Original Article
High recurrence and good functional results after arthroscopic resection of pigmented villonodular synovitis
Alta recidiva y buenos resultados funcionales tras la resección artroscópica de la sinovitis villonodular pigmentaria de la rodilla
A. Isarta,
, P.E. Gelbera,b, M. Besalduchb, X. Pelforta, J.I. Erquiciaa, M. Tey-Ponsa, J.C. Monllaua,c
Corresponding author
a Institut Català de Traumatologia i Medicina de l’Esport (ICATME)-Hospital Universitari Quirón-Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain
b Servicio de Cirugía Ortopédica y Traumatología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
c Servicio de Cirugía Ortopédica y Traumatología, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
Read
2469
Timeswas read the article
372
Total PDF
2097
Total HTML
Share statistics
array:24 [ "pii" => "S1988885615000760" "issn" => "19888856" "doi" => "10.1016/j.recote.2015.09.007" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "580" "copyright" => "SECOT" "copyrightAnyo" => "2014" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:400-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 38 "formatos" => array:2 [ "HTML" => 23 "PDF" => 15 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1888441515000739" "issn" => "18884415" "doi" => "10.1016/j.recot.2015.05.006" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "580" "copyright" => "SECOT" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:400-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 192 "formatos" => array:3 [ "EPUB" => 4 "HTML" => 121 "PDF" => 67 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Alta recidiva y buenos resultados funcionales tras la resección artroscópica de la sinovitis villonodular pigmentaria de la rodilla" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "400" "paginaFinal" => "405" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "High recurrence and good functional results after arthroscopic resection of pigmented villonodular synovitis" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1040 "Ancho" => 990 "Tamanyo" => 109345 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Imagen sagital de RM (adquisición T2) de un paciente con SVP en compartimento anterior y posterior de la rodilla (SVPD).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Isart, P.E. Gelber, M. Besalduch, X. Pelfort, J.I. Erquicia, M. Tey-Pons, J.C. Monllau" "autores" => array:7 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Isart" ] 1 => array:2 [ "nombre" => "P.E." "apellidos" => "Gelber" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Besalduch" ] 3 => array:2 [ "nombre" => "X." "apellidos" => "Pelfort" ] 4 => array:2 [ "nombre" => "J.I." "apellidos" => "Erquicia" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Tey-Pons" ] 6 => array:2 [ "nombre" => "J.C." "apellidos" => "Monllau" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1988885615000760" "doi" => "10.1016/j.recote.2015.09.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000760?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441515000739?idApp=UINPBA00004N" "url" => "/18884415/0000005900000006/v1_201510290039/S1888441515000739/v1_201510290039/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1988885615000759" "issn" => "19888856" "doi" => "10.1016/j.recote.2015.09.006" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "577" "copyright" => "SECOT" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:406-12" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 34 "formatos" => array:2 [ "HTML" => 26 "PDF" => 8 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Safety and efficacy of kyphoplasty in the treatment of tumoral disease of the spine" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "406" "paginaFinal" => "412" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Seguridad y eficacia de la cifoplastia en el tratamiento de la enfermedad tumoral de la columna vertebral" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1299 "Ancho" => 1500 "Tamanyo" => 264888 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Complications in the surgical technique. Anterior leak and leak in the path of the cannula (tail) with no neurological repercussions.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. García-Maroto, J. García-Coiradas, G. Milano, J.L. Cebrián, F. Marco, L. López-Durán" "autores" => array:6 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "García-Maroto" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "García-Coiradas" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Milano" ] 3 => array:2 [ "nombre" => "J.L." "apellidos" => "Cebrián" ] 4 => array:2 [ "nombre" => "F." "apellidos" => "Marco" ] 5 => array:2 [ "nombre" => "L." "apellidos" => "López-Durán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441515000582" "doi" => "10.1016/j.recot.2015.05.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441515000582?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000759?idApp=UINPBA00004N" "url" => "/19888856/0000005900000006/v1_201510220017/S1988885615000759/v1_201510220017/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1988885615000784" "issn" => "19888856" "doi" => "10.1016/j.recote.2015.09.009" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "584" "copyright" => "SECOT" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:394-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 237 "formatos" => array:2 [ "HTML" => 211 "PDF" => 26 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Effect of removing the ischaemia tourniquet on the transfusion needs of the patient undergoing primary knee arthroplasty" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "394" "paginaFinal" => "399" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efecto de la retirada del manguito de isquemia sobre las necesidades transfusionales en el paciente intervenido de artroplastia primaria de rodilla" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1473 "Ancho" => 1645 "Tamanyo" => 86431 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Influence of duration of surgery on the need for blood transfusions (measured in packed red blood cells).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "X. Paredes-Carnero, G.L. Rosero-Ruíz, J.J. Centeno-García, F.J. Pombo-Taboada" "autores" => array:4 [ 0 => array:2 [ "nombre" => "X." "apellidos" => "Paredes-Carnero" ] 1 => array:2 [ "nombre" => "G.L." "apellidos" => "Rosero-Ruíz" ] 2 => array:2 [ "nombre" => "J.J." "apellidos" => "Centeno-García" ] 3 => array:2 [ "nombre" => "F.J." "apellidos" => "Pombo-Taboada" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441515000776" "doi" => "10.1016/j.recot.2015.05.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441515000776?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000784?idApp=UINPBA00004N" "url" => "/19888856/0000005900000006/v1_201510220017/S1988885615000784/v1_201510220017/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "High recurrence and good functional results after arthroscopic resection of pigmented villonodular synovitis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "400" "paginaFinal" => "405" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Isart, P.E. Gelber, M. Besalduch, X. Pelfort, J.I. Erquicia, M. Tey-Pons, J.C. Monllau" "autores" => array:7 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Isart" "email" => array:1 [ 0 => "isartanna@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "P.E." "apellidos" => "Gelber" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Besalduch" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "X." "apellidos" => "Pelfort" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "J.I." "apellidos" => "Erquicia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "M." "apellidos" => "Tey-Pons" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "J.C." "apellidos" => "Monllau" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Institut Català de Traumatologia i Medicina de l’Esport (ICATME)-Hospital Universitari Quirón-Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía Ortopédica y Traumatología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Cirugía Ortopédica y Traumatología, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Alta recidiva y buenos resultados funcionales tras la resección artroscópica de la sinovitis villonodular pigmentaria de la rodilla" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1932 "Ancho" => 977 "Tamanyo" => 152384 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">(a) Diffuse pigmented villonodular synovitis (DPVNS). (b) Localised pigmented villonodular synovitis (LPVNS).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Pigmented villonodular synovitis (PVNS) is a disease of the synovial membrane characterised by the proliferation of mononuclear cells. It is an infrequent and benign entity, which typically affects the knees of young adults (<40 years).<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The literature distinguishes 2 forms of presentation of PVNS, diffuse (DPVNS) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a) and localised (LPVNS) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b). The localised form is characterised by lobular and pendulous lesions from the synovium, which usually present in the femoropatellar region. On the other hand, DPVNS is characterised by involvement of all or most of the joint synovium.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">2</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Although the treatment of PVNS is generally considered to consist in a full excision of the affected synovium, there is no consensus regarding the surgical technique to employ. While some authors advocate resection through open surgery,<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">1–6</span></a> others report similar rates of recurrence through total arthroscopic synovectomy.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">3,7–9</span></a> Arthroscopic synovectomy enables a better preservation of knee functionality, with few complications, and an acceptable rate of recurrence, although the latter could depend on the form of PVNS. Complementary therapies with external radiotherapy or isotopic synoviorthesis have been proposed as alternatives in partial or incomplete resections as coadjuvant treatment, with the aim of improving local disease control. There have been no reports of success with a second surgical resection upon recurrence of PVNS.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">2–14</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The objective of this study was to evaluate the functional results and rate of recurrence in a series of patients diagnosed with PVNS, both the diffuse and localised forms, who were treated though arthroscopic resection.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We selected patients diagnosed with PVNS between the years 1996 and 2011 out of a database including all patients who underwent knee surgery through an arthroscopic technique at our centre.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The inclusion criteria were: (1) patients with knee pain; (2) full preoperative study with a presumptive diagnosis of PVNS by magnetic resonance imaging (MRI); (3) intervened through arthroscopic technique; (4) with confirmation of PVNS by pathological anatomy; and (5) with a monitoring period over 24 months.</p><p id="par0035" class="elsevierStylePara elsevierViewall">We excluded patients with intraosseous PVNS lesions.</p><p id="par0040" class="elsevierStylePara elsevierViewall">A total of 6006 knee arthroscopies were conducted at our centre between 1996 and 2011. Of these, 24 (0.4%) fulfilled the inclusion criteria of our study. A total of 6 cases (0.1%) were excluded due to intraosseous lesions. The group of patients presented a median follow-up period of 60 months (range: 34–204 months) with no losses during follow-up. The demographic results are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. A total of 13 patients suffered DPVNS, while the remaining 11 presented LPVNS, all of them diagnosed intraoperatively. Out of these cases, 7 presented lesions in the posterior compartment of the knee, whilst the 4 remaining patients did so in the femoropatellar compartment.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Functional assessment</span><p id="par0045" class="elsevierStylePara elsevierViewall">For each patient we registered the clinical and functional condition, both preoperatively and during the last postoperative assessment, using the IKDC test,<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">15</span></a> Western Ontario Meniscal Evaluation Tool (WOMET)<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">16</span></a> (assessment scale for meniscal involvement, evaluating physical and recreational symptoms, lifestyle and emotions), Kujala<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">17</span></a> (subjective and functional evaluation test for patellofemoral conditions) and Tegner test.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">18</span></a> The range of mobility obtained in each case was also recorded.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Radiographic assessment</span><p id="par0050" class="elsevierStylePara elsevierViewall">Patients underwent a radiographic study through telemetric radiography of the lower limbs under load, a profile radiograph, an axial radiograph of the patella and a Rosemberg projection (posteroanterior at 45° flexion, under load) of both knees in the preoperative period, at 6 months and at 2 years postoperatively, always following the same protocol. We used the Ahlbäck classification to study the grade of arthrosis, both in the preoperative telemetric radiographs and in the control images obtained 2 years after the intervention. In addition, we obtained an MRI scan of the affected knee, in order to diagnose the lesion and its location during the preoperative period (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Surgical technique</span><p id="par0055" class="elsevierStylePara elsevierViewall">All the interventions were conducted by 4 surgeons specialising in the knee, through 4 routine arthroscopic portals: 2 anterior (anterolateral and anteromedial) to access the femoropatellar compartment and 2 posterior (posterolateral and posteromedial) to access the posterior compartment. A total synovectomy was performed with a 5.5<span class="elsevierStyleHsp" style=""></span>mm incisional terminal (Gator, ConMed Linvatec, Largo, FL, USA) in oscillating mode, and any existing associated lesions were treated. We also obtained a biopsy of synovial tissue in all cases, placing a number 10 intraarticular drainage for the first 24<span class="elsevierStyleHsp" style=""></span>h.</p><p id="par0060" class="elsevierStylePara elsevierViewall">In the postoperative period, we established prophylaxis with low molecular weight heparin for a period of 15 days, along with a rehabilitation protocol which enabled full load on the limb and muscular strengthening according to tolerance.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Associated lesions</span><p id="par0065" class="elsevierStylePara elsevierViewall">In our series, 6 (25%) patients presented associated lesions, diagnosed through the preoperative MRI scan: 3 of them suffered meniscopathy and 3 chondral lesions. The meniscopathies affected the medial compartment. One was treated through suture and the other 2 through a partial meniscectomy. Regarding the chondral lesions, 2 were grade III and were treated through microfractures, whilst the third was a grade IV at the level of the trochlea, and did not require any treatment. The postoperative controls did not show any worsening of the associated lesions or any arthritic changes in the radiographs.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Pathological anatomy</span><p id="par0070" class="elsevierStylePara elsevierViewall">The analysis was conducted by an anatomopathologist specialising in musculoskeletal tumours. In all cases, the diagnosis was obtained after observing the presence of villi and brown nodules formed by groups of histiocytes with a fibrous stroma, deposits of hemosiderin, giant cells and foam cells<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">7</span></a> in the intraoperative sample.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0075" class="elsevierStylePara elsevierViewall">The categorical variables were described through frequencies and percentages, whereas the quantitative variables were described using the mean and standard deviation or the median and 25 and 75 percentiles. The pre- and postoperative differences between patients in the IKDC, WOMET, Kujala and Tegner tests were described using a nonparametric Wilcoxon test, whilst the differences in the presence of associated lesions were analysed using the Mann–Whitney <span class="elsevierStyleItalic">U</span> test. We considered as statistically significant values of <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05 and the statistical analysis was carried out with the statistics software package SPSS 18.0 (SPSS Inc., Chicago, IL, USA).</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Functional results</span><p id="par0080" class="elsevierStylePara elsevierViewall">The results of the functional test revealed an improvement of 30.6 points in the IKDC (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.001), 37.4 points in the WOMET (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.001) and 34.03 points in the Kujala (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.001) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) tests for the overall series of patients. No differences were found in any of the tests after the sample of patients was divided into those suffering LPVNS and DPVNS (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). When studying the results divided into 2 groups (patients with PVNS and patients with PVNS plus associated disease), we observed a greater improvement in the IKDC of 40.6 points (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.05) and in the Kujala of 46.8 points (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.026) among those presenting concomitant diseases (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">There was no extension deficit in any case and the final mean flexion observed was 127° (range: 120–140°). No preoperative or postoperative complications were noted in relation to the surgical technique, such as deep vein thrombosis, infection, rigidity or haemarthrosis.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Radiographic results</span><p id="par0090" class="elsevierStylePara elsevierViewall">When the radiographs were analysed by means of the Ahlbäck classification in patients suffering PVNS, no significant arthritic changes were observed comparing the preoperative radiographs with those at the end of the monitoring period, neither in cases of LPVNS nor cases of DPVNS (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.001).</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Disease recurrence</span><p id="par0095" class="elsevierStylePara elsevierViewall">In total, 8 of the 24 patients (33%) presented recurrence of PVNS, with a mean period of 56.9 months (range: 23–168 months) between the first intervention and the recurrence. All the cases corresponded to the diffuse form of PVNS. Two of them underwent external radiotherapy, 5 underwent an arthroscopic resection and another case underwent open surgery through a posterior access route (Trickey approach) to complete the resection of the diseased tissue affecting the extraarticular region of the popliteal space. Until the last control, patients in this group were asymptomatic both clinically and radiographically after a minimum follow-up of 21 months after recurrence.</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">The main finding of this study was that a single arthroscopic resection in the localised form of PVNS produced good functional results and a medium-term cure. However, the percentage of patients who presented disease recurrence in the diffuse form was considerably high. In any case, the association of a second arthroscopic resection or some other coadjuvant procedure in such cases managed to control the disease, at least in the short term, in 87.5% of the patients. Likewise, after a mean follow-up period of 5 years, De Ponti et al.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">8</span></a> observed that the risk of recurrence was 20% in the case of DPVNS treated through arthroscopic technique with no adjuvant treatment. In addition, Zvijac et al.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">9</span></a> reported a 14% rate of recurrence of DPVNS in patients treated arthroscopically after a mean follow-up period of 3.5 years.</p><p id="par0105" class="elsevierStylePara elsevierViewall">On the other hand, Colman et al.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">19</span></a> studied the risk of recurrence of DPVNS with different techniques and observed a lower recurrence with the mixed technique (arthroscopic/open) compared to the arthroscopic or isolated open alternative: 9% vs 62% vs 64%, respectively. Flandry et al.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">4</span></a> reported a series of patients operated through open technique with multiple approaches in which they only found 2 recurrences in a group of 23 patients with a mean follow-up period of 58 months.</p><p id="par0110" class="elsevierStylePara elsevierViewall">There have also been reports of deficits in postoperative mobility. The studies by Johansson et al.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">5</span></a> and Flandry et al.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">4</span></a> observed a limitation of the range of movement in knees operated through open technique, with a mean 0–15° extension and 90–130° flexion, in 24% and in 50% of patients, respectively. On the other hand, the present study observed that resection through an arthroscopic technique resulted in full extension in all cases and a mean flexion of 127°.</p><p id="par0115" class="elsevierStylePara elsevierViewall">From the standpoint of functional scales, we observed an improvement regardless of whether the patients suffered DPVNS or LPVNS. Gu et al.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">20</span></a> compared DPVNS treated arthroscopically vs open surgery and saw an improvement in IKDC from a mean 56.3 points preoperatively to 89.4 points 3 years after the surgery in patients treated arthroscopically (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001) and from a mean 58.2 points in the preoperative period to 72.1 points 3 years after the intervention among those treated by an open technique (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001). In the present work, we also observed a functional improvement in that scale, which went from 47.8 to 78.4 points. Similarly, the study by Aurégan et al.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">21</span></a> noted good functional results and levels of activity with significant improvements, without finding any differences between LPVNS and DPVNS.</p><p id="par0120" class="elsevierStylePara elsevierViewall">One of the worst consequences of PVNS is early degenerative changes in otherwise healthy and young patients. Flandry et al.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">4</span></a> reported a 48% rate of advanced degenerative changes following open synovectomy. During the monitoring period of patients included in the present study, we did not observe any cases with advanced arthrosis secondary to the intervention. This could be attributed to the arthroscopic technique, which is obviously less invasive and aggressive.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The main limitation of the present work lies in being an observational and retrospective study with a limited sample of patients and without a control group of patients who had undergone open surgery, with a median of 60 months follow-up.</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conclusion</span><p id="par0130" class="elsevierStylePara elsevierViewall">PVNS resected through an arthroscopic technique presents good functional and curative results in the medium term, along with low morbidity. The diffuse form of the PVNS often requires a second surgical intervention, due to its high rate of recurrence following arthroscopic resection.</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Level of evidence</span><p id="par0135" class="elsevierStylePara elsevierViewall">Level of evidence IV<span class="elsevierStyleSmallCaps">.</span></p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Ethical responsibilities</span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Protection of people and animals</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that this investigation did not require experiments on humans or animals.</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Confidentiality of data</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that this work does not reflect any patient data.</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Right to privacy and informed consent</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare that this work does not reflect any patient data.</p></span></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Conflict of interests</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres572760" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec589810" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres572759" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec589811" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Functional assessment" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Radiographic assessment" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Surgical technique" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Associated lesions" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Pathological anatomy" ] 5 => array:2 [ "identificador" => "sec0040" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0045" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0050" "titulo" => "Functional results" ] 1 => array:2 [ "identificador" => "sec0055" "titulo" => "Radiographic results" ] 2 => array:2 [ "identificador" => "sec0060" "titulo" => "Disease recurrence" ] ] ] 7 => array:2 [ "identificador" => "sec0065" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0070" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0075" "titulo" => "Level of evidence" ] 10 => array:3 [ "identificador" => "sec0080" "titulo" => "Ethical responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0085" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0090" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0095" "titulo" => "Right to privacy and informed consent" ] ] ] 11 => array:2 [ "identificador" => "sec0100" "titulo" => "Conflict of interests" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-11-16" "fechaAceptado" => "2015-05-31" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec589810" "palabras" => array:3 [ 0 => "Villonodular synovitis" 1 => "Knee" 2 => "Arthroscopy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec589811" "palabras" => array:3 [ 0 => "Sinovitis villonodular" 1 => "Rodilla" 2 => "Artroscopia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pigmented villonodular synovitis (PVS) is a synovial proliferation disorder of uncertain aetiology, with some controversy as regards its proper treatment. The purpose of the study was to evaluate the functional outcome and recurrence rate in a series of patients diagnosed with both the diffuse and the localised types of PVS and treated by arthroscopic resection.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Twenty-four patients diagnosed with PVS were retrospectively assessed. There were 11 cases with the diffuse type, and 13 cases with the localised type of PVS. They were followed-up for a median of 60 months (range, 34–204). They underwent arthroscopic synovectomy, and were functionally evaluated with IKDC, WOMET, and Kujala scores.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">There was recurrence in 8 out of 13 (61.5%) cases with the diffuse type of PVS. Two of these patients were treated with radiation. One patient underwent surgical resection with an open procedure due to extra-articular involvement. The remaining 5 patients underwent a second arthroscopic resection, and no recurrence was subsequently observed. Cases with localised PVS did not recur after a single arthroscopic resection. IKDC, WOMET and Kujala scores improved by 30.6, 37.4 and 34.03 points, respectively.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Pigmented villonodular synovitis treated by arthroscopic resection showed good functional results at mid-term follow-up. A single arthroscopic resection was sufficient to treat the localised PVS, whereas the diffuse type of PVS required a second arthroscopic resection in most cases, due to its high rate of recurrence.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La sinovitis villonodular pigmentaria (SVP) es un trastorno de la proliferación sinovial de etiología incierta, con un tratamiento controvertido. El objetivo del estudio es valorar los resultados funcionales y la tasa de recurrencia en una serie de pacientes diagnosticados de SVP de rodilla, tanto en su forma difusa como en su forma localizada, tratados mediante resección artroscópica.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de 24 pacientes diagnosticados por resonancia magnética de SVP local/difusa entre 1996 y 2011. Se trataron 11 casos de forma localizada y 13 de forma difusa. Tras un seguimiento medio de 60 meses (rango: 34-204). Se intervinieron mediante sinovectomía artroscópica y se valoraron funcionalmente en el postoperatorio con los test IKDC, WOMET, Kujala y Tegner.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ocho pacientes afectados de SVP difusa recidivaron (un 61,5% de las formas difusas). De ellos 2 requirieron radioterapia, uno cirugía abierta por afectación extraarticular y 5 nueva resección artroscópica sin detectarse posteriormente nueva recidiva. En 6 pacientes se observaron lesiones asociadas (en 3 meniscopatía y en 3 lesiones condrales). No hubo recidivas en la forma localizada. El IKDC mejoró de media 30,6 puntos, el WOMET 37,4 puntos y Kujala 34,03 puntos.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La SVP resecada mediante técnica artroscópica presenta buenos resultados funcionales y curativos a medio plazo con una baja morbilidad. La forma difusa de la SVP requiere con frecuencia una segunda intervención quirúrgica por su alta tasa de recidiva tras su resección artroscópica.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Please cite this article as: Isart A, Gelber PE, Besalduch M, Pelfort X, Erquicia JI, Tey-Pons M, et al. Alta recidiva y buenos resultados funcionales tras la resección artroscópica de la sinovitis villonodular pigmentaria de la rodilla. Rev Esp Cir Ortop Traumatol. 2015;59:400–405.</p>" ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1932 "Ancho" => 977 "Tamanyo" => 152384 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">(a) Diffuse pigmented villonodular synovitis (DPVNS). (b) Localised pigmented villonodular synovitis (LPVNS).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1040 "Ancho" => 990 "Tamanyo" => 109345 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Sagittal MRI scan (T2 sequence) from a patient with PVNS in the anterior and posterior compartments of the knee (DPVNS).</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">PVNS, pigmented villonodular synovitis.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age (years)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37 (range: 13–62) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Gender (male/female)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13/11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Laterality (right/left)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12/12 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">PVNS</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Local \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 patients \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diffuse \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 patients \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PVNS with associated lesions</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 patients \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab934763.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Demographic results.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Test \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Preoperative \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Postoperative \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> (value)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IKDC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47.8 (24.1–65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78.4 (36.8–100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">WOMET \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.2 (41.3–78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.8 (0.1–53.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kujala \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51.57 (35–79) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85.6 (60–100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tegner \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.92 (1–3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (1–7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.042 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab934762.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Significant <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.005.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Test results in the preoperative and postoperative periods.</p>" ] ] 4 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">DPVNS, diffuse pigmented villonodular synovitis; LPVNS, localised pigmented villonodular synovitis.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Test \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Preoperative</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span> (value)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Postoperative</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span> (value)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Difference</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span> (value)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LPVNS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DPVNS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LPVNS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DPVNS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LPVNS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DPVNS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IKDC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36.8 (28.5–58.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47.7 (24.1–65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.571 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">87.7 (55.2–100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74.7 (36.8–100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.151 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.6 (12.1–49) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 (8.4–45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.83 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">WOMET \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.7 (41.3–77.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.8 (43.3–78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.573 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.8 (0.1–47.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.4 (1.5–53.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.852 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74.1 (51.3–97.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75.4 (53.5–98.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.892 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kujala \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49.8 (35–58.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53.58 (39–79) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">90.3 (61–100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83.6 (60–100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.151 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.5 (11–52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 (7–54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.125 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tegner \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.7 (1–2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (1–3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.683 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.7 (1–7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.62 (1–6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.461 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (1–5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.6 (1–3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.214 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab934765.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Significant <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.005.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Results of the test in preoperative period, postoperative period and mean thereof in LPVNS and DPVNS.</p>" ] ] 5 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">PVNS, pigmented villonodular synovitis.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Test \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">18/24 (PVNS) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">6/24 (PVNS<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>associated lesions) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> (value)<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kujala \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.47 (12–43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46.8 (44.2–49.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.026 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IKDC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.2 (12.4–40.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.6 (33.2–46.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">WOMET \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.4 (13.3–51.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 (38–51.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.33 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab934764.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Significant <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.005.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Mean results of the test comparing patients only with PVNS vs patients with PVNS plus associated lesions.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0110" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical results of open synovectomy for treatment of diffuse pigmented villonodular synovitis of the knee: case series and review of literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Nakahara" 1 => "S. Matsuda" 2 => "K. Harimaya" 3 => "A. Sakamoto" 4 => "Y. Matsumoto" 5 => "K. Okazaki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.knee.2011.12.002" "Revista" => array:6 [ "tituloSerie" => "Knee" "fecha" => "2012" "volumen" => "19" "paginaInicial" => "684" "paginaFinal" => "687" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22264713" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0115" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented villonodular synovitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W.K. Tyler" 1 => "A.F. Vidal" 2 => "R.J. Williams" 3 => "J.H. Healey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Orthop Surg" "fecha" => "2006" "volumen" => "14" "paginaInicial" => "376" "paginaFinal" => "385" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16757677" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0120" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcomes after excision of pigmented villonodular synovitis of the knee" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V. Sharma" 1 => "E.Y. Cheng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11999-009-0922-7" "Revista" => array:6 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "2009" "volumen" => "467" "paginaInicial" => "2852" "paginaFinal" => "2858" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19543865" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0125" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical treatment of diffuse pigmented villonodular synovitis of the knee" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.C. Flandry" 1 => "J.C. Hughston" 2 => "K.E. Jacobson" 3 => "R.L. Barrack" 4 => "S.B. McCann" 5 => "D.M. Kurtz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "1994" "volumen" => "300" "paginaInicial" => "183" "paginaFinal" => "192" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8131333" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0130" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented villonodular synovitis of joints" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.E. Johansson" 1 => "S. Ajjoub" 2 => "L.P. Coughlin" 3 => "J.A. Wener" 4 => "R.L. Cruess" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "1982" "volumen" => "163" "paginaInicial" => "159" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7067247" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0135" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K.R. Chin" 1 => "S.J. Barr" 2 => "C. Winalski" 3 => "D. Zurakowski" 4 => "G.W. Brick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Bone Joint Surg Am" "fecha" => "2002" "volumen" => "84-A" "paginaInicial" => "2192" "paginaFinal" => "2202" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12473708" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109711011521" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0140" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented villonodular synovitis of the knee. The results of total arthroscopic synovectomy, partial, arthroscopic synovectomy, and arthroscopic local excision" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.J. Ogilvie-Harris" 1 => "J. McLean" 2 => "M.E. Zarnett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Bone Joint Surg Am" "fecha" => "1992" "volumen" => "74" "paginaInicial" => "119" "paginaFinal" => "123" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0145" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Result of arthroscopic treatment of pigmented villonodular synovitis of the knee" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. De Ponti" 1 => "V. Sansone" 2 => "M. Malcherè" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arthroscopy" "fecha" => "2003" "volumen" => "19" "paginaInicial" => "602" "paginaFinal" => "607" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12861198" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0150" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Arthroscopic treatment of pigmented villonodular synovitis of the knee" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.E. Zvijac" 1 => "A.C. Lau" 2 => "K.S. Hechtman" 3 => "J.W. Uribe" 4 => "E.W. Tjin-A-Tsoi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/ar.1999.v15.015061" "Revista" => array:6 [ "tituloSerie" => "Arthroscopy" "fecha" => "1999" "volumen" => "15" "paginaInicial" => "613" "paginaFinal" => "617" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10495177" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0155" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome following radiation treatment for high-risk pigmented villonodular synovitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. O'Sullivan" 1 => "B. Cummings" 2 => "C. Catton" 3 => "R. Bell" 4 => "A. Davis" 5 => "V. Fornasier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0360-3016(95)00514-Y" "Revista" => array:6 [ "tituloSerie" => "Int J Radiat Oncol Biol Phys" "fecha" => "1995" "volumen" => "32" "paginaInicial" => "777" "paginaFinal" => "786" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7790264" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0160" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented villonodular synovitis: a retrospective single-center study of 122 cases and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Ottaviani" 1 => "X. Ayral" 2 => "M. Dougados" 3 => "L. Gossec" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.semarthrit.2010.07.005" "Revista" => array:6 [ "tituloSerie" => "Semin Arthritis Rheum" "fecha" => "2011" "volumen" => "40" "paginaInicial" => "539" "paginaFinal" => "546" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20884045" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0165" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sinovitis villonodular pigmentada difusa. Revisión de 13 casos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Carpintero" 1 => "M.A. Garcia" 2 => "E. Gascón" 3 => "J. Serrano" 4 => "M. Mesa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Cir Osteoarthr" "fecha" => "1998" "volumen" => "33" "paginaInicial" => "161" "paginaFinal" => "165" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0170" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sinovitis villonodular pigmentada (forma difusa)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V. Sanchis" 1 => "E. Baixauli" 2 => "J.C. Monteagudo" 3 => "C.I. Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp de Cir Ost" "fecha" => "1989" "volumen" => "24" "paginaInicial" => "23" "paginaFinal" => "26" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0175" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sinovitis villonodular pigmentada de localización en la extremidad inferior" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.R. Valenti" 1 => "J.A. Cara" 2 => "G. Mora" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Ortop Traumatol" "fecha" => "1995" "volumen" => "39" "paginaInicial" => "26" "paginaFinal" => "29" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0180" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development and validation of the International Knee Documentation Committee Subjective Knee Form" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.J. Irrgang" 1 => "A.F. Anderson" 2 => "A.L. Boland" 3 => "C.D. Harner" 4 => "M. Kurosaka" 5 => "P. Neyret" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Sports Med" "fecha" => "2001" "volumen" => "29" "paginaInicial" => "600" "paginaFinal" => "613" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11573919" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0185" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The development and validation of a quality of life-measurement tool for patients with meniscal pathology: the Western Ontario Meniscal Evaluation Tool (WOMET)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Kirkley" 1 => "A. Griffin" 2 => "D. Whelan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/JSM.0b013e31814c3e15" "Revista" => array:6 [ "tituloSerie" => "Clin J Sport Med" "fecha" => "2007" "volumen" => "17" "paginaInicial" => "349" "paginaFinal" => "356" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17873546" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0190" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Scoring of patellofemoral disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "U.M. Kujala" 1 => "L.H. Jaakkola" 2 => "S.K. Koskinen" 3 => "S. Taimela" 4 => "M. Hurme" 5 => "O. Nelimarkka" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arthroscopy" "fecha" => "1993" "volumen" => "9" "paginaInicial" => "159" "paginaFinal" => "163" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8461073" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0195" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rating systems in the evaluation of knee ligament injuries" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y. Tegner" 1 => "J. Lysholm" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "1985" "volumen" => "198" "paginaInicial" => "43" "paginaFinal" => "49" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4028566" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109704001081" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0200" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does combined open and arthroscopic synovectomy for diffuse PVNS of the knee improve recurrence rates?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.W. Colman" 1 => "J. Ye" 2 => "K.R. Weiss" 3 => "M.A. Goodman" 4 => "R.L. McGough 3rd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11999-012-2589-8" "Revista" => array:6 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "2013" "volumen" => "471" "paginaInicial" => "883" "paginaFinal" => "890" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22996360" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0205" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of open and arthroscopic surgery for treatment of diffuse pigmented villonodular synovitis of the knee" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H.F. Gu" 1 => "S.J. Zhang" 2 => "C. Zhao" 3 => "Y. Chen" 4 => "Q. Bi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00167-014-2852-5" "Revista" => array:7 [ "tituloSerie" => "Knee Surg Sports Traumatol Arthrosc" "fecha" => "2014" "volumen" => "22" "paginaInicial" => "2830" "paginaFinal" => "2836" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24474584" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109713020779" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0210" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary arthroscopic synovectomy for pigmented villo-nodular synovitis of the knee: recurrence rate and functional outcomes after a mean follow-up of seven years" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.C. Aurégan" 1 => "Y. Bohu" 2 => "N. Lefevre" 3 => "S. Klouche" 4 => "J.F. Naouri" 5 => "S. Herman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.otsr.2013.08.004" "Revista" => array:6 [ "tituloSerie" => "Orthop Traumatol Surg Res" "fecha" => "2013" "volumen" => "99" "paginaInicial" => "937" "paginaFinal" => "943" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24161841" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/19888856/0000005900000006/v1_201510220017/S1988885615000760/v1_201510220017/en/main.assets" "Apartado" => array:4 [ "identificador" => "7577" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/19888856/0000005900000006/v1_201510220017/S1988885615000760/v1_201510220017/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000760?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 2 | 6 |
| 2024 October | 33 | 6 | 39 |
| 2024 September | 48 | 7 | 55 |
| 2024 August | 31 | 4 | 35 |
| 2024 July | 32 | 2 | 34 |
| 2024 June | 43 | 2 | 45 |
| 2024 May | 40 | 0 | 40 |
| 2024 April | 28 | 14 | 42 |
| 2024 March | 32 | 5 | 37 |
| 2024 February | 35 | 5 | 40 |
| 2024 January | 73 | 4 | 77 |
| 2023 December | 58 | 7 | 65 |
| 2023 November | 75 | 6 | 81 |
| 2023 October | 80 | 8 | 88 |
| 2023 September | 28 | 4 | 32 |
| 2023 August | 34 | 1 | 35 |
| 2023 July | 62 | 3 | 65 |
| 2023 June | 43 | 3 | 46 |
| 2023 May | 108 | 6 | 114 |
| 2023 April | 109 | 6 | 115 |
| 2023 March | 112 | 3 | 115 |
| 2023 February | 64 | 8 | 72 |
| 2023 January | 50 | 6 | 56 |
| 2022 December | 49 | 11 | 60 |
| 2022 November | 47 | 5 | 52 |
| 2022 October | 31 | 9 | 40 |
| 2022 September | 37 | 18 | 55 |
| 2022 August | 43 | 21 | 64 |
| 2022 July | 29 | 10 | 39 |
| 2022 June | 29 | 5 | 34 |
| 2022 May | 22 | 6 | 28 |
| 2022 April | 30 | 14 | 44 |
| 2022 March | 60 | 10 | 70 |
| 2022 February | 35 | 9 | 44 |
| 2022 January | 43 | 8 | 51 |
| 2021 December | 44 | 11 | 55 |
| 2021 November | 48 | 5 | 53 |
| 2021 October | 77 | 10 | 87 |
| 2021 September | 45 | 16 | 61 |
| 2021 August | 24 | 8 | 32 |
| 2021 July | 17 | 4 | 21 |
| 2021 June | 17 | 6 | 23 |
| 2021 May | 21 | 9 | 30 |
| 2021 April | 23 | 10 | 33 |
| 2021 March | 18 | 19 | 37 |
| 2021 February | 27 | 12 | 39 |
| 2021 January | 35 | 7 | 42 |
| 2020 December | 1 | 2 | 3 |
| 2018 February | 1 | 1 | 2 |
| 2018 January | 9 | 0 | 9 |
| 2017 December | 4 | 0 | 4 |
| 2017 November | 9 | 1 | 10 |
| 2016 September | 0 | 4 | 4 |
| 2016 July | 0 | 1 | 1 |
| 2016 June | 0 | 2 | 2 |
| 2016 May | 0 | 3 | 3 |
| 2016 April | 0 | 2 | 2 |
| 2016 February | 0 | 1 | 1 |
Show all
