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Abstract presented at the Annual Scientific Meeting of the International Society for Hip Arthroscopy| Volume 28, ISSUE 6, SUPPLEMENT 2, e67-e68, June 2012

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Paper 41: Hip Arthroscopy for the Diagnosis and Treatment of Synovial Chondromatosis of the Hip

      Summary

      This study aims to evaluate the use of arthroscopy in the diagnosis and treatment of hip synovial chondromatosis.

      Data

      Introduction

      This study aims to evaluate the use of arthroscopy in the diagnosis and treatment of hip synovial chondromatosis.

      Materials and Methods

      Twenty-nine patients with hip synovial chondromatosis treated with arthroscopy between 1993 and 2006 were reviewed retrospectively. The mean age was 40.6 years. The mean duration of symptoms at arthroscopy was 52 months. All patients complained of pain and 62.5% had mechanical symptoms. There was limited ROM in 57.7% and a limp in 27.6% of patients. Twenty three patients had a minimum follow up of 12 months or had a second procedure within 12 months.

      Results

      Synovial chondromatosis was detected in 62% of patients' imaging studies but was seen at arthroscopy in all patients. Other findings include labral changes in 77.8%, femoral head changes in 82.7%, and acetabular changes in 88% of patients. Six patients had another arthroscopy at an average of 48 months with one requiring an arthrotomy 5 months later. Two of the six patients had a grade 3 cartilage lesion at the index procedure. One patient with a grade 3 lesion at the initial arthroscopy required an arthrotomy 14 months later. Five patients required a total hip replacement at an average of 52.4 months. Four of the five patients had a Grade 3 or 4 cartilage lesion at the initial surgery. Fifty percent of patients were doing well at an average of 64.2 months requiring no additional treatment. Only one of the 11 patients had a cartilage lesion of at least grade 3.

      Conclusion

      Radiographs,including MRI, are not sensitive enough to detect all cases of synovial chondromatosis especially if the loose bodies are not ossified. In addition, there are more extensive articular changes and more loose bodies seen intraoperatively than radiographically. The study also suggests that outcome is influenced by the extent of articular changes and ongoing synovial activity of the disease.