The Use of Radiosynovectomy Using Yttrium-90 as an Adjunct to Mechanical Synovectomy for Pigmented Villonodular Synovitis

Introduction: Pigmented VilloNodular Synovitis (PVNS) or Giant Cell Tumour of the Tendon sheath (GCTT) is a rare disorder involving proliferation of the synovium in any joint, however the knee, hip and ankle joints are most commonly targeted.Pigmented VilloNodular Synovitis (PVNS) or Giant Cell Tumour of the Tendon sheath (GCTT) is a rare disorder involving proliferation of the synovium in any joint, however the knee, hip and ankle joints are most commonly targeted.The aim of this study is to assess the outcome of patients with PVNS of the knee managed by intra-articular injection of Yttrium-90, after arthroscopic/open debulking synovectomy. Methods: A cohort of eight knees from six patients, three knees in the combined arthroscopic synovectomy and radiosynovectomy group, and five knees in the radiosynovectomy treatment alone groupPatients from both groups were asked to complete KOOS questionnaires. Their answers were collated and scores calculated using the designated specific equation. Results: Our results demonstrate that although patients in the combined arthroscopic synovectomy and radio-synovectomy arm possess on average higher pain scores and symptoms than those who underwent radiosynovectomy alone, the combined therapy had higher scores in ADLs, Sport-Rec, QoL, and overall KOOS scores. Conclusion: Neo-adjuvent arthroscopic mechanical debridement is a safe and quick procedure with minimal side effects, with improved overall KOOS scores.