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Bai Z, Zhou H, Zhang C, Chen C. Arthroscopic Treatment of Atypical Synovial Osteochondromatosis of Infrapatellar Fat Pad: A 4-Year Follow-up Case Report and Literature Review. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2022; 7:60-63. [DOI: 10.14218/erhm.2021.00035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kawakami Y, Hara H, Kawamoto T, Niikura T, Kuroda R, Akisue T. Extraskeletal Para-articular Osteochondroma of the Ankle Joint in a Child: A Case Report. JBJS Case Connect 2020; 10:e0274. [PMID: 32649094 DOI: 10.2106/jbjs.cc.19.00274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We present a rare case of extraskeletal para-articular osteochondroma (ESPAOC) in the ankle of a 9-year-old boy, which was causing pain and limiting the range of motion of the ankle joint. The lesion might have also contributed to the deformity of the medial aspect of the talus. Total resection resolved all of the symptoms, with no recurrence at 1-year postoperatively. CONCLUSION Operative excision should be considered when ESPAOC directly restricts ankle motion because it can lead to chronic pain and joint degeneration if left untreated.
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Affiliation(s)
- Yohei Kawakami
- 1Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan 2Division of Orthopaedic Surgery, Kobe University International Clinical Cancer Research Center, Kobe, Japan 3Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Hashimoto K, Nishimura S, Yamagishi K, Tsukamoto I, Nakagawa K, Inoue S, Asada S, Kakinoki R, Akagi M. Extra-articular synovial osteochondroma of the Hoffa's fat pad involving the patellar tendon: A case report and literature review. Mol Clin Oncol 2020; 12:355-357. [PMID: 32190319 PMCID: PMC7057915 DOI: 10.3892/mco.2020.1998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 02/04/2020] [Indexed: 11/08/2022] Open
Abstract
Synovial osteochondroma (SO) is a relatively uncommon tumor affecting the synovial joints that is characterized by the development of hyaline cartilage from the synovial membrane. The basic pathophysiology of SO is thought to be the metaplastic change of the synovium to hyaline cartilage. Large extra- or para-articular lesions in the Hoffa's fat pad are relatively uncommon. A 56-year-old woman complained of knee pain associated with a large lesion on the anterior of the right knee. She also had restricted range of motion in the knee. Examination revealed an elastic hard 8x9-cm lesion involving the patellar tendon. Computed tomography and magnetic resonance imaging demonstrated a mosaic-intensity mass lesion in the inferior side of the Hoffa's fat pad as well as the patellar tendon. The patient underwent needle biopsy. Histological analysis revealed a solitary SO. There were no atypical features suggestive of malignancy and the mass was resected marginally. The patient had no recurrence or knee functional disorder 3 years postoperatively. There are no reports of SO involving the patellar tendon with restriction of range of motion. Removal of the mass lesion for management for SO, as in the present case, is unusual. To the best of our knowledge, this is the first case of extra-articular SO in the Hoffa's fat pad involving the patellar tendon causing a restriction of range of motion of the knee. Marginal surgical resection improved knee function.
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Affiliation(s)
- Kazuhiko Hashimoto
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Shunji Nishimura
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Koutaro Yamagishi
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Ichiro Tsukamoto
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Koichi Nakagawa
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Shinji Inoue
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Shigeki Asada
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Ryosuke Kakinoki
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
| | - Masao Akagi
- Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama, Osaka 589-8511, Japan
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Temponi EF, Mortati RB, Mortati GMH, Mortati LB, Sonnery-Cottet B, de Carvalho Júnior LH. Synovial Chondromatosis of the Knee in a 2-Year-Old Child: A Case Report and Review of the Literature. JBJS Case Connect 2018; 6:e71. [PMID: 29252648 DOI: 10.2106/jbjs.cc.15.00284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We describe a rare case of synovial chondromatosis of the knee of a 2-year-old child. The diagnosis was based on the history, physical examination, and complementary examinations (radiography and magnetic resonance imaging). Anterior and posterior approaches were used for total synovectomy and resection of loose bodies. CONCLUSION Physicians should keep this condition in mind, even in young children, because early identification prevents future secondary degenerative changes in the knee joint. As far as we know, this is the youngest child with synovial chondromatosis of the knee reported in the English-language literature.
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Affiliation(s)
| | - Rafael Borghi Mortati
- Hospital Regional de Caridade Nossa Senhora Aparecida, União da Vitória, Paraná, Brazil
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Lee DH, Jeong TW. Uncommon Primary Synovial Chondromatosis Involving Only the Infrapatellar Fat Pad in an Elderly Patient. Knee Surg Relat Res 2016; 28:79-82. [PMID: 26955617 PMCID: PMC4779810 DOI: 10.5792/ksrr.2016.28.1.79] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 03/20/2015] [Accepted: 05/11/2015] [Indexed: 11/03/2022] Open
Abstract
Primary synovial chondromatosis is a rare condition of idiopathic synovial chondrometaplasia and usually occurs during the third to fifth decades of life. Conversely, secondary synovial chondromatosis results from the growth of separated particles from articular cartilage or osteophytes in patients with joint diseases, such as degenerative osteoarthritis, and occurs mostly in elderly people. We describe here a 76-year-old male histopathologically confirmed as having primary synovial chondromatosis with no calcification of the infrapatellar fat pad (IFP) of the knee joint. To our knowledge, this is the first description of primary synovial chondromatosis of the knee joint confined to the IFP in a patient >60 years old.
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Affiliation(s)
- Dae-Hee Lee
- Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae-Wan Jeong
- Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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The surgical treatment of anterior knee pain due to infrapatellar fat pad pathology: A systematic review. Orthop Traumatol Surg Res 2015; 101:469-75. [PMID: 25935799 DOI: 10.1016/j.otsr.2015.01.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 01/13/2015] [Accepted: 01/27/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Anterior knee pain (AKP) encompasses a range of pathologies. As a result, there are a number of therapeutic options used to treat AKP. The non-operative treatments have been analysed in a number of randomised controlled trials and systematic reviews. There is however a scarcity of such publications covering the surgical management of AKP. There are no systematic reviews that have investigated surgical interventions for AKP due to pathology of the infrapatellar fat pad (IFP). The aims of this study were to review the literature systematically, to establish which surgical procedures have been used to treat IFP disease and to determine their efficacy. METHODS The review was conducted in accordance with the PRISMA reporting guidelines. A search of the literature was performed on 1st January 2014 using multiple databases including CENTRAL, MEDLINE, EMBASE, PubMed, and Google Scholar. The quality of the studies was assessed using Oxford Evidence-Based Medicine Levels of Evidence guidelines and the GRADE approach. RESULTS Twenty-four eligible studies were found and included. The critical appraisal identified that the current evidence-base has low methodology quality. The clinical findings indicated that there is a positive trend towards the surgical management of IFP disease for AKP symptoms. Excision of IFP tumours and resection of the IFP in Hoffa's disease can lead to improvements in symptoms and function. CONCLUSIONS Truly robust evidence to support the surgical management of IFP pathology requires randomised controlled trials; however the expenses involved to design such trials means that they are unlikely to be undertaken for this uncommon disorder. Consequently well-designed and well-reported case series need to be undertaken to improve our current understanding that includes recording quantitative measures such as range of knee motion, VAS Pain scores and a validated scoring system.
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Intra-articular giant synovial osteochondroma: case reports of the ankle and knee joint. Case Rep Orthop 2015; 2015:320139. [PMID: 25785214 PMCID: PMC4345263 DOI: 10.1155/2015/320139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 02/01/2015] [Accepted: 02/05/2015] [Indexed: 11/24/2022] Open
Abstract
Two cases of giant intra-articular osteochondromas (knee and ankle joint) are reported; pathologically they are rare representations of synovial chondromatosis. A 17-year-old man presented with a tumorous mass which had been localized in his left ankle for many years, increasing in volume during the last months. The lesion was removed by posteromedial ankle arthrotomy. The second case was observed in a 39-year-old woman with a slow-growing mass in her right knee joint. The lesion was removed from the Hoffa fat pad by open anteromedial arthrotomy.
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Singh S, Neelakandan K, Sood C, Krishnan J. Disseminated synovial chondromatosis of the knee treated by open radical synovectomy using combined anterior and posterior approaches. J Clin Orthop Trauma 2014; 5:157-60. [PMID: 25983490 PMCID: PMC4223814 DOI: 10.1016/j.jcot.2014.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 07/21/2014] [Indexed: 11/20/2022] Open
Abstract
Synovial chondromatosis of the knee is a rare benign neoplasm of the synovium. Likewise, uncertainty on management still prevails. Though rare, it nevertheless warrants greater emphasis than it receives in the literature to allow correct diagnosis and accurate early surgical intervention. It predominantly involves the anterior compartment of the knee and disseminated disease is extremely rare. The optimal approach for surgical treatment of such an extensive synovial chondromatosis of knee remains unclear. Herein, we describe a case of extensive generalized synovial chondromatosis of the knee extending into the Baker's cyst in a 30 years old female. A diagnosis of synovial chondromatosis was made by clinical evaluation and MR imaging and confirmed by histopathological examination. Patient was successfully treated by open radical synovectomy of knee using both anterior and posterior approaches in a single step procedure.
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Affiliation(s)
- Shailendra Singh
- Fellow, Department of Orthopaedic Surgery, Flinders Medical Centre and Repatriation General Hospital, Adelaide, Australia
- Corresponding author. Department of Orthopaedics, Flinders Medical Centre, Bedford Park, 5042, Australia.
| | - Karthik Neelakandan
- Fellow, Department of Orthopaedic Surgery, Flinders Medical Centre and Repatriation General Hospital, Adelaide, Australia
| | - Chetan Sood
- Fellow, Department of Orthopaedic Surgery, Flinders Medical Centre and Repatriation General Hospital, Adelaide, Australia
| | - Jeganath Krishnan
- Professor & Chair in Orthopaedic Surgery, Flinders University, Adelaide, Australia
- Professor in Orthopaedics, The International Musculoskeletal Research Institute, Adelaide, Australia
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Jesalpura JP, Chung HW, Patnaik S, Choi HW, Kim JI, Nha KW. Arthroscopic treatment of localized synovial chondromatosis of the posterior knee joint. Orthopedics 2010; 33:49. [PMID: 20055354 DOI: 10.3928/01477447-20091124-22] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Synovial chondromatosis is an uncommon, benign neoplastic process typically affecting adult men and most commonly involving the knee, hip, and elbow joints. Intra-articular primary synovial chondromatosis in the knee joint may be localized or generalized. The symptoms associated with localized synovial chondromatosis may include diffuse pain, swelling, restricted motion, crepitus with symptoms of locking and giving way, and posteromedial tenderness mimicking medial meniscus tear. Diagnosis is usually established with magnetic resonance imaging (MRI) and confirmed by histological examination. To our knowledge, synovial chondromatosis of the knee joint in the posteromedial corner has not been reported in the literature.
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Affiliation(s)
- Jaimeen P Jesalpura
- Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University, Ilsan, Korea
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