Surgical Treatment of Intra-articular Knee XXXX : When and How?

@entity1 @entity66 @entity447 @entity73 @entity1003 @entity158 @entity1211 @entity5631 @entity1462
BACKGROUND: To assess the efficacy of surgical treatment of intra-articular knee @entity1211 ( @entity1211 ). METHODS: Between 1998 and 2010, 8 @entity1 (mean age: 12.3 y) underwent surgical resection of their @entity1462 (7 venous and 1 capillary venous) involving the knee joint. The lesion was diffuse in 6 cases and well-demarcated in 2 cases. All @entity1 were suffering from knee @entity158 and had recurrent @entity5631 . Color-Doppler ultrasonography, magnetic resonance imaging, computed tomography scan, and blood test were performed preoperatively. Preoperative and postoperative physical examination, clinical symptoms, and orthopaedic evaluation were retrospectively reviewed. Surgery consisted in arthrotomy with total excision of the @entity1462 for the 2 well-demarcated lesions and synovectomy with squeezing of the surrounding @entity1462 for 5 @entity66 . One @entity1 with an extensive @entity1211 associated with severe @entity1003 and mild @entity447 had undergone synovectomy by knee arthroscopy. RESULTS: Immediate postoperative follow-up was uneventful in 6 @entity1 , whereas 2 @entity1 with @entity1462 and @entity1003 suffered from postoperative @entity5631 , delaying their rehabilitation. After a mean follow-up of 5.1 years, persistence of the @entity1211 within the joint was observed in the 6 initially @entity66 . The 2 well-demarcated lesions showed no evidence of disease at latest follow-up. Four @entity1 with preoperative @entity73 were not substantially improved regarding their range of knee motion at latest follow-up, whereas the 4 others were free of symptoms. Only 1 @entity1 presented a recurrent @entity5631 after a 5-year-symptom-free period and had to be reoperated. @entity1 without preoperative chondropathy recovered normal knee function mobility. CONCLUSIONS: This retrospective study highlights the importance of early surgery in @entity1 with intra-articular @entity1211 , even if asymptomatic, to prevent @entity73 . For well-demarcated lesions, total resection by arthrotomy can provide definitive healing without resuming of symptoms. Although @entity66 treated by synovectomy still persist in the joint, treatment avoids recurrence of @entity5631 and, therefore, protects the cartilage from further erosion. LEVEL OF EVIDENCE: Level IV cases series.
