One-Stage Synovectomies Result in Improved Short-Term Outcomes Compared to Two-Stage Synovectomies of Diffuse-Type Tenosynovial Giant Cell Tumor (D-TGCT) of the Knee: A Multicenter, Retrospective, Cohort Study

• Published in: Cancers Vol. 15; no. 3; p. 941
• Main Authors: Spierenburg, Geert, Verspoor, Floortje G M, Wunder, Jay S, Griffin, Anthony M, Ferguson, Peter C, Houdek, Matthew T, King, David M, Boyle, Richard, Randall, Robert Lor, Thorpe, Steven W, Priester, Jacob I, Geiger, Erik J, van der Heijden, Lizz, Bernthal, Nicholas M, Schreuder, Bart H W B, Gelderblom, Hans, van de Sande, Michiel A J
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.02.2023; MDPI
• Subjects: Care and treatment; Cohort analysis; Cysts; FDA approval; Giant cell tumors; Hospitals; Knee; Knee joint; Length of stay; Ligaments; Methods; Patients; Range of motion; Rehabilitation; Sarcoma; Surgery; Tendons; Tumors; Netherlands; United States > US; one-stage; knee; tenosynovial giant cell tumor; TGCT; synovectomy; two-stage; diffuse-type
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers15030941

Diffuse-type tenosynovial giant cell tumors' (D-TGCTs) intra- and extra-articular expansion about the knee often necessitates an anterior and posterior surgical approach to facilitate an extensive synovectomy. There is no consensus on whether two-sided synovectomies should be performed in one or two stages. This retrospective study included 191 D-TGCT patients from nine sarcoma centers worldwide to compare the postoperative short-term outcomes between both treatments. Secondary outcomes were rates of radiological progression and subsequent treatments. Between 2000 and 2020, 117 patients underwent one-stage and 74 patients underwent two-stage synovectomies. The maximum range of motion achieved within one year postoperatively was similar (flexion 123-120°, = 0.109; extension 0°, = 0.093). Patients undergoing two-stage synovectomies stayed longer in the hospital (6 vs. 4 days, < 0.0001). Complications occurred more often after two-stage synovectomies, although this was not statistically different (36% vs. 24%, = 0.095). Patients treated with two-stage synovectomies exhibited more radiological progression and required subsequent treatments more often than patients treated with one-stage synovectomies (52% vs. 37%, = 0.036) (54% vs. 34%, = 0.007). In conclusion, D-TGCT of the knee requiring two-side synovectomies should be treated by one-stage synovectomies if feasible, since patients achieve a similar range of motion, do not have more complications, but stay for a shorter time in the hospital.