Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic Review

Background: 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 surg...

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Main Authors: Zhen Jonathan Liang, MBBS (Hons), Yu Liu, MBBS, Vachalam Rangasamie Danakkrisna, MBBS, Zi Qiang Glen Liau, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), FAMS (Ortho), MBA
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:Arthroplasty Today
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352344125001839
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author Zhen Jonathan Liang, MBBS (Hons)
Yu Liu, MBBS
Vachalam Rangasamie Danakkrisna, MBBS
Zi Qiang Glen Liau, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), FAMS (Ortho), MBA
author_facet Zhen Jonathan Liang, MBBS (Hons)
Yu Liu, MBBS
Vachalam Rangasamie Danakkrisna, MBBS
Zi Qiang Glen Liau, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), FAMS (Ortho), MBA
author_sort Zhen Jonathan Liang, MBBS (Hons)
collection DOAJ
description Background: 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. Methods: 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. Results: 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. Conclusions: 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.
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spelling doaj-art-7bc83cd72c0f4e2a8c29993e23ce77132025-08-20T04:01:57ZengElsevierArthroplasty Today2352-34412025-10-013510179610.1016/j.artd.2025.101796Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic ReviewZhen Jonathan Liang, MBBS (Hons)0Yu Liu, MBBS1Vachalam Rangasamie Danakkrisna, MBBS2Zi Qiang Glen Liau, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), FAMS (Ortho), MBA3Department of Orthopaedic Surgery, National University Hospital, Singapore; Corresponding author. 5 Lower Kent Ridge Rd, Singapore 119074. Tel.: +65 9102 0777.Department of Orthopaedic Surgery, Alexandra Hospital, SingaporeDepartment of Orthopaedic Surgery, Alexandra Hospital, SingaporeDepartment of Orthopaedic Surgery, National University Hospital, Singapore; Department of Orthopaedic Surgery, Alexandra Hospital, SingaporeBackground: 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. Methods: 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. Results: 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. Conclusions: 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.http://www.sciencedirect.com/science/article/pii/S2352344125001839Synovial ChondromatosisKneeArthroscopyTotal knee arthroplastySynovectomy
spellingShingle Zhen Jonathan Liang, MBBS (Hons)
Yu Liu, MBBS
Vachalam Rangasamie Danakkrisna, MBBS
Zi Qiang Glen Liau, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), FAMS (Ortho), MBA
Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic Review
Arthroplasty Today
Synovial Chondromatosis
Knee
Arthroscopy
Total knee arthroplasty
Synovectomy
title Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic Review
title_full Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic Review
title_fullStr Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic Review
title_full_unstemmed Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic Review
title_short Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic Review
title_sort surgical options for primary synovial chondromatosis of the knee a systematic review
topic Synovial Chondromatosis
Knee
Arthroscopy
Total knee arthroplasty
Synovectomy
url http://www.sciencedirect.com/science/article/pii/S2352344125001839
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