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目的探讨高侵袭性膝关节色素沉着绒毛结节性滑膜炎(PVNS)发病原因及手术注意事项。方法对2010-03—2012-07收治的11例高侵袭性PVNS患者都行2次手术治疗,第1次是关节镜下切除病变,刮除病灶,减少复发,并便于植骨愈合;1个月后行第2次开放性手术,再次彻底切除病变,患肢不负重,3个月后复查MRI。结果随访12~26个月,平均16.9个月。受侵袭骨质均取得较好愈合效果,随访期间未见PVNS复发迹象。结论对于高侵袭性PVNS在尽量彻底切除同时,辅以放疗,可以减少复发。
Objective To investigate the etiology and surgical precautions of highly invasive kyphosis of pigmented villonodular synovitis (PVNS). Methods The 11 patients with highly invasive PVNS admitted from 2010-03 to 2012-07 underwent 2 surgeries. The first operation was arthroscopic excision, lesion removal, recurrence reduction and bone graft healing. One Month after the second open surgery, once again complete removal of the lesion, limb burden, review MRI after 3 months. The results were followed up for 12 to 26 months, an average of 16.9 months. Invasive bone obtained good healing effect, no signs of PVNS recurrence during follow-up. Conclusions For highly aggressive PVNS in the same time as completely resection, combined with radiotherapy, can reduce recurrence.