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Synovial Disorders of the Hip

Hip Arthroscopy and Hip Joint Preservation Surgery

Abstract

The hip is a synovial joint which links the axial skeleton to that of the lower extremity by the articulation of the femur and acetabulum. The tissue of the synovium which lines the joint has the important role of regulation of synovial fluid production but also can be a source of significant but rare pathology. These disorders include synovial chondromatosis and pigmented villonodular synovitis (PVNS). Synovial chondromatosis will typically present with monoarticular pain and stiffness with mechanical complaints of locking and catching during the third to fifth decade of life due to the generation of loose bodies. Pigmented villonodular synovitis is another benign proliferative disorder of the synovium. While the lesion is benign, it can be locally aggressive and cause the destruction of both intra- and extra-articular structures in the third and fourth decades of life. Both disorders are treated with arthroscopic or open debridement with synovectomy. Synovial disorders of the hip are fortunately very rare but can be devastating. Surgical treatment, when undertaken in a timely fashion, can be effective at preserving hip function.

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References

  1. Iwanaga T, et al. Morphology and functional roles of synoviocytes in the joint. Arch Histol Cytol. 2000;63(1):17–31.

    Article  CAS  PubMed  Google Scholar 

  2. Barland P, Novikoff AB, Hamerman D. Electron microscopy of the human synovial membrane. J Cell Biol. 1962;14:207–20.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Maurice H, Crone M, Watt I. Synovial chondromatosis. J Bone Joint Surg Br. 1988;70(5):807–11.

    CAS  PubMed  Google Scholar 

  4. Apte SS, Athanasou NA. An immunohistological study of cartilage and synovium in primary synovial chondromatosis. J Pathol. 1992;166(3):277–81.

    Article  CAS  PubMed  Google Scholar 

  5. Buddingh EP, et al. Chromosome 6 abnormalities are recurrent in synovial chondromatosis. Cancer Genet Cytogenet. 2003;140(1):18–22.

    Article  CAS  PubMed  Google Scholar 

  6. Davis RI, et al. Cell proliferation studies in primary synovial chondromatosis. J Pathol. 1998;184(1):18–23.

    Article  CAS  PubMed  Google Scholar 

  7. Villacin AB, Brigham LN, Bullough PG. Primary and secondary synovial chondrometaplasia: histopathologic and clinicoradiologic differences. Hum Pathol. 1979;10(4):439–51.

    Article  CAS  PubMed  Google Scholar 

  8. Milgram JW. Synovial osteochondromatosis: a histopathological study of thirty cases. J Bone Joint Surg Am. 1977;59(6):792–801.

    CAS  PubMed  Google Scholar 

  9. Murphy FD, Dahlin DC, Sullivan CR. Articular synovial chondromatosis. J Bone Joint Surg. 1962;44(1):77–86.

    Google Scholar 

  10. Kramer J, et al. MR appearance of idiopathic synovial osteochondromatosis. J Comput Assist Tomogr. 1993;17(5):772–6.

    Article  CAS  PubMed  Google Scholar 

  11. Ogilvie-Harris DJ, Saleh K. Generalized synovial chondromatosis of the knee: a comparison of removal of the loose bodies alone with arthroscopic synovectomy. Arthroscopy. 1994;10(2):166–70.

    Article  CAS  PubMed  Google Scholar 

  12. Schoeniger R, et al. Modified complete synovectomy prevents recurrence in synovial chondromatosis of the hip. Clin Orthop Relat Res. 2006;451:195–200.

    Article  PubMed  Google Scholar 

  13. Gilbert SR, Lachiewicz PF. Primary synovial osteochondromatosis of the hip: report of two cases with long-term follow-up after synovectomy and a review of the literature. Am J Orthop (Belle Mead NJ). 1997;26(8):555–60.

    CAS  Google Scholar 

  14. Coles MJ, Tara Jr HH. Synovial chondromatosis: a case study and brief review. Am J Orthop (Belle Mead NJ). 1997;26(1):37–40.

    CAS  Google Scholar 

  15. Lim SJ, et al. Operative treatment of primary synovial osteochondromatosis of the hip. J Bone Joint Surg Am. 2006;88(11):2456–64.

    Article  PubMed  Google Scholar 

  16. Boyer T, Dorfmann H. Arthroscopy in primary synovial chondromatosis of the hip: description and outcome of treatment. J Bone Joint Surg Br. 2008;90(3):314–8.

    Article  CAS  PubMed  Google Scholar 

  17. Witwity T, Uhlmann RD, Fischer J. Arthroscopic management of chondromatosis of the hip joint. Arthroscopy. 1988;4(1):55–6.

    Article  CAS  PubMed  Google Scholar 

  18. Krebs VE. The role of hip arthroscopy in the treatment of synovial disorders and loose bodies. Clin Orthop Relat Res. 2003;406:48–59.

    Article  PubMed  Google Scholar 

  19. Lee JB, et al. Arthroscopic treatment of synovial chondromatosis of the hip. Am J Sports Med. 2012;40(6):1412–8.

    Article  PubMed  Google Scholar 

  20. Hardacker J, Mindell ER. Synovial chondromatosis with secondary subluxation of the hip. A case report. J Bone Joint Surg Am. 1991;73(9):1405–7.

    CAS  PubMed  Google Scholar 

  21. Sakellariou A, Johnstone DJ, Pringle JA. Synovial chondromatosis presenting as a pathological fracture of the femoral neck in an 89-year-old woman–a case report. Acta Orthop Scand. 1998;69(6):640–1.

    Article  CAS  PubMed  Google Scholar 

  22. Campanacci DA, et al. Synovial chondrosarcoma of the hip: report of two cases and literature review. Chir Organi Mov. 2008;92(3):139–44.

    Article  PubMed  Google Scholar 

  23. Ackerman D, et al. Results of total hip and total knee arthroplasties in patients with synovial chondromatosis. J Arthroplasty. 2008;23(3):395–400.

    Article  PubMed  Google Scholar 

  24. Ligato A, Nelson S, Bengs BC. Hip resurfacing as treatment for synovial chondromatosis. Orthopedics. 2010;33(3).

    Google Scholar 

  25. Jaffe HL, Lichtenstein L, Sutro CJ. Pigmented villonodular synovitis, bursitis and tenosynovitis: a discussion of the synovial and bursal equivalents of the tenosynovial lesion commonly denoted as xanthoma, xanthogranuloma, giant cell tumor, or myeloplaxoma of the tendon sheath, with some considerations of this tendon sheath lesion itself. Arch Pathol. 1941;31:731–65.

    Google Scholar 

  26. Ma X, et al. Pigmented villonodular synovitis: a retrospective study of seventy five cases (eighty one joints). Int Orthop. 2013;37(6):1165–70.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Choong PF, et al. Pigmented villonodular synovitis. Monoclonality and metastasis–a case for neoplastic origin? Acta Orthop Scand. 1995;66(1):64–8.

    Article  CAS  PubMed  Google Scholar 

  28. Sciot R, et al. Analysis of 35 cases of localized and diffuse tenosynovial giant cell tumor: a report from the Chromosomes and Morphology (CHAMP) study group. Mod Pathol. 1999;12(6):576–9.

    CAS  PubMed  Google Scholar 

  29. Abdul-Karim FW, et al. Diffuse and localized tenosynovial giant cell tumor and pigmented villonodular synovitis: a clinicopathologic and flow cytometric DNA analysis. Hum Pathol. 1992;23(7):729–35.

    Article  CAS  PubMed  Google Scholar 

  30. Mankin H, Trahan C, Hornicek F. Pigmented villonodular synovitis of joints. J Surg Oncol. 2011;103(5):386–9.

    Article  PubMed  Google Scholar 

  31. Masih S, Antebi A. Imaging of pigmented villonodular synovitis. Semin Musculoskelet Radiol. 2003;7(3):205–16.

    Article  PubMed  Google Scholar 

  32. Dorwart RH, et al. Pigmented villonodular synovitis of synovial joints: clinical, pathologic, and radiologic features. AJR Am J Roentgenol. 1984;143(4):877–85.

    Article  CAS  PubMed  Google Scholar 

  33. Steinbach LS, et al. MRI of the knee in diffuse pigmented villonodular synovitis. Clin Imaging. 1989;13(4):305–16.

    Article  CAS  PubMed  Google Scholar 

  34. Amber IB, Clark BJ, Greene GS. Pigmented villonodular synovitis: dedicated PET imaging findings. BMJ Case Rep. 2013

    Google Scholar 

  35. Vastel L, et al. Surgical treatment of pigmented villonodular synovitis of the hip. J Bone Joint Surg Am. 2005;87(5):1019–24.

    Article  PubMed  Google Scholar 

  36. Chin KR, et al. Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee. J Bone Joint Surg Am. 2002;84-A(12):2192–202.

    PubMed  Google Scholar 

  37. Shabat S, et al. The use of surgery and yttrium 90 in the management of extensive and diffuse pigmented villonodular synovitis of large joints. Rheumatology (Oxford). 2002;41(10):1113–8.

    Article  CAS  Google Scholar 

  38. O’Sullivan B, et al. Outcome following radiation treatment for high-risk pigmented villonodular synovitis. Int J Radiat Oncol Biol Phys. 1995;32(3):777–86.

    Article  PubMed  Google Scholar 

  39. Gonzalez Della Valle A, et al. Pigmented villonodular synovitis of the hip: 2- to 23-year followup study. Clin Orthop Relat Res. 2001;388:187–99.

    Article  PubMed  Google Scholar 

  40. Hoberg M, Amstutz HC. Metal-on-metal hip resurfacing in patients with pigmented villonodular synovitis: a report of two cases. Orthopedics. 2010;33(1):50.

    Article  PubMed  Google Scholar 

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Correspondence to Brian McGrath M.D. .

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McGrath, B., Kuechle, J. (2014). Synovial Disorders of the Hip. In: Nho, S., Leunig, M., Kelly, B., Bedi, A., Larson, C. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7321-3_107-1

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  • DOI: https://doi.org/10.1007/978-1-4614-7321-3_107-1

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  • Publisher Name: Springer, New York, NY

  • Online ISBN: 978-1-4614-7321-3

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Chapter history

  1. Latest

    Synovial Disorders of the Hip
    Published:
    31 August 2021

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_107-2

  2. Original

    Synovial Disorders of the Hip
    Published:
    05 June 2014

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_107-1