Disseminated Knee Synovial Chondromatosis treated by Arthroscopy and combined Anterior and Posterior Approaches

Abstract

Synovial Chondromatosis (also called Synovial Osteochondromatosis) is a rare benign joint disease caused by synovial cartilage metaplasia, the etiology remains unknown and the disease is characterized by the formation of cartilaginous nodules in the synovium. Calcification or ossification can occur at a late stage of the disease. A 48-year-old Chinese woman presented to out-patient department complaining of recurrent and progressively worsening right knee pain, swelling and stiffness after a minor contusion 4 years ago. She underwent careful preoperative imaging and planning followed by a two-stage arthroscopic and open surgery (combined anterior and posterior approaches). Histopathological examination of the specimens confirmed our suspected diagnosis of Synovial Chondromatosis. 15 months after surgery, she has regained full range of movement, but continues to experience residual insidious knee pain when standing for a long time. Synovial chondromatosis is a rare proliferative disorder that causes pain, swelling, and restriction of movement to the joints it affects. It low incidence rate and differential diagnosis makes it sometimes difficult to diagnose, reason why adequate radiology imaging and arthroscopic exploration are decisive for the diagnosis. Surgical lavage and excision have proven to be the reasonable and preferable course of treatment of synovial chondromatosis.