Hip Arthroscopy for Synovial Chondromatosis: Tips and Tricks

Abstract

Hip arthroscopy is an important diagnostic and therapeutic tool in the management of synovial chondromatosis. Removal of osteochondral fragments (OCFs) from the central and peripheral compartments is crucial for the relief of mechanical symptoms and subsequent joint destruction. Direct access to the central compartment is often limited because of the ball-and-socket morphology and limitation of traction. We present our surgical technique for removing OCFs and a new method for the removal of a large loose body using a nitinol stone retrieval basket. The technique facilitates removal of difficult-to-access fragments from the central compartment. Moreover, this technique allows removal of far-medial OCFs from the peripheral compartment.

Simultaneous pigmented villonodular synovitis and synovial chondromatosis of the hip: case report

“…Clinically, SC presents with joint pain, swelling and a limited range of motion. Radiographic evidence of SC includes free bodies (sometimes calcified or ossified), medial joint space widening, cam type FAI and labral tears [1, 3, 4, 7].…”

“…Arthroscopic intervention and subtotal synovectomy to remove all free bodies and diseased synovium is the recommended management and has been shown to be beneficial for the patient [1, 3, 4, 8]. The aforementioned procedure to arthroscopically remove chondral lesions, damaged tissue, resolve FAI, and repair the labrum, was followed to treat the SC [3]. The recurrence rate of SC is 7.1% after arthroscopic intervention and does not depend on the stage of the disease.…”

“…PVNS and SC are separate diseases and must be treated individually. The SC was treated with arthroscopic loose body removal and synovectomy [3]. The PVNS was a focal lesion indicating that excision of the nodule and diseased tissue should be sufficient, but warrants follow up monitoring with MRI.…”

“…Arthroscopic hip surgery was performed through an antero-lateral viewing portal and a modified anterior working portal according to the basic principles of hip arthroscopy for SC [3].…”

Arthroscopic Synovectomy of the Hip Joint: The Regional Surgical Technique

“…S ynovial diseases such as pigmented villonodular synovitis (PVNS), synovial chondromatosis, and rheumatoid arthritis are common causes of hip joint dysfunction in clinical practice. [1][2][3][4] Synovial pathological changes of such diseases could lead to articular cartilage lesions or even irreversible joint degeneration of the hip. 5 Traditional surgical treatment uses open surgery and synovectomy; however, with the development of arthroscopic technology, arthroscopic synovectomy of the hip has gradually become the first treatment option for surgeons.…”