Purpose: The purpose of this study was to investigate the clinical and arthroscopic findings
of osteoarthritis (OA) of the knee with localized synovial hypertrophy in the anteromedial
compartment and the clinical results of arthroscopic partial synovectomy. Type of Study: Retrospective case series. Methods: We treated 19 osteoarthritic knees with localized synovial hypertrophy in 19 patients
by arthroscopic partial synovectomy under local anesthesia. All patients had complained
of knee pain (mechanical type pain) and catching sensations preoperatively. Preoperative
diagnosis based on physical findings and imaging studies was a medial meniscus tear
with medial OA in all patients. The mean follow-up was 37 months (range, 28 to 46
months). Clinical results were assessed with the Hospital for Special Surgery (HSS)
scoring scale, overall subjective estimation, and patient satisfaction. Results: The catching sensation resolved immediately after surgery in all patients. The mean
HSS score improved from 56.8 to 72.4 points (P < .01). Nine patients (47.4%) were rated excellent or good according to the overall
subjective estimation, and 11 patients (57.9%) were satisfied with the treatment.
Both HSS score and patient satisfaction were higher in patients (10 patients) who
complained of intraoperative pain during synovectomy than in those (9 patients) who
hardly felt the pain. Conclusions: Localized synovial hypertrophy in the anteromedial compartment of OA knees occasionally
caused symptoms of pain and catching sensations that resembled meniscal symptoms.
Arthroscopic partial synovectomy was effective, especially for those who complained
of intraoperative pain during synovectomy under local anesthesia. Level of Evidence: Level IV.
Key Words
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© 2005 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
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- Meniscal Impingement Syndrome Versus Localized Synovial Hypertrophy?ArthroscopyVol. 22Issue 12
- PreviewIn the article by Ikeuchi et al.1 entitled “Localized Synovial Hypertrophy in the Anteromedial Compartment of the Osteoarthritic Knee,” we recognized similarities in their Figs 1A and 1B, arthroscopic views of localized synovial hypertrophy in the anteromedial compartment with accompanying “degenerated cartilage of the medial femoral condyle,” to content in our article published nearly 10 years before, entitled “Meniscal Impingement Syndrome.”2 Unlike the patients in the study of Chow et al.,3 where 20 of 21 patients (95%) had a history of injury before the onset of symptoms, in the patient cohort of Ikeuchi et al., only 5 of 19 (26%) had injury-related symptoms.
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