Arthroscopic Management of Synovial Osteochondromatosis of the Hip

Abstract

Synovial osteochondromatosis is a benign metaplasia of the synovium resulting in the formation of osteocartilaginous nodules within the synovial lining. At presentation, radiographs typically reveal these nodules to have broken free from the synovial lining, becoming loose bodies residing in the free space of the affected joint. These fragments readily receive the necessary nutrients for continued growth from the synovial fluid in which they reside. Controversy exists over the management of the disease. Some physicians call for arthrotomy with a complete synovectomy, whereas others vouch for a minimally invasive arthroscopic approach. In the case described here, the surgeon decided on hip arthroscopy to treat synovial osteochondromatosis in a 61-year-old woman. All but one loose body that was adherent in the anterior hip capsule was successfully removed and the patient recovered promptly. This case highlights the importance of hip arthroscopy and its usefulness not only in treating conditions such as synovial osteochondromatosis, but also in accurately diagnosing them. Recognition and management of hip conditions such as synovial osteochondromatosis through arthroscopy result in minimally invasive treatment and decreased morbidity and may markedly accelerate patient rehabilitation. It is the authors' belief that this unique case further suggests the practicality of using hip arthroscopy to successfully treat synovial osteochondromatosis.

Clinical Outcomes after Arthroscopic Treatment of Synovial Chondromatosis in the Hip

“…8,9,21,22 Patients undergoing arthroscopic surgery tend to have a shorter stay in hospital, less postoperative pain, fewer complications, and faster recovery. 3,23 Our findings are similar to previous studies in that and we found arthroscopy for SC of the hip elicited good results.…”

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

“…Compared to open surgery, arthroscopic surgery was associated with less invasiveness, decreased hospital stay, less postoperative pain, less surgical complications, and faster recovery. 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.…”