":\"Recurrence of arthroscopic treatment of pigmented villonodular synovitis of the knee: A systematic review and meta-analysis\",\"authors\":\"Sohrab Keyhani, Mehran Soleymanha, Fardis Vosoughi, Ali Nikibakhsh, Ervin Zadgari, Maryam Mousavi, Robert F. LaPrade\",\"doi\":\"10.1002/jeo2.70169\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>The purpose of this study was to assess the efficacy of arthroscopic intervention on the treatment of pigmented villonodular synovitis (PVNS) patients, with a focus on the potential advantages of this approach in lowering the risk of disease recurrence.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We performed a systematic review and meta-analysis following the PRISMA 2020 protocol. Our search encompassed five databases, namely PubMed, Embase, Scopus, Web of Science and Cochrane Library. Statistical analysis was conducted on the extracted data by using the R ver. 4.4.0 software. This study included English-language observational studies (case series and cohort studies) published up to 31 March 2024, focusing on in vivo human subjects with at least 2 years of follow-up. Studies with less than 2 years of follow-up, non-arthroscopic treatment methods or addressing PVNS in structures other than the knee were excluded.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>We identified 24 articles, comprising 7 case series and 17 cohort studies, based on title, abstract, and quality assessments. Approximately 16% (95% confidence interval [CI]: 10.4%–24.75%) of knees that underwent arthroscopic surgery were found to be at risk of recurrence. In line with our expectations, sub-group analysis comparing recurrence rates among different subtypes of PVNS found that the diffuse subtype exhibited a higher recurrence rate of 19.4% (95% CI: 10.01%–34.15%), compared to the local subtype, which had a recurrence rate of 9.5% (95% CI: 4.47%–19.01%). Based on the meta-regression analysis, no significant association was found between the recurrence rate and the publication year or patient mean age. However, there was a noticeable rise in the recurrence rate with a longer follow-up period, indicating a probable correlation between extended follow-up and increased recurrence rates.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Our findings suggest that arthroscopic surgery for PVNS, particularly for the diffuse subtype, results in a higher recurrence rate compared to the localized subtype. However, the inherent challenges in achieving complete resection through arthroscopy, particularly in cases with extensive disease involvement, may contribute to the observed recurrence rates.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of Evidence</h3>\\n \\n <p>Level III systematic review and meta-analysis.</p>\\n </section>\\n </div>\",\"PeriodicalId\":36909,\"journal\":{\"name\":\"Journal of Experimental Orthopaedics\",\"volume\":\"12 1\",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-02-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70169\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Experimental Orthopaedics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/jeo2.70169\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Experimental Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/jeo2.70169","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

摘要

目的本研究的目的是评估关节镜干预治疗色素绒毛结节性滑膜炎（PVNS）患者的疗效，重点关注该方法在降低疾病复发风险方面的潜在优势。方法：我们按照PRISMA 2020方案进行了系统回顾和荟萃分析。我们的搜索包括5个数据库，即PubMed， Embase, Scopus， Web of Science和Cochrane Library。采用R - ver对提取的数据进行统计分析。4.4.0软件。该研究包括截至2024年3月31日发表的英语观察性研究（病例系列和队列研究），重点关注至少2年随访的体内人类受试者。随访时间少于2年的研究、非关节镜治疗方法或解决非膝关节结构PVNS的研究被排除在外。结果基于标题、摘要和质量评估，我们确定了24篇文章，包括7个病例系列和17个队列研究。大约16%（95%可信区间[CI]: 10.4%-24.75%）的膝关节接受关节镜手术后发现有复发风险。与我们的预期一致，亚组分析比较不同亚型PVNS的复发率发现，弥漫亚型的复发率为19.4% (95% CI: 10.01%-34.15%)，而局部亚型的复发率为9.5% （95% CI: 4.47%-19.01%）。基于meta回归分析，未发现复发率与发表年份或患者平均年龄有显著相关性。然而，随着随访时间的延长，复发率明显上升，这表明延长随访与复发率增加之间可能存在相关性。结论：关节镜下手术治疗PVNS，尤其是弥漫性PVNS，复发率高于局限性PVNS。然而，通过关节镜实现完全切除的固有挑战，特别是在疾病广泛累及的情况下，可能导致观察到的复发率。III级系统评价和荟萃分析。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

摘要图片

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

Recurrence of arthroscopic treatment of pigmented villonodular synovitis of the knee: A systematic review and meta-analysis

Purpose

The purpose of this study was to assess the efficacy of arthroscopic intervention on the treatment of pigmented villonodular synovitis (PVNS) patients, with a focus on the potential advantages of this approach in lowering the risk of disease recurrence.

Methods

We performed a systematic review and meta-analysis following the PRISMA 2020 protocol. Our search encompassed five databases, namely PubMed, Embase, Scopus, Web of Science and Cochrane Library. Statistical analysis was conducted on the extracted data by using the R ver. 4.4.0 software. This study included English-language observational studies (case series and cohort studies) published up to 31 March 2024, focusing on in vivo human subjects with at least 2 years of follow-up. Studies with less than 2 years of follow-up, non-arthroscopic treatment methods or addressing PVNS in structures other than the knee were excluded.

Results

We identified 24 articles, comprising 7 case series and 17 cohort studies, based on title, abstract, and quality assessments. Approximately 16% (95% confidence interval [CI]: 10.4%–24.75%) of knees that underwent arthroscopic surgery were found to be at risk of recurrence. In line with our expectations, sub-group analysis comparing recurrence rates among different subtypes of PVNS found that the diffuse subtype exhibited a higher recurrence rate of 19.4% (95% CI: 10.01%–34.15%), compared to the local subtype, which had a recurrence rate of 9.5% (95% CI: 4.47%–19.01%). Based on the meta-regression analysis, no significant association was found between the recurrence rate and the publication year or patient mean age. However, there was a noticeable rise in the recurrence rate with a longer follow-up period, indicating a probable correlation between extended follow-up and increased recurrence rates.

Conclusion

Our findings suggest that arthroscopic surgery for PVNS, particularly for the diffuse subtype, results in a higher recurrence rate compared to the localized subtype. However, the inherent challenges in achieving complete resection through arthroscopy, particularly in cases with extensive disease involvement, may contribute to the observed recurrence rates.