TABLE IV

Grades of Recommendation for Treatment of Tenosynovial Giant-Cell Tumors of the Foot and Ankle

Treatment OptionRecommendationGrade*
Open synovectomy/excisionThere is poor-quality evidence to support the use of open surgical synovectomy/excision of tenosynovial giant-cell tumors of the foot and ankleC
Arthroscopic synovectomy/excisionThere is insufficient evidence to make a recommendation for or against the use of arthroscopic excision/synovectomy of tenosynovial giant-cell tumors of the foot and ankleI
External beam radiation therapy (EBRT)There is insufficient evidence to make a recommendation for or against the use of EBRT for the treatment of tenosynovial giant-cell tumors of the foot and ankleI
Intra-articular radioactive isotope injectionThere is insufficient evidence to make a recommendation for or against the use of intra-articular radioactive isotope injection for the treatment of tenosynovial giant-cell tumors of the foot and ankleI
Targeted pharmacological treatmentsThere is insufficient evidence to make a recommendation for or against arthroscopic excision of tenosynovial giant cell-tumors of the foot and ankleI
  • * Grade A indicates good evidence (Level-I studies with consistent findings) for or against recommending intervention. Grade B indicates fair evidence (Level-II or III studies with consistent findings) for or against recommending intervention. Grade C indicates conflicting or poor-quality evidence (Level-IV or V studies) not allowing a recommendation for or against intervention. Grade I indicates that there is insufficient evidence to make a recommendation.