关键词:

髋关节, 色素沉着绒毛结节性滑膜炎, 滑膜切除, 关节置换 ,

Abstract:

Objective To observe the clinical efficacy of open synovectomy or open synovectomy combined with total hip arthroplasty for the treatment of pigmented villonodular synovitis（PVNS）of the hip. Methods The data on thirty⁃two patients with PVNS of the hip hospitalized during the period of May 2012 to August 2019 were retrospectively analyzed. 20 patients underwent open synovectomy alone（incision group）and 12 underwent syno⁃ vectomy combined with total hip arthroplasty（arthroplasty group）. Harris hip scores and postoperative complica⁃ tions including recurrence and dislocation were used as evaluation indexes. Results The mean follow⁃up duration was（3.9 ± 2.3）years in 32 patients，and the Harris hip score improved from（56.9 ± 6.1）preoperatively to（87.8 ± 4.4）postoperatively（P < 0.05）. One year after surgery，the score improved from（57.0 ± 6.0）preoperatively to （86.3 ± 3.9）postoperatively in the incision group（P < 0.05）and from（54.0 ± 6.3）to（90.1 ± 2.6）in the arthro⁃ plasty group（P < 0.05），with an improvement of（28.9 ± 3.6）and（35.6 ± 4.3）points，respectively（P < 0.05）. During follow⁃up，recurrence occurred in two patients and hip subluxation developed in one in the incision group only，while none were found in the arthroplasty group. No perprosthetic joint infection and prosthesis loosening or revision were found in the arthroplasty group. Conclusions Open synovectomy and total hip arthroplasty are treatment methods for different degrees of PVNS of the hip，and both can improve hip function in patients. Total hip arthroplasty may achieve better outcomes than open synovectomy. Postoperative recurrence is likely to occur after open synovectomy.

Key words:

hip, pigmented villonodular synovitis, synovectomy, arthroplasty