Abstract：
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°, p = 0.109; extension 0°, p = 0.093). Patients undergoing two-stage synovectomies stayed longer in the hospital (6 vs. 4 days, p < 0.0001). Complications occurred more often after two-stage synovectomies, although this was not statistically different (36% vs. 24%, p = 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%, p = 0.036) (54% vs. 34%, p = 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.
摘要：
弥漫性腱膜巨细胞瘤（D-TGCT）膝关节周围的关节内和关节外扩张通常需要前后手术入路，以促进广泛的滑膜切除术。对于应该在一个或两个阶段中进行双侧活检，尚无共识。这项回顾性研究包括来自全球9个肉瘤中心的191名D-TGCT患者，以比较两种治疗方法的术后短期结果。次要结果是放射学进展率和后续治疗。在2000年至2020年之间，117例患者接受了一期手术，74例患者接受了二期手术。术后一年内达到的最大活动范围相似（屈曲123-120°，p=0.109;延伸0°,p=0.093)。接受两阶段滑膜切除术的患者在医院停留的时间更长（6vs.4天,p<0.0001)。并发症更经常发生在两个阶段的滑膜切除术后，尽管这在统计学上没有差异(36%与24%,p=0.095)。与接受一期synovecomies治疗的患者相比，接受两阶段synovecomies治疗的患者表现出更多的放射学进展，并且需要更多的后续治疗（52％vs.37%,p=0.036）（54%与34%,p=0.007)。总之,如果可行，需要双侧滑膜切除术的膝关节D-TGCT应采用一期滑膜切除术治疗，由于患者的运动范围相似，没有更多的并发症，但在医院待的时间要短一些.
