Knee Arthroscopy for the Treatment of Lipoma Arborescens

Abstract

Background: Lipoma arborescens is a rare, intra-articular benign lesion characterized by hyperplastic formation of villous projections that commonly presents as nonspecific mechanical knee pain. The treatment of choice for lipoma arborescens of the knee is open or arthroscopic synovectomy. However, data are lacking on the success of arthroscopic treatment, despite its increasingly widespread use. We aimed to systemically review the outcomes of arthroscopic treatment of lipoma arborescens.Methods: PubMed and Embase were searched by 2 reviewers independently on October 9, 2018, and all relevant articles in the English and French languages up to and including that date were considered. The search terms "lipoma arborescens," "knee," "arthroscopy," and "arthroscopic" were used. Articles were screened on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Results: Among the 110 initial studies that were retrieved, 28 satisfied the inclusion criteria. A total of 71 knees in 65 patients ranging from 13 to 78 years of age underwent arthroscopic synovectomy for the treatment of lipoma arborescens. The duration of follow-up ranged from 3 weeks to 84 months. The recurrence rate was 2.8%, and 2 patients underwent conversion to open surgery. One patient had postoperative hematoma that required evacuation, and another patient reported persistent residual pain at the time of the latest follow-up.Conclusions: On the basis of this uncontrolled, systematic review, arthroscopic synovectomy is a safe and effective treatment for lipoma arborescens of the knee, with a success rate of .95%.

Arthroscopic treatment of a lipoma arborescens of the elbow

“…According to a systematic review about the treatment of LA in the knee, gold standard treatment is arthroscopic synovectomy with a success rate exceeding 95%. [ 14 ] Evidences for LA treatment of the elbow joint are insufficient but it is safe to assume that an arthroscopic approach is also the most effective.…”

Surgical management of upper limb lipoma arborescens: a systematic review

“…Excision and synovectomy of the affected joint have been proposed as a treatment option. Both open and arthroscopic techniques have been reported, leading to good short-term functional results without recurrences [ 5 , 15 ]. According to this systematic review, one-stage open or arthroscopic procedures address both LA and potential concurrent pathologies, such as rotator cuff or labral tears, and should be considered as standard treatment option.…”

“…However, it is unclear whether lesion size and location may play a role in determining specific approaches. A systematic review on the arthroscopic treatment of LA of the knee revealed a satisfactory short-term outcome [ 15 ]. The present study supports similar findings: patients may benefit from less invasive arthroscopic procedures when feasible, as arthroscopic treatment of shoulder [ 2 , 3 , 28 , 35 , 36 ] and elbow lesions [ 13 ] led to promising short-term outcomes.…”

“…The knee is the most frequent location of LA [ 1 – 3 ]; however, lesions of the wrist, elbow, shoulder, ankle, and hip joints have been reported [ 2 , 10 , 13 – 16 ]. For LA in the knee, arthroscopic synovectomy demonstrated excellent short-term results and a low rate of recurrence [ 15 ]. To the best of our knowledges, no review is available concerning the management of LA located in the upper limb.…”

Evaluation and Management of Intra-Articular Tumors of the Knee

“…This surgical approach obtains good clinical outcomes with a low recurrence rate of 2.8%, suggesting it should be the first-line surgical intervention. 44 In the setting of secondary lipoma arborescens, the inciting process should also be addressed at the time of surgery, if possible, to limit disease recurrence. 45 There are limited data surrounding outcomes of patients undergoing TKA in the setting of lipoma arborescens.…”