Surgical Hip Dislocation for the Treatment of Synovial Chondromatosis Associated with a Cam Deformity
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Published:
Oct 17, 2023
Keywords:
Synovial chondromatosis, femoroacetabular impingement, surgical hip dislocation, hip arthroscopy
Main Article Content
Abstract
Synovial chondromatosis is a rare benign disease of the synovial tissue that can cause joint damage if not properly treated. On the other hand, cam deformity causes friction between the acetabular rim and the femoral neck-head junction, which can lead to chondrolabral damage and, in its natural progression, result in osteoarthritis. The treatment of synovial chondromatosis of the hip is controversial, involving open surgery or arthroscopy, but it should include complete removal of loose bodies and synovectomy to prevent recurrences. In contrast, a cam lesion can often be managed with arthroscopy. We present a clinical case where both conditions were associated and treated with controlled hip dislocation. The choice of controlled dislocation allows for a comprehensive view of the joint and has been successfully used in cases of synovial chondromatosis associated with cam lesions.
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How to Cite
Pérez Abdala, J. I., Novillo, M., Zanotti, G., & Buttaro, M. (2023). Surgical Hip Dislocation for the Treatment of Synovial Chondromatosis Associated with a Cam Deformity. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(5), 581-585. https://doi.org/10.15417/issn.1852-7434.2023.88.5.1776
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19. Gautier E, Ganz K, Krügel N, Gill T, Ganz R. Anatomy of the medial femoral circumflex artery and its surgical
implications. J Bone Joint Surg Br 2000;82(5):679-83. https://doi.org/10.1302/0301-620x.82b5.10426
20. Ferreyra A, Allende V, Masquijo J, Allende G. Experiencia inicial con la luxación controlada de cadera. Rev Asoc
Argent Ortop Traumatol 2012;77(1):29-38. Disponible en:http://www.scielo.org.ar/scielo.php?pid=S1852-74342012000100004&script=sci_arttext
21. Hassan MM, Farooqi AS, Feroe AG, Lee A, Cusano A, Novais E, et al. Open and arthroscopic management of
femoroacetabular impingement: a review of current concepts. J Hip Preserv Surg 2022;9(4):265-75.
https://doi.org/10.1093/jhps/hnac043
22. Comba F, Quinteros CM, Martorell G, Buttaro MA, Zanotti G, Piccaluga F. Condromatosis sinovial de cadera.
Tratamiento artroscópico. Rev Asoc Argent Ortop Traumatol 2014;79:179-85. https://doi.org/10.15417/325
https://doi.org/10.2106/JBJS.RVW.O.00054
2. van der Valk MR, Veltman ES, Assink J, Veen MR. Synovial chondromatosis of the hip, a case report and literature review. J Orthop 2019;16(3):249-53. https://doi.org/10.1016/j.jor.2019.02.010
3. Iyengar K, Mishra AK, Vaish A, Kurisunkal V, Vaishya R, Botchu R. Primary synovial chondromatosis of the
hip joint (PrSC of the hip): A retrospective cohort analysis and review of the literature. J Clin Orthop Trauma
2022;35:102068. https://doi.org/10.1016/j.jcot.2022.102068
4. Schoeniger R, Naudie DD, Siebenrock KA, Trousdale RT, Ganz R. Modified complete synovectomy prevents
recurrence in synovial chondromatosis of the hip. Clin Orthop Relat Res 2006;451:195-200.
https://doi.org/10.1097/01.blo.0000229280.53109.d5
5. Nakamura Y, Echigoya N, Toh S. Synovial osteochondromatosis of the hip treated through a surgical dislocation. J Arthroplasty 2009;24(7):1143. https://doi.org/10.1016/j.arth.2008.09.004
6. Boyer T, Dorfmann H. Arthroscopy in primary synovial chondromatosis of the hip: description and outcome of
treatment. J Bone Joint Surg Br 2008;90(3):314-8. https://doi.org/10.1302/0301-620X.90B3.19664
7. Lim SJ, Park YS. Operative treatment of primary synovial osteochondromatosis of the hip. Surgical technique. J
Bone Joint Surg Am 2007;89 Suppl 2 Pt.2:232-45. https://doi.org/10.2106/JBJS.G.00187
8. de Sa D, Horner NS, MacDonald A, Simunovic N, Ghert MA, Philippon MJ, et al. Arthroscopic surgery for synovial chondromatosis of the hip: a systematic review of rates and predisposing factors for recurrence. Arthroscopy 2014;30(11):1499-1504.e2. https://doi.org/10.1016/j.arthro.2014.05.033
9. Zhang X, Gao G, Wang J, Xu Y. Clinical outcomes after arthroscopic treatment of synovial chondromatosis in the hip. Cartilage 2021;13(1_suppl):1324S-1330S. https://doi.org/10.1177/1947603520912316
10. Fang S, Li H, Wang Y, Xu P, Sun H, Li S, et al. Surgical hip dislocation for treatment of synovial chondromatosis of the hip. Int Orthop 2021;45(11):2819-24. https://doi.org/10.1007/s00264-021-05045-x
11. Yoon PW, Yoo JJ, Koo KH, Yoon KS, Kim HJ. Joint space widening in synovial chondromatosis of the hip. J Bone
Joint Surg Am 2011;93(3):303-10. https://doi.org/10.2106/JBJS.J.00473
12. Leunig M, Beaulé PE, Ganz R. The concept of femoroacetabular impingement: current status and future
perspectives. Clin Orthop Relat Res 2009;467(3):616-22. https://doi.org/10.1007/s11999-008-0646-0
13. Albers CE, Wambeek N, Hanke MS, Schmaranzer F, Prosser GH, Yates PJ. Imaging of femoroacetabular
impingement-current concepts. J Hip Preserv Surg 2016;3(4):245-61. https://doi.org/10.1093/jhps/hnw035
14. Sankar WN, Nevitt M, Parvizi J, Felson DT, Agricola R, Leunig M. Femoroacetabular impingement: defining the
condition and its role in the pathophysiology of osteoarthritis. J Am Acad Orthop Surg 2013;21 Suppl 1:S7-S15.
https://doi.org/10.5435/JAAOS-21-07-S7
15. Wyles CC, Heidenreich MJ, Jeng J, Larson DR, Trousdale RT, Sierra RJ. The John Charnley Award: Redefining
the natural history of osteoarthritis in patients with hip dysplasia and impingement. Clin Orthop Relat Res
2017;475(2):336-50. https://doi.org/10.1007/s11999-016-4815-2
16. Abolghasemian M, Gharanizadeh K, Kuzyk P, Masdari Z, Fakharian M, Safir O. Hips with synovial chondromatosis may display the features of femoroacetabular impingement. J Bone Joint Surg Am 2014;96(2):e11. https://doi.org/10.2106/JBJS.L.01550
17. Padhy D, Park SW, Jeong WK, Lee DH, Park JH, Han SB. Femoroacetabular impingement due to synovial
chondromatosis of the hip joint. Orthopedics 2009;32(12):921. https://doi.org/10.3928/01477447-20091020-30
18. Ganz R, Gill TJ, Gautier E, Ganz K, Krügel N, Berlemann U. Surgical dislocation of the adult hip a technique
with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br
2001;83(8):1119-24. https://doi.org/10.1302/0301-620x.83b8.11964
19. Gautier E, Ganz K, Krügel N, Gill T, Ganz R. Anatomy of the medial femoral circumflex artery and its surgical
implications. J Bone Joint Surg Br 2000;82(5):679-83. https://doi.org/10.1302/0301-620x.82b5.10426
20. Ferreyra A, Allende V, Masquijo J, Allende G. Experiencia inicial con la luxación controlada de cadera. Rev Asoc
Argent Ortop Traumatol 2012;77(1):29-38. Disponible en:http://www.scielo.org.ar/scielo.php?pid=S1852-74342012000100004&script=sci_arttext
21. Hassan MM, Farooqi AS, Feroe AG, Lee A, Cusano A, Novais E, et al. Open and arthroscopic management of
femoroacetabular impingement: a review of current concepts. J Hip Preserv Surg 2022;9(4):265-75.
https://doi.org/10.1093/jhps/hnac043
22. Comba F, Quinteros CM, Martorell G, Buttaro MA, Zanotti G, Piccaluga F. Condromatosis sinovial de cadera.
Tratamiento artroscópico. Rev Asoc Argent Ortop Traumatol 2014;79:179-85. https://doi.org/10.15417/325