Raval Pradyumna, Vijayan Ashish, Jariwala Arpit
Department of Orthopaedic and Trauma Surgery, Tayside Orthopaedic Rehabilitation Technology Centre, Ninewells Hospital and Medical School, University of Dundee,, Dundee, UK.
Department of Orthopaedics, Ninewells Hospital and Medical School, Dundee, UK.
Orthop Surg. 2016 Nov;8(4):511-515. doi: 10.1111/os.12294.
Synovial chondromatosis is a rare and benign condition of unknown cause. It is also known as synovial osteochondromatosis. It is characterized by involvement of the synovial tissue, which lines various joints of our body. Initial symptoms range from pain in the joint, locking of the joint at times, especially the knee, to arthritis of the joint that is a late feature of this condition. Although large joints such as the knee are commonly affected, involvement of the shoulder joint is a rare occurrence. Historically an open arthrotomy was preferred for removal of loose bodies coupled with a thorough synovectomy. However, arthroscopy for loose body retrieval has gained popularity over the past two decades. Arthroscopic surgery is an extremely skilled procedure and there is a learning curve for operating in certain anatomical areas such as the shoulder. However, not only does an arthroscopy provide the surgeon with an excellent view of the shoulder but the patient also has a faster recovery. We report a rare case of shoulder synovial chondromatosis in which more than 100 loose bodies were successfully retrieved by an arthroscopy in an individual who had an excellent outcome post-surgery, reaffirming our faith in the procedure. A detailed literature review of arthroscopic procedures is also presented.
滑膜软骨瘤病是一种病因不明的罕见良性疾病。它也被称为滑膜骨软骨瘤病。其特征是滑膜组织受累，滑膜组织衬于人体的各个关节。初始症状包括关节疼痛、关节有时卡顿（尤其是膝关节），以及作为该疾病晚期特征的关节炎。虽然膝关节等大关节通常会受到影响，但肩关节受累的情况很少见。过去，开放式关节切开术是首选的去除游离体的方法，并结合彻底的滑膜切除术。然而，在过去二十年中，关节镜下取出游离体越来越受欢迎。关节镜手术是一项技术要求极高的手术，在某些解剖区域（如肩部）进行手术存在学习曲线。然而，关节镜检查不仅能为外科医生提供肩部的清晰视野，而且患者恢复得也更快。我们报告了一例罕见的肩部滑膜软骨瘤病病例，通过关节镜成功取出了100多个游离体，该患者术后效果良好，这再次坚定了我们对该手术的信心。本文还对关节镜手术进行了详细的文献综述。
