Leung Odin Tymon, Lui Tun Hing
Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR, China.
Arthrosc Tech. 2023 Jun 5;12(7):e1057-e1063. doi: 10.1016/j.eats.2023.02.023. eCollection 2023 Jul.
Synovial osteochondromatosis is a benign process that most commonly affects the knee joint (70%). It is characterized by proliferative metaplasia of synovial membrane into chondrocytes, resulting in the formation of multiple cartilaginous nodules, which can detach from the synovium to become multiple intra-articular loose bodies. It usually involves the anterior compartment, including infrapatellar fat pad, suprapatellar pouch, and anterior interval, and rarely involves the posterior compartment of the knee. Treatment for synovial osteochondromatosis usually involves surgery, especially in the presence of locking symptoms or decreased range of motion. Arthroscopy has gradually replaced a traditional open approach, resulting in low morbidity, low postoperative pain, better cosmetic results, early recovery of range of motion, short rehabilitation course, and an early return to previous function. In case of involvement of the posterior compartment of the knee joint, arthroscopic access may be difficult. In this Technical Note, the technical details of arthroscopic synovectomy and removal of loose bodies in synovial osteochondromatosis of the knee is described. This arthroscopic technique can deal with the disease, involving both the anterior and posterior compartments of the knee joint.
滑膜骨软骨瘤病是一种良性病变,最常累及膝关节(70%)。其特征是滑膜增生化生为软骨细胞,导致形成多个软骨结节,这些结节可从滑膜脱落成为多个关节内游离体。它通常累及前侧间室,包括髌下脂肪垫、髌上囊和前间隙,很少累及膝关节后侧间室。滑膜骨软骨瘤病的治疗通常需要手术,尤其是出现交锁症状或活动范围减小时。关节镜检查已逐渐取代传统的开放手术方法,具有发病率低、术后疼痛轻、美容效果好、活动范围恢复早、康复疗程短以及能早期恢复至先前功能等优点。如果膝关节后侧间室受累,关节镜检查可能会有困难。在本技术说明中,描述了膝关节滑膜骨软骨瘤病关节镜下滑膜切除术及游离体摘除术的技术细节。这种关节镜技术可以处理累及膝关节前侧和后侧间室的疾病。