Liang Zhen Jonathan, Liu Yu, Danakkrisna Vachalam Rangasamie, Liau Zi Qiang Glen
Department of Orthopaedic Surgery, National University Hospital, Singapore.
Department of Orthopaedic Surgery, Alexandra Hospital, Singapore.
Arthroplast Today. 2025 Aug 13;35:101796. doi: 10.1016/j.artd.2025.101796. eCollection 2025 Oct.
Synovial chondromatosis is a rare benign condition characterized by the formation of cartilaginous nodules within the synovium of joints, bursae, or tendon sheaths. While nonsurgical management exists, surgical intervention is often necessary. This systematic review aims to evaluate surgical options for managing synovial chondromatosis of the knee and compare recurrence rates following each procedure.
Adhering to the Preferred Reporting Items of Systematic Review and Meta-Analysis guidelines, a literature search was conducted using PubMed, SCOPUS, and Embase, up to April 2025. Studies included detailed surgical interventions for primary synovial chondromatosis of the knee.
Thirty-seven studies met the inclusion criteria, comprising 30 case reports, 4 retrospective studies, and 3 case series, involving 120 patients (70 males, 49 females, 1 unspecified). Surgical techniques were categorized into open, arthroscopic, and combined approaches. Open approaches included arthrotomies without synovectomy, partial and total synovectomies, and total knee arthroplasty. Arthroscopic approaches involved washouts and synovectomies (partial and total). Combined approaches included staged surgeries with both open and arthroscopic techniques. Recurrence rates varied: open arthrotomy (0%; 1 and 20 year follow-up), arthroscopic synovectomy (5.71%; average follow-up duration 1.53 years), open synovectomy (12.5%; average follow-up 2.04 years), total knee arthroplasty (20.8% average follow-up 10.3 years), and arthroscopic washout (31.4%; average follow-up 6.56 years). Combined approaches reported no recurrences in 6 cases with average follow-up 1.44 years.
This systematic review highlights variability in recurrence across techniques. Arthroscopic synovectomy and combined approaches demonstrated the lowest recurrence; however, the choice of surgical method should be tailored to the individual patient's condition and the surgeon's expertise.
滑膜软骨瘤病是一种罕见的良性疾病，其特征是在关节、滑囊或腱鞘的滑膜内形成软骨结节。虽然存在非手术治疗方法，但手术干预通常是必要的。本系统评价旨在评估膝关节滑膜软骨瘤病的手术选择，并比较每种手术方法后的复发率。
遵循系统评价和Meta分析的首选报告项目指南，截至2025年4月，使用PubMed、SCOPUS和Embase进行文献检索。纳入的研究包括针对膝关节原发性滑膜软骨瘤病的详细手术干预。
37项研究符合纳入标准，包括30例病例报告、4项回顾性研究和3个病例系列，涉及120例患者（男性70例，女性49例，1例未指明性别）。手术技术分为开放手术、关节镜手术和联合手术。开放手术包括不进行滑膜切除的关节切开术、部分和全滑膜切除术以及全膝关节置换术。关节镜手术包括冲洗和滑膜切除术（部分和全滑膜切除术）。联合手术包括开放手术和关节镜技术分期手术。复发率各不相同：开放关节切开术（0%；1年和20年随访）、关节镜滑膜切除术（5.71%；平均随访时间1.53年）、开放滑膜切除术（12.5%；平均随访2.04年）、全膝关节置换术（20.8%，平均随访10.3年）和关节镜冲洗术（31.4%；平均随访6.56年）。联合手术在6例平均随访1.44年的病例中未报告复发。
本系统评价强调了不同技术复发率的差异。关节镜滑膜切除术和联合手术的复发率最低；然而，手术方法的选择应根据个体患者的情况和外科医生的专业知识进行调整。
