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Abstract presented at the Annual Scientific Meeting of the International Society for Hip Arthroscopy| Volume 28, ISSUE 6, SUPPLEMENT 2, e52, June 2012

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Paper 16: Arthroscopic Management of Pigmented Villonodular Synovitis in the Hip

      Summary

      This is the first clinical case series to report on the role of primary synovectomy for a synovial-based disorder in the hip. Arthroscopy has diagnostic and therapeutic utility, producing acceptable results with minimal morbidity.

      Data

      Introduction

      Synovial disease is a well-recognized indication for arthroscopy, and arthroscopic surgery of the hip is a well-accepted technique, yet there are few publications on arthroscopic management of synovial disease in the hip. The purpose of this study is to report the results of prospectively collected data on arthroscopic synovectomy for pigmented villonodular synovitis (PVNS) in the hip.

      Methods

      All patients undergoing hip arthroscopy are prospectively assessed with a modified Harris hip score preop and postop at 3, 12, 24, 60 and 120 months. Fourteen patients were identified with histologically confirmed PVNS and minimum one-year follow-up. This cohort represents the substance of this report.

      Results

      There was 100% follow-up at an average of 32 months (range 12-60 months.) All patients improved with an average of 28 points (preop 60; postop 88) which was statistically significant (p<0.001). There were no complications. The average age was 27 years (range 14-46 years) with nine females and four males. The disease pattern was nodular in seven cases, diffuse in five and combined in two. Ten cases had other associated intraarticular pathology including labral tears (7), chondral damage (7), loose fragments (3), impingement (3) and disrupted ligamentum teres (1).

      Discussion

      Although synovial disease is mentioned as an indication for hip arthroscopy, the only published series are for loose body removal associated with synovial chondromatosis. This is the first clinical case series to report on the role of primary synovectomy for a synovial-based disorder in the hip. Arthroscopy has diagnostic and therapeutic utility, producing acceptable results with minimal morbidity.