Disseminated synovial chondromatosis of the knee treated by open radical synovectomy using staged combined anterior and posterior approaches: a case report.

INTRODUCTION

Synovial chondromatosis is a rare, benign condition characterized by the formation of multiple cartilaginous nodules within the synovial membrane of joints. Despite its rarity, there remains significant uncertainty regarding its optimal management. Early diagnosis and appropriate surgical intervention are essential, yet the literature on best practices remains limited. The anterior compartment of the knee is mostly affected, and widespread illness is quite uncommon. In severe cases, the most effective surgical approach for severe cases is still debated. This report presents a rare case of knee synovial chondromatosis with extensive involvement of both anterior and posterior compartments, treated with a staged surgical approach.

CASE PRESENTATION

A 50-year-old Semitic male presented with a 15-year history of progressively worsening right knee pain and swelling. Physical examination revealed significant swelling, restricted range of motion, and a palpable mass in the anterior and posterior knee, prompting further imaging. Magnetic resonance imaging confirmed the presence of large loose bodies and extensive synovial hypertrophy, leading to the decision for surgical intervention. The patient underwent a staged open radical synovectomy, first targeting the anterior compartment followed by the posterior compartment. Two large loose bodies were removed, and histopathology confirmed synovial chondromatosis with synovial papillary hyperplasia. The patient responded well postoperatively, with improved range of motion following physiotherapy.

CONCLUSION

Generalized synovial chondromatosis of the knee is a rare but significant condition that requires early diagnosis and surgical intervention to prevent joint degeneration. A staged anterior and posterior synovectomy provides effective management of the disease with good clinical outcomes and reduced risk of recurrence.