Arthroscopic treatment for pigmented villonodular synovitis of the shoulder associated with massive rotator cuff tear.

PURPOSE: Our purpose was to investigate arthroscopic treatment of patients diagnosed with pigmented villonodular synovitis (PVNS) of the shoulder and massive rotator cuff tear with the initial presentation of large, recurrent joint effusion.

METHODS: From December 2005 to June 2007, 5 patients (3 males and 2 females) diagnosed with PVNS of the shoulder and massive rotator cuff tear were treated with arthroscopic synovectomy, partial cuff repair, or debridement if the cuff was irreparable. All 5 patients were followed-up for a mean of 22.4 months (range, 12 to 33 months). Outcomes were measured with use of the American Shoulder and Elbow Surgeons (ASES) and University of California at Los Angeles (UCLA) scoring systems. Two patients received partial rotator cuff repair by suture anchors and another 2 received suture repairs only. All of the patients had residual tear with variable sizes.

RESULTS: With a mean follow-up of 22.4 months (range, 12 to 33 months), the mean ASES and UCLA scores improved from preoperative values of 48.2 and 7.8 to 80.0 and 29.6 points, respectively (P < .05). All patients were satisfied with the procedure, and no signs of recurrence were noted during the follow-up period.

CONCLUSIONS: Five cases of PVNS of the shoulder and massive rotator cuff tears with the initial symptoms of shoulder effusion and function limitation were reported. After arthroscopic synovectomy and partial rotator cuff repair or debridement, all patients gained symptomatic and limited functional improvement at an average follow-up of 22 months.

LEVEL OF EVIDENCE: Level IV, therapeutic case series.