A systematic literature review of synovial chondromatosis and pigmented villonodular synovitis of the hip

Abstract

Benign Synovial disorders of the hip are rare. In patients with chronic hip pain secondary to benign synovial disorders, early diagnosis and surgical intervention demonstrate good outcomes, and patients may benefit due to prevention of morbidity from further joint destruction. There is no clear consensus between higher successes through open versus arthroscopic surgical debridement. In the final phase of benign synovial disorders of the hip, THA of different types based on the patient's age should be considered.

Remaining Loose Bodies after Arthroscopic Surgery Including Extensive Capsulectomy for Synovial Chondromatosis of the Hip

“…In the treatment of synovial chondromatosis of the hip, removal of loose bodies is essential to relieve pain, prevent recurrence, and delay progression or secondary joint arthritis. 10 11 19 24) Traditionally, open surgery has been considered as the optimal treatment for synovial chondromatosis of the hip. 25) Although arthroscopy has been introduced to treat this disorder, there has been some concern about the feasibility of radical synovectomy, high recurrence rates, and the frequent necessity of reoperation due to remaining loose bodies.…”

“… 14 18 26) The recurrence rates after arthroscopic treatment for synovial chondromatosis ranged from 7.1% to 16.7%. 15 19) Although almost all regions of the synovium can be identified during the arthroscopic procedure, it is difficult to remove loose bodies located at the medial portion of the hip joint, as an arthroscope cannot easily reach this area. 14 15 27) To completely remove loose bodies, the arthroscopic procedure might require a prolonged traction time, which results in traction-related complications including neuropraxia of the pudendal nerve and perineal skin problems as in one of our patients.…”

“… 10 17 18) Meanwhile, incomplete removal or recurrence is the concern of arthroscopic surgery because complete synovectomy is technically difficult. 11 19) When loose bodies remain, reoperation is possibly required for patients with persistent symptoms after the surgery. 1 15 20) However, there has been no study on the natural course of remaining loose bodies due to incomplete removal after arthroscopic surgery.…”

Tender Nodules of the Foot

“…Recurrence rates with partial synovectomy are as high as 56% within 2 years (Startzman, Collins, & Carreira, 2016). Pigmented villonodular synovitis within the hip carries a worse prognosis than that found in other joints, likely due to the large space within the hip and an increased time to diagnosis (Byrd, Jones, Maiers, 2013).…”

Pigmented villonodular synovitis does not influence the outcome following cementless total hip arthroplasty using ceramic-on-ceramic articulation: a case-control study with middle-term follow-up

“…It is characterized by a proliferation of synovial villi and nodules within joint spaces, bursa, or tendon sheaths [ 5 ]. As synovial hyperplasia pervades the hip, it causes discomfort by narrowing the joint space, leading to sharp hip pain [ 3 ]. A radical synovectomy, whether via arthroscopy or an open surgical approach, has been utilized as a treatment for hips with mild cartilage degeneration.…”