title: Arthroscopic treatment of synovial chondromatosis of the hip.
abstract: BACKGROUND
  Recently, arthroscopic loose body removal and synovectomy have been performed as treatments for synovial chondromatosis of the hip joint. However, to date, no reports have been published on the outcomes of arthroscopic treatments.
  
  
  OBJECTIVE
  Arthroscopic treatment is effective for synovial chondromatosis of the hip joint and has advantages such as low recurrence rates, faster return to activities of daily life, and few surgical complications.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  From June 1996 to July 2008, 24 patients with synovial chondromatosis of the hip who were followed up after arthroscopic removal of loose bodies and synovectomy were evaluated. The common arthroscopic portals were the anterior, anterolateral, and posterolateral portals. In some cases, we applied a medial portal for removal of loose bodies in the posteromedial pouch. Preoperative and postoperative assessments were made through simple radiographs, 3-dimensional computed tomography, magnetic resonance imaging, visual analog scale (VAS) for pain, range of motion of the joint, Harris Hip Score, and Merle D'Aubigné and Postel score.
  
  
  RESULTS
  Postoperative mean follow-up period was 41 months. There were no major complications. Patients were able to walk weightbearing on average 2 days after surgery and were discharged in an average of 3.5 days (range, 3-5 days) after surgery. In postoperative radiological imaging, 4 patients showed progression of joint osteoarthritis, and 1 of them underwent total hip arthroplasty. The VAS score before surgery was 8.1 ± 1.3 and after surgery was 3.1 ± 1.4. Range of motion of the hip joint before surgery was increased after surgery, except in 1 patient who required a third operation. Harris Hip Score before surgery was an average of 39 ± 6.9 and improved to an average of 82 ± 10.2 after surgery. Eighteen patients (75%) had good or excellent outcomes. Symptomatic disease recurred in 4 patients (16.7%), and 1 of these 4 patients showed a subsequent recurrence.
  
  
  CONCLUSIONS
  The treatment of synovial chondromatosis of the hip using arthroscopic loose body removal and synovectomy is relatively successful, and rehabilitation of patients is fast, therefore making it an effective treatment with satisfactory postsurgical results. However, a technical limitation of arthroscopy is the difficulty in approaching the posterolateral and posteromedial areas of the peripheral compartment.
authors.affiliation: Department of Orthopaedic Surgery, Chungnam National University School of Medicine, 33 Munhwaro, Junggu, Daejeon, 301-721, Korea.
authors.forename: Jung-Bum
authors.initials: JB
authors.lastname: Lee
authors.forename: Chan
authors.initials: C
authors.lastname: Kang
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Lee
authors.forename: Pil-Sung
authors.initials: PS
authors.lastname: Kim
authors.forename: Deuk-Soo
authors.initials: DS
authors.lastname: Hwang
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000534:rehabilitation; D001182:Arthroscopy / Q000379:methods* / Q000534:rehabilitation; D015838:Chondromatosis, Synovial / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D005260:Female; D006615:Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007594:Joint Loose Bodies / Q000000981:diagnostic imaging / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012008:Recurrence; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology