【摘 要】
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Objective: Surgical resection of the diseased synovium is the main method for the treatment of pigmented villonodular synovitis in knee. Postoperative radiotherapy is an adjuvant therapy to reduce recurrence. However, whether it should be combined with ra
【机 构】
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The First Clinical College of Guangzhou University of Chinese Medicine,Guangzhou 510080,China;The Fi
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Objective: Surgical resection of the diseased synovium is the main method for the treatment of pigmented villonodular synovitis in knee. Postoperative radiotherapy is an adjuvant therapy to reduce recurrence. However, whether it should be combined with radiotherapy is controversial. The study is designed to evaluate the efficacy of synovectomy combined with postoperative radiotherapy in the treatment of pigmented villonodular synovitis compared with only synovectomy in knee. Methods: The related references were searched from SinoMed, CNKI, Wanfang, VIP, PubMed, Embase, Cochrane Library and Web of Science from inception to October 2020, and the studies of synovectomy combined with postoperative radiotherapy were screened. According to the type of research, the corresponding evaluation methods were selected for quality evaluation of the literature. RevMan 5.3 software was used for meta-analysis. The primary outcome was recurrence, and the secondary outcome included complications, excellent and good rate of function of knee, range of motion of knee, Lysholm score and IKDC score of knee etcetera. Results: A total of 11 articles were included in meta-analysis, with 510 cases, 280 in the combined group and 230 in the control group. The results of meta-analysis showed that: (1) The recurrence rate in the combination group was significantly lower than that in the control group, OR=0.33 [95％CI (0.20,0.55)], p < 0.0001. (2) The complications in the combined group were higher than that in the control group, OR=2.70 [95％CI (1.16,6.31)], p=0.02. (3) The excellent and good rate of the combined group was significantly better than that of the control group, OR=2.86 [95％CI (1.23,6.64)], p=0.01, and it also may be the result of different evaluation criteria of each study. (4) There was no significant difference range of motion[MD=2.96,95％CI(-0.54,6.47),p=0.10], Lysholm score[MD=3.22,95％CI(-0.51,6.96),p=0.09] and IKDC score[MD=2.88,95％CI(-1.07,6.82),p=0.15] in knee between the two groups. Conclusions: The meta-analysis shows that synovectomy combined with radiotherapy can reduce the recurrence rate of pigmented villonodular synovitis in knee, but compared with only operation, there are higher complications. However, the above conclusions need to be verified by long-term follow-up of more high-quality clinical studies.
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