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Arthroscopic treatment of solitary benign intra-articular lesions of the knee that cause mechanical symptoms.
Arthroscopy 2005; 21(1):12-8A

Abstract

PURPOSE

Most cases of knee locking and giving-way are caused by meniscal tears, loose bodies, or chondral lesions. Intra-articular benign tumors or tumor-like lesions can present with symptoms that resemble acute mechanical derangement. From a database of 2,200 arthroscopic interventions, 19 cases of intra-articular masses that presented with catching and locking symptoms in the knee were retrospectively analyzed.

TYPE OF STUDY

Case series.

METHODS

Our review revealed 33 patients with benign intra-articular masses in the knee joint. Nineteen of these individuals had sought medical attention for mechanical symptoms of catching or locking. The other 14 patients had a variety of symptoms including pain, swelling, and limitation of knee motion, but did not have mechanical symptoms. Age, sex, history of trauma, knee pain and effusion, medical illnesses, physical examination, arthroscopic findings, and pathologic findings were noted.

RESULTS

The average age of the 6 male and 13 female patients was 37.5 years (range, 18 to 58 years). Preoperative magnetic resonance imaging confirmed the diagnosis in 7 cases and 12 cases were diagnosed during knee arthroscopy. The mean follow-up time after surgery was 52.5 months (range, 6 to 120 months). Pathologic examination of the lesions revealed 15 cases of localized pigmented villonodular synovitis (79%), 1 lipoma arborescens (5%), 1 pseudocyst (5%), and 2 nonspecific synovial masses (11%). None of the lesions showed malignant transformation.

CONCLUSIONS

Solitary benign intra-articular lesions should be considered a rare cause of mechanical knee symptoms. Localized pigmented villonodular synovitis originating from the extensor mechanism or fat pad is the most common solitary intra-articular mass lesion in the knee and usually arises in the patellofemoral compartment. Recurrence has not occurred in our series, which includes 14 of 19 patients with greater than 24 months follow-up.

LEVEL OF EVIDENCE

Level IV.

Authors+Show Affiliations

Baskent University Faculty of Medicine, Department of Orthopaedics and Traumatology, Adana Medical Center, Adana, Turkey. mozalay@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15650661

Citation

Ozalay, Metin, et al. "Arthroscopic Treatment of Solitary Benign Intra-articular Lesions of the Knee That Cause Mechanical Symptoms." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 21, no. 1, 2005, pp. 12-8.
Ozalay M, Tandoğan RN, Akpinar S, et al. Arthroscopic treatment of solitary benign intra-articular lesions of the knee that cause mechanical symptoms. Arthroscopy. 2005;21(1):12-8.
Ozalay, M., Tandoğan, R. N., Akpinar, S., Cesur, N., Hersekli, M. A., Ozkoç, G., & Uysal, M. (2005). Arthroscopic treatment of solitary benign intra-articular lesions of the knee that cause mechanical symptoms. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 21(1), pp. 12-8.
Ozalay M, et al. Arthroscopic Treatment of Solitary Benign Intra-articular Lesions of the Knee That Cause Mechanical Symptoms. Arthroscopy. 2005;21(1):12-8. PubMed PMID: 15650661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroscopic treatment of solitary benign intra-articular lesions of the knee that cause mechanical symptoms. AU - Ozalay,Metin, AU - Tandoğan,Reha N, AU - Akpinar,Sercan, AU - Cesur,Necip, AU - Hersekli,Murat Ali, AU - Ozkoç,Gürkan, AU - Uysal,Mustafa, PY - 2005/1/15/pubmed PY - 2005/12/13/medline PY - 2005/1/15/entrez SP - 12 EP - 8 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 21 IS - 1 N2 - PURPOSE: Most cases of knee locking and giving-way are caused by meniscal tears, loose bodies, or chondral lesions. Intra-articular benign tumors or tumor-like lesions can present with symptoms that resemble acute mechanical derangement. From a database of 2,200 arthroscopic interventions, 19 cases of intra-articular masses that presented with catching and locking symptoms in the knee were retrospectively analyzed. TYPE OF STUDY: Case series. METHODS: Our review revealed 33 patients with benign intra-articular masses in the knee joint. Nineteen of these individuals had sought medical attention for mechanical symptoms of catching or locking. The other 14 patients had a variety of symptoms including pain, swelling, and limitation of knee motion, but did not have mechanical symptoms. Age, sex, history of trauma, knee pain and effusion, medical illnesses, physical examination, arthroscopic findings, and pathologic findings were noted. RESULTS: The average age of the 6 male and 13 female patients was 37.5 years (range, 18 to 58 years). Preoperative magnetic resonance imaging confirmed the diagnosis in 7 cases and 12 cases were diagnosed during knee arthroscopy. The mean follow-up time after surgery was 52.5 months (range, 6 to 120 months). Pathologic examination of the lesions revealed 15 cases of localized pigmented villonodular synovitis (79%), 1 lipoma arborescens (5%), 1 pseudocyst (5%), and 2 nonspecific synovial masses (11%). None of the lesions showed malignant transformation. CONCLUSIONS: Solitary benign intra-articular lesions should be considered a rare cause of mechanical knee symptoms. Localized pigmented villonodular synovitis originating from the extensor mechanism or fat pad is the most common solitary intra-articular mass lesion in the knee and usually arises in the patellofemoral compartment. Recurrence has not occurred in our series, which includes 14 of 19 patients with greater than 24 months follow-up. LEVEL OF EVIDENCE: Level IV. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/15650661/Arthroscopic_treatment_of_solitary_benign_intra_articular_lesions_of_the_knee_that_cause_mechanical_symptoms_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749806304008540 DB - PRIME DP - Unbound Medicine ER -