Surgical outcomes of synovial osteochondromatosis: An evaluation of 15 cases

INTRODUCTION: In this study, we evaluated 13 patients who were treated and followed-up for synovial chondromatosis in our clinic.
METHODS: Fifteen patients (9 males, 6 females,; mean age 43 years; range 16 to 72 years) had synovial chondromatosis localized in the knee (n=6), shoulder (n=3), hip (n=2), elbow (n=2), and ankle (n=2). Joint loose bodies were removed together with total synovectomy by open surgery in thirteen patients. Histopathologic confirmation was obtained in all the patients. Two patients refused surgical treatment and were treated conservatively. The mean follow-up period was 71 months (range 12 to 204 month).
RESULTS: One patient developed recurrence sixteen months after surgery, for which repeat total synovectomy was performed in the shoulder and no other recurrences were observed. No malignant transformation was observed in any patient. Symptomatic improvement was obtained in all the patients with treated surgically. Pain and limitation of motion were observed in the patients who were followed up conservatively.
DISCUSSION AND CONCLUSION: As a result of our study, it was found that the knee joint was the most commonly involved joint and there was no gender difference in terms of incidence. All patients must be followed-up with regard to recurrence. Further studies are needed on the efficacy of physical therapy in synovial chondromatosis in patients without surgical treatment. Patients often present with non-specific clinical symptoms. Therefore, synovial osteochondromatosis should be kept in mind in patients presenting with pain and swelling.

Sinovyal osteokondromatoziste cerrahi sonuçlarýmýz: 15 olgunun deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Bu çalýþmada sinovyal osteokondromatozis nedeniyle kliniðimizde takip ve tedavisi yapýlan 15 hasta deðerlendirilmiþtir.
YÖNTEM ve GEREÇLER: Sinovyal osteokondromatozisli 15 hastanýn (9 erkek, 6 kadýn; ort. yaþ 43; daðýlým 16-72 yaþ), tutulum yerleri sýklýk sýrasýna göre diz (n=6), omuz (n=3), kalça (n=2), dirsek (n=2) ve ayak bileði (n=2) idi. On üç hastaya açýk cerrahi ile total sinovyektomi ve serbest fragman eksizyonu uygulandý. Tanýlar bütün hastalarda histopatolojik olarak doðrulandý. Ýki hasta operasyonu kabul etmedi ve konservatif tedaviye alýndý. Ortalama takip süresi 71 aydý. (daðýlým 12-204 ay).
BULGULAR: On üç hastanýn birinde on altý ay sonra nüks görüldü. Hastaya yeniden total sinovyektomi yapýldý ve sonraki takiplerinde ikinci bir nükse rastlanmadý. Hiçbir hastada malign transformasyon gözlenmedi. Cerrahi sonrasý hastalarýn aðrý þikayetlerinde belirgin düzelme gözlendi. Konservatif tedavi ile takip edilen hastalarda aðrý ve hareket kýsýtlýlýðýnýn devam ettiði görüldü.
TARTIÞMA ve SONUÇ: Çalýþmamýzýn sonucunda diz ekleminin en sýk tutulan eklem olduðu ve görülme sýklýðý açýsýndan cinsiyet farkýnýn olmadýðý görüldü. Hastalarýn cerrahi sonrasý nüks açýsýndan takip edilmesi gerekmektedir. Cerrahi tedavi uygulanamayan hastalarda fizik tedavinin sinoviyal kondromatoziste etkinliði ile ilgili daha fazla çalýþmaya ihtiyaç vardýr. Olgular sýklýkla spesifik olmayan klinik semptomlarla baþvurduðundan aðrý ve þiþlik ile baþvuran hastalarda sinovyal osteokondromatozisin mutlaka akýlda tutulmasý gerekmektedir.