{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:36:11Z","timestamp":1778214971817,"version":"3.51.4"},"reference-count":56,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,21]],"date-time":"2024-01-21T00:00:00Z","timestamp":1705795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Persistent knee synovitis leads to joint discomfort, incapacitating inflammation, and functional limitations. The conventional approach has involved surgical procedures to eliminate the actively inflamed synovial membrane. This study aims to investigate the recurrence-free survival and functional outcome after synovectomy and subsequent radiosynoviorthesis (RSO) in patients with knee synovitis. Methods: Thirty-seven knees diagnosed with pigmented villonodular synovitis (PVNS), rheumatoid arthritis (RA), and peripheral spondyloarthritis underwent synovectomy and subsequent RSO between May 2005 and October 2016. The mean age was 34.9 \u00b1 15.1 years, and the mean follow-up period was 84 \u00b1 36.4 months. Clinical outcomes were assessed using the Oxford Knee Score and the presence of swelling and pain at the last follow-up. Recurrence-free survival denotes the duration from synovectomy to surgical re-synovectomy. Results: In general, twelve knees underwent re-synovectomy after a mean follow-up of 34.8 \u00b1 24.9 months. The recurrence-free survival was 83.8% at two years, 71.3% at five years, and 61.7% at ten years. The subgroup analysis revealed recurrence-free survival at two years in 63.6% of patients with PVNS, 86.7% of those with RA, and 100% of individuals with peripheral spondyloarthritis. Conclusions: This study demonstrates that combined therapy for synovitis is an effective approach, significantly improving clinical outcomes.<\/jats:p>","DOI":"10.3390\/jcm13020601","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T11:36:41Z","timestamp":1705923401000},"page":"601","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Recurrence-Free Survival after Synovectomy and Subsequent Radiosynoviorthesis in Patients with Synovitis of the Knee\u2014A Retrospective Data Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5050-0316","authenticated-orcid":false,"given":"Melanie","family":"Schindler","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Division of Orthopedics, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Puchner","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Division of Orthopedics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Reinhard","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University Medical Centre Regensburg, Asklepios Klinikum Bad Abbach, 93077 Bad Abbach, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Leiss","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University Medical Centre Regensburg, Asklepios Klinikum Bad Abbach, 93077 Bad Abbach, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6321-1804","authenticated-orcid":false,"given":"Reinhard","family":"Windhager","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Division of Orthopedics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1617-0800","authenticated-orcid":false,"given":"Richard","family":"Lass","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Division of Orthopedics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1007\/s00402-013-1770-1","article-title":"Pigmented villo-nodular synovitis and giant-cell tumor of tendon sheaths: A binational retrospective study","volume":"133","author":"Bruns","year":"2013","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.2106\/JBJS.RVW.15.00086","article-title":"Pigmented Villonodular Synovitis: A Comprehensive Review and Proposed Treatment Algorithm","volume":"4","author":"Stephan","year":"2016","journal-title":"JBJS Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s11912-020-00926-7","article-title":"Management of Pigmented Villonodular Synovitis (PVNS): An Orthopedic Surgeon\u2019s Perspective","volume":"22","author":"Bernthal","year":"2020","journal-title":"Curr. Oncol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.berh.2008.11.006","article-title":"Progression in early rheumatoid arthritis","volume":"23","author":"Combe","year":"2009","journal-title":"Best. Pract. Res. Clin. Rheumatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1007\/s00393-018-0534-2","article-title":"[The knee joint in rheumatoid arthritis- current orthopaedic surgical treatment options]","volume":"77","author":"Maderbacher","year":"2018","journal-title":"Z. Rheumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1136\/ard.2010.133645","article-title":"The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general","volume":"70","author":"Rudwaleit","year":"2011","journal-title":"Ann. Rheum. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1002\/art.1780341003","article-title":"The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy","volume":"34","author":"Dougados","year":"1991","journal-title":"Arthritis Rheum."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/0049-0172(90)90023-9","article-title":"A wider spectrum of spondyloarthropathies","volume":"20","author":"Khan","year":"1990","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_9","first-page":"520","article-title":"Early clinical results of open and arthroscopic synovectomy in knee inflammation","volume":"9","author":"Grzegorzewski","year":"2007","journal-title":"Ortop. Traumatol. Rehabil."},{"key":"ref_10","first-page":"1171","article-title":"Treatment of chronic knee synovitis with arthroscopic synovectomy: Longterm results","volume":"29","author":"Legouffe","year":"2002","journal-title":"J. Rheumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"205","DOI":"10.3109\/s101650170005","article-title":"Follow-up results of arthroscopic synovectomy for the rheumatoid knee","volume":"11","author":"Momohara","year":"2001","journal-title":"Mod. Rheumatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/BF00266717","article-title":"Arthroscopic versus open synovectomy in the rheumatoid knee","volume":"13","author":"Matsui","year":"1989","journal-title":"Int. Orthop."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s12149-008-0167-7","article-title":"Radiosynoviorthesis (RSO): Influencing factors and therapy monitoring","volume":"22","author":"Zuderman","year":"2008","journal-title":"Ann. Nucl. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/rheumatology\/kel352","article-title":"Therapeutic status of radiosynoviorthesis of the knee with yttrium 90Y colloid in rheumatoid arthritis and related indications","volume":"46","author":"Kampen","year":"2007","journal-title":"Rheumatology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1302\/0301-620X.80B1.0800063","article-title":"Questionnaire on the perceptions of patients about total knee replacement","volume":"80","author":"Dawson","year":"1998","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.arthro.2010.06.003","article-title":"Combined arthroscopic and radiation synovectomy of the knee joint in rheumatoid arthritis: 14-year follow-up","volume":"27","author":"Goetz","year":"2011","journal-title":"Arthroscopy"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1007\/s00402-013-1853-z","article-title":"Combined arthroscopic synovectomy and radiosynoviorthesis in the treatment of chronic non-specific synovitis of the knee","volume":"133","author":"Yildiz","year":"2013","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1302\/0301-620X.97B4.34907","article-title":"The effect of surgical synovectomy and radiotherapy on the rate of recurrence of pigmented villonodular synovitis of the knee: An individual patient meta-analysis","volume":"97","author":"Mollon","year":"2015","journal-title":"Bone Jt. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2339","DOI":"10.1007\/s00296-011-1956-1","article-title":"Efficacy of radiosynoviorthesis and its impact on chosen inflammatory markers","volume":"32","author":"Zwolak","year":"2012","journal-title":"Rheumatol. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1302\/0301-620X.50B2.290","article-title":"The diagnosis and treatment of pigmented villonodular synovitis","volume":"50","author":"Byers","year":"1968","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/00003086-198910000-00034","article-title":"Pigmented villonodular synovitis. A retrospective review of affected large joints","volume":"247","author":"Schwartz","year":"1989","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_22","first-page":"448","article-title":"Recurrent and non-recurrent pigmented villonodular synovitis 1","volume":"22","author":"Adem","year":"2002","journal-title":"Ann. Pathol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"119","DOI":"10.2106\/00004623-199274010-00015","article-title":"Pigmented villonodular synovitis of the knee. The results of total arthroscopic synovectomy, partial, arthroscopic synovectomy, and arthroscopic local excision","volume":"74","author":"McLean","year":"1992","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/j.arthro.2014.04.101","article-title":"Treatment of pigmented villonodular synovitis of the knee","volume":"30","author":"Klouche","year":"2014","journal-title":"Arthroscopy"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/j.knee.2016.05.010","article-title":"Arthroscopic synovectomy of the knee in rheumatoid arthritis defined by the 2010 ACR\/EULAR criteria","volume":"23","author":"Triolo","year":"2016","journal-title":"Knee"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s00259-021-05541-7","article-title":"The EANM guideline for radiosynoviorthesis","volume":"49","author":"Kampen","year":"2022","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/hae.13710","article-title":"Outpatient treatment for haemophilic arthropathy with radiosynovectomy: Radiation dose to family members","volume":"25","author":"Oliveira","year":"2019","journal-title":"Haemophilia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1007\/s00259-019-04350-3","article-title":"A prospective observational study on the long-term results of 90Yttrium citrate radiosynoviorthesis of synovitis in osteoarthritis of the knee joint","volume":"46","author":"Szentesi","year":"2019","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s12149-019-01418-w","article-title":"The results of 394 consecutive cases of knee joint radiation synovectomy (radiosynoviorthesis) using 90Y","volume":"34","author":"Miszczyk","year":"2020","journal-title":"Ann. Nucl. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1093\/rheumatology\/36.10.1100","article-title":"A retrospective review of yttrium-90 synovectomy in the treatment of knee arthritis","volume":"36","author":"Taylor","year":"1997","journal-title":"Br. J. Rheumatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s00402-018-3097-4","article-title":"The effects of radiosynoviorthesis in pigmented villonodular synovitis of the knee","volume":"139","author":"Capellen","year":"2019","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_32","first-page":"293","article-title":"Radiosynoviorthesis: Almost seventy years of experience but still somewhat fameless","volume":"66","author":"Knol","year":"2022","journal-title":"Q. J. Nucl. Med. Mol. Imaging"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.blre.2019.01.002","article-title":"Radiosynovectomy in haemophilia","volume":"35","year":"2019","journal-title":"Blood Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/00006231-200207000-00013","article-title":"Clinical outcome of radiosynoviorthesis: A meta-analysis including 2190 treated joints","volume":"23","author":"Kresnik","year":"2002","journal-title":"Nucl. Med. Commun."},{"key":"ref_35","first-page":"130","article-title":"Radiation synovectomy with (90) Yttrium, (186) Rhenium and (169) Erbium: A systematic literature review with meta-analyses","volume":"27","author":"Boer","year":"2009","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1055\/s-0038-1625120","article-title":"Serious complications after radiosynoviorthesis. Survey on frequency and treatment modalities","volume":"45","author":"Kampen","year":"2006","journal-title":"Nuklearmedizin"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Kampen, W.U., and Fischer, M. (2015). Local Treatment of Inflammatory Joint Diseases, Springer International Publishing.","DOI":"10.1007\/978-3-319-16949-1"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1111\/j.1365-2516.2012.02802.x","article-title":"A retrospective cohort study of cancer incidence among patients treated with radiosynoviorthesis","volume":"18","author":"Rivard","year":"2012","journal-title":"Haemophilia"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1002\/art.41042","article-title":"2019 Update of the American College of Rheumatology\/Spondylitis Association of America\/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis","volume":"71","author":"Ward","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1002\/acr.24596","article-title":"2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis","volume":"73","author":"Fraenkel","year":"2021","journal-title":"Arthritis Care Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"14551","DOI":"10.1038\/s41598-019-51211-y","article-title":"Long-term efficacy of imatinib mesylate in patients with advanced Tenosynovial Giant Cell Tumor","volume":"9","author":"Verspoor","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e21.00035","DOI":"10.2106\/JBJS.ST.21.00035","article-title":"Extensile Anterior and Posterior Knee Exposure for Complete Synovectomy of Diffuse Tenosynovial Giant Cell Tumor (Pigmented Villonodular Synovitis)","volume":"12","author":"Lingamfelter","year":"2022","journal-title":"JBJS Essent. Surg. Tech."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"760","DOI":"10.2174\/15680266113139990094","article-title":"Tyrosine kinase inhibitors for the treatment of rheumatoid arthritis","volume":"13","year":"2013","journal-title":"Curr. Top. Med. Chem."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1073\/pnas.0507321103","article-title":"A landscape effect in tenosynovial giant-cell tumor from activation of CSF1 expression by a translocation in a minority of tumor cells","volume":"103","author":"West","year":"2006","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1002\/cncr.26409","article-title":"Efficacy of imatinib mesylate for the treatment of locally advanced and\/or metastatic tenosynovial giant cell tumor\/pigmented villonodular synovitis","volume":"118","author":"Cassier","year":"2012","journal-title":"Cancer"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/S1470-2045(15)00132-1","article-title":"CSF1R inhibition with emactuzumab in locally advanced diffuse-type tenosynovial giant cell tumours of the soft tissue: A dose-escalation and dose-expansion phase 1 study","volume":"16","author":"Cassier","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1056\/NEJMoa1411366","article-title":"Structure-Guided Blockade of CSF1R Kinase in Tenosynovial Giant-Cell Tumor","volume":"373","author":"Tap","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2852","DOI":"10.1007\/s11999-009-0922-7","article-title":"Outcomes after excision of pigmented villonodular synovitis of the knee","volume":"467","author":"Sharma","year":"2009","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.2106\/00004623-200212000-00011","article-title":"Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee","volume":"84","author":"Chin","year":"2002","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/j.knee.2017.03.011","article-title":"Pigmented villonodular synovitis of the knee: A retrospective analysis of 214 cases at a UK tertiary referral centre","volume":"24","author":"Patel","year":"2017","journal-title":"Knee"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/BPB.0b013e32809256f2","article-title":"Knee synovectomy in children with juvenile idiopathic arthritis","volume":"17","author":"Facchini","year":"2008","journal-title":"J. Pediatr. Orthop. B"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/S0749-8063(00)90050-1","article-title":"Arthroscopic synovectomy of the knee joint in early cases of rheumatoid arthritis: Follow-up results of a multicenter study","volume":"16","author":"Klug","year":"2000","journal-title":"Arthroscopy"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1002\/jor.21233","article-title":"Surgical synovectomy decreases density of sensory nerve fibers in synovial tissue of non-inflamed controls and rheumatoid arthritis patients","volume":"29","author":"Ossyssek","year":"2010","journal-title":"J. Orthop. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s00402-017-2864-y","article-title":"Long-term outcome of pigmented villonodular synovitis of the hip after joint preserving therapy","volume":"138","author":"Hufeland","year":"2018","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1136\/ard.2005.047373","article-title":"The intra-articular distribution of 90yttrium does not influence the clinical outcome of radiation synovectomy of the knee","volume":"66","author":"Jahangier","year":"2007","journal-title":"Ann. Rheum. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3219","DOI":"10.1007\/s00296-011-2143-0","article-title":"Efficacy of radiosynovectomy in rheumatoid arthritis","volume":"32","author":"Liepe","year":"2012","journal-title":"Rheumatol. Int."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/601\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:46:34Z","timestamp":1760103994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,21]]},"references-count":56,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["jcm13020601"],"URL":"https:\/\/doi.org\/10.3390\/jcm13020601","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,21]]}}}