Synovial Osteochondromatosis of the Hip Treated Through a Surgical Dislocation

Surgical treatment of synovial osteochondromatosis of the hip using a modified-Hardinge approach with a Z-shaped capsular incision

“…Additionally, an arthroscope was used to confirm any undetected loose bodies. 2 , 6 , 7 No patients had recurrence of diseases and there were no complications such as infection, osteonecrosis of the femoral head, or progression of KL grade at the latest follow up.…”

“…However, some complications due to trochanteric flip osteotomy such as trochanteric fixation failure and heterotopic ossification were described. 2 , 7 , 8 Additionally, Schoeniger and Ganz applied the surgical dislocation technique for the management of eight patients with synovial osteochondoromatosis of the hip. In regards to the results, there were no patients that had recurrence of the disease and there were no notable complications nor signs of avascular necrosis of femoral head.…”

“… 4 , 5 However, management of the arthroscopic procedure for synovial osteochondromatosis of the hip is particularly difficult. 3 , 6 , 7 Some of the loose bodies have shown too large of a diameter, which makes total arthroscopic removal difficult. Additionally, even modern arthroscopic techniques cannot adequately observe all pathologic lesions such as posteroinferior lesions in the acetabulum or extra-articular lesions.…”

“…Ganz recently developed a surgical dislocation technique through a posterior approach with trochanteric flip osteotomy to avoid femoral head necrosis and applied this to the treatment of synovial osteochondromatosis of the hip. 7 However, the surgical dislocation with trochanteric flip osteotomy had complications related to the greater trochanter such as failure to achieve union. The current study presents a modified technique for the surgical dislocation through a Z-shaped capsular incision without trochanteric flip osteotomy for the treatment of synovial osoteochondromatosis of the hip.…”

Synovial chondromatosis of the hip with atypical MRI morphology and mistakable clinical symptoms — a case report

“…Thus, a decision must be made on whether to accept complications in order to achieve complete synovectomy or to risk recurrence after an arthroscopic procedure. This issue remains controversial (Boyer and Dorfmann 2008, Nakamura et al 2009). …”