{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:30:34Z","timestamp":1787700634129,"version":"build-2784847793"},"reference-count":78,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"4","license":[{"start":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T00:00:00Z","timestamp":1427846400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:p>Pigmented villonodular synovitis (PVNS) is a rare proliferative process of the synovium which most commonly affects the knee and occurs in either a localised (LPVNS) or a diffuse form (DPVNS). The effect of different methods of surgical synovectomy and adjuvant radiotherapy on the rate of recurrence is unclear. We conducted a systematic review and identified 35 observational studies in English which reported the use of surgical synovectomy to treat PVNS of the knee.<\/jats:p><jats:p>A meta-analysis included 630 patients, 137 (21.8%) of whom had a recurrence after synovectomy. For patients with DPVNS, low-quality evidence found that the rate of recurrence was reduced by both open synovectomy (odds ration (OR) = 0.47; 95% CI 0.25 to 0.90; p = 0.024) and combined open and arthroscopic synovectomy (OR = 0.19, 95% CI = 0.06 to 0.58; p = 0.003) compared with arthroscopic surgery. Very low-quality evidence found that the rate of recurrence of DPVNS was reduced by peri-operative radiotherapy (OR = 0.31, 95% CI 0.14 to 0.70; p = 0.01). Very low-quality evidence suggested that the rate of recurrence of LPVNS was not related to the surgical approach.<\/jats:p><jats:p>This meta-analysis suggests that open synovectomy or synovectomy combined with peri-operative radiotherapy for DPVNS is associated with a reduced rate of recurrence. Large long-term prospective multicentre observational studies, with a focus on both rate of recurrence and function, are required to confirm these findings.<\/jats:p><jats:p>Cite this article: Bone Joint J 2015;97-B:550\u20137.<\/jats:p>","DOI":"10.1302\/0301-620x.97b4.34907","type":"journal-article","created":{"date-parts":[[2015,3,27]],"date-time":"2015-03-27T22:05:23Z","timestamp":1427493923000},"page":"550-557","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":137,"title":["The effect of surgical synovectomy and radiotherapy on the rate of recurrence of pigmented villonodular synovitis of the knee"],"prefix":"10.1302","volume":"97-B","author":[{"given":"B.","family":"Mollon","sequence":"first","affiliation":[{"name":"University of Toronto, 149 College Street, Room 508A, Toronto, Ontario, M5T 1P5, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Toronto, 149 College Street, Room 508A, Toronto, Ontario, M5T 1P5, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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