Impact of targeted strengthening and gait training on recurrence prevention after synovectomy for diffuse Pigmented Villonodular Synovitis (PVNS): A single-subject case report

Abstract

Background: Pigmented villonodular synovitis (PVNS) is a rare, benign but locally aggressive synovial disorder with a high risk of recurrence. Postoperative management plays a pivotal role in restoring joint function, minimizing complications, and preventing relapse. This case study evaluates the postoperative rehabilitation and outcomes following arthroscopic synovectomy for knee PVNS in a young adult.Methods: A 34-year-old male diagnosed with diffuse PVNS of the right knee underwent arthroscopic synovectomy. Postoperative management included a structured rehabilitation program emphasizing pain control, progressive range of motion (ROM) training, quadriceps strengthening, proprioceptive re-education, and functional retraining. Pain (VAS), knee function (Lysholm and IKDC scores), ROM, and muscle strength were assessed at 2 weeks, 6 weeks, 3 months, and 6 months postoperatively.Results: The patient demonstrated significant improvement: VAS score decreased from 7/10 to 1/10, knee flexion improved from 90° to 130°, and quadriceps strength progressed from Grade 2 to Grade 5 by 6 months. Functional outcomes showed remarkable recovery, with the Lysholm score improving from 52 to 90 and IKDC from 48 to 88. No signs of recurrence were noted during 6-month follow-up.Conclusion: Structured and evidence-based postoperative rehabilitation following arthroscopic synovectomy for PVNS can achieve substantial pain relief, functional recovery, and return to daily activities while reducing recurrence risk. This study emphasizes the importance of a multidisciplinary approach and long-term surveillance in optimizing patient outcomes.