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Youn Soo Park - One of the best experts on this subject based on the ideXlab platform.
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operative treatment of primary synovial Osteochondromatosis of the hip surgical technique
Journal of Bone and Joint Surgery American Volume, 2007Co-Authors: Youn Soo ParkAbstract:BACKGROUND: Primary synovial Osteochondromatosis of the hip, a rare benign condition characterized by multiple intra-articular osteochondral loose bodies and synovial hyperplasia, may result in mechanical symptoms and degenerative arthritis if untreated. The purpose of this study was to report the results of arthrotomy alone or combined with anterior dislocation of the hip to perform synovectomy and removal of loose bodies in patients with this condition. METHODS: We retrospectively reviewed a consecutive series of twenty-one patients (twenty-one hips) with primary synovial Osteochondromatosis of the hip treated with open surgical debridement. On the basis of the extent of extra-articular involvement as seen on preoperative magnetic resonance imaging, eight of the twenty-one patients underwent synovectomy and removal of loose bodies following anterior dislocation of the hip and thirteen underwent the same procedure with arthrotomy alone. At a mean of 4.4 years postoperatively, the patients were assessed clinically and radiographically with special attention to disease recurrence, osteoarthritis progression, and surgical complications. RESULTS: The mean Harris hip score for the entire series of patients improved from 58 points preoperatively to 91 points at the time of the latest follow-up. Eighteen of the twenty-one patients had a good or excellent clinical result, and seventeen patients were satisfied with the result of the surgery. The clinical scores, patient satisfaction scores, and radiographic grades of osteoarthritis at the time of the latest follow-up did not differ significantly between the group treated with dislocation and the group treated without dislocation. Symptomatic disease recurred in two of the thirteen hips treated with arthrotomy alone and in none of the hips that had undergone dislocation. However, the surgical complication rate was higher in the group treated with dislocation than it was in the group treated without dislocation (p = 0.042). While patients with some signs of mild osteoarthritis at the initial procedure had a higher rate of osteoarthritis progression, severe osteoarthritis requiring arthroplasty had developed in only one patient at the time of follow-up. CONCLUSIONS: At a mean of 4.4 years postoperatively, we found that open synovectomy and removal of loose bodies for the treatment of primary synovial Osteochondromatosis of the hip is a reliable procedure that can effectively relieve symptoms. Our results also indicated that synovial Osteochondromatosis may recur in patients with extensive involvement who are treated with synovectomy alone without dislocation of the hip; however, surgical complications are more likely to occur in patients managed with anterior dislocation of the hip and synovectomy. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. ORIGINAL ABSTRACT CITATION: “Operative Treatment of Primary Synovial Osteochondromatosis of the Hip” (2006;88: 2456-64).
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operative treatment of primary synovial Osteochondromatosis of the hip
Journal of Bone and Joint Surgery American Volume, 2006Co-Authors: Hye Won Chung, Yoonla Choi, Youngwan Moon, Youn Soo ParkAbstract:BACKGROUND: Primary synovial Osteochondromatosis of the hip, a rare benign condition characterized by multiple intra-articular osteochondral loose bodies and synovial hyperplasia, may result in mechanical symptoms and degenerative arthritis if untreated. The purpose of this study was to report the results of arthrotomy alone or combined with anterior dislocation of the hip to perform synovectomy and removal of loose bodies in patients with this condition. METHODS: We retrospectively reviewed a consecutive series of twenty-one patients (twenty-one hips) with primary synovial Osteochondromatosis of the hip treated with open surgical debridement. On the basis of the extent of extra-articular involvement as seen on preoperative magnetic resonance imaging, eight of the twenty-one patients underwent synovectomy and removal of loose bodies following anterior dislocation of the hip and thirteen underwent the same procedure with arthrotomy alone. At a mean of 4.4 years postoperatively, the patients were assessed clinically and radiographically with special attention to disease recurrence, osteoarthritis progression, and surgical complications. RESULTS: The mean Harris hip score for the entire series of patients improved from 58 points preoperatively to 91 points at the time of the latest follow-up. Eighteen of the twenty-one patients had a good or excellent clinical result, and seventeen patients were satisfied with the result of the surgery. The clinical scores, patient satisfaction scores, and radiographic grades of osteoarthritis at the time of the latest follow-up did not differ significantly between the group treated with dislocation and the group treated without dislocation. Symptomatic disease recurred in two of the thirteen hips treated with arthrotomy alone and in none of the hips that had undergone dislocation. However, the surgical complication rate was higher in the group treated with dislocation than it was in the group treated without dislocation (p = 0.042). While patients with some signs of mild osteoarthritis at the initial procedure had a higher rate of osteoarthritis progression, severe osteoarthritis requiring arthroplasty had developed in only one patient at the time of follow-up. CONCLUSIONS: At a mean of 4.4 years postoperatively, we found that open synovectomy and removal of loose bodies for the treatment of primary synovial Osteochondromatosis of the hip is a reliable procedure that can effectively relieve symptoms. Our results also indicated that synovial Osteochondromatosis may recur in patients with extensive involvement who are treated with synovectomy alone without dislocation of the hip; however, surgical complications are more likely to occur in patients managed with anterior dislocation of the hip and synovectomy. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. ORIGINAL ABSTRACT CITATION: “Operative Treatment of Primary Synovial Osteochondromatosis of the Hip” (2006;88: 2456-64).
Michio Inada - One of the best experts on this subject based on the ideXlab platform.
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reconstruction of the triangular fibrocartilage complex after surgery for treatment of synovial Osteochondromatosis of the distal radioulnar joint
Journal of Hand Surgery (European Volume), 1990Co-Authors: Yuji Inada, Akihiro Fukui, Masami Maeda, Susumu Tamai, Michio InadaAbstract:Abstract Synovial Osteochondromatosis of the hand is uncommon, except for tenosynovial chondromatosis of the digits. It is even more rare in the wrist joint. A patient with synovial Osteochondromatosis of the distal radioulnar joint that involved the triangular fibrocartilage complex is described. At operation, synovectomy, excision of osteochondral bodies, and removal of the entire triangular fibrocartilage complex was done. The triangular fibrocartilage complex was reconstructed using part of the extensor carpi ulnaris tendon. One year after operation, the patient had regained almost full range of motion and is without pain.
Yuji Inada - One of the best experts on this subject based on the ideXlab platform.
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reconstruction of the triangular fibrocartilage complex after surgery for treatment of synovial Osteochondromatosis of the distal radioulnar joint
Journal of Hand Surgery (European Volume), 1990Co-Authors: Yuji Inada, Akihiro Fukui, Masami Maeda, Susumu Tamai, Michio InadaAbstract:Abstract Synovial Osteochondromatosis of the hand is uncommon, except for tenosynovial chondromatosis of the digits. It is even more rare in the wrist joint. A patient with synovial Osteochondromatosis of the distal radioulnar joint that involved the triangular fibrocartilage complex is described. At operation, synovectomy, excision of osteochondral bodies, and removal of the entire triangular fibrocartilage complex was done. The triangular fibrocartilage complex was reconstructed using part of the extensor carpi ulnaris tendon. One year after operation, the patient had regained almost full range of motion and is without pain.
Koichi Saotome - One of the best experts on this subject based on the ideXlab platform.
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Secondary Osteochondromatosis in the subacromial bursa: a report of two cases and review of the literature
Journal of Orthopaedic Science, 2004Co-Authors: Junichiro Hamada, Kazuya Tamai, Koichi SaotomeAbstract:Osteochondromatosis is classified into primary and secondary lesions; primary Osteochondromatosis is a tumor-like lesion, whereas secondary lesions are due to such joint or bursal disorders as osteoarthritis and osteochondral fractures. There is no clinical distinction between these two conditions. Only the pathological findings of loose bodies and synovium can clearly distinguish between them. In this report, we present two patients with secondary Osteochondromatosis in the subacromial bursa. Both had shoulder pain and were treated surgically. We discuss methods of differentiating between primary and secondary lesions and elucidate the pathogenesis of Osteochondromatosis in the subacromial bursa by analyzing findings for 17 shoulders with this condition reported in the literature. We also present two more cases. We reviewed the 12 cases of Osteochondromatosis in the literature for histopathological findings of loose bodies and the presence or absence of acromial osteophytes. Our findings suggest that Osteochondromatosis of the subacromial bursa is secondary in most cases, and that osteocartilaginous fragments from acromial osteophytes can be shed into the subacromial bursa and grow into loose bodies.
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growth potential of loose bodies an immunohistochemical examination of primary and secondary synovial Osteochondromatosis
Journal of Orthopaedic Research, 1999Co-Authors: Koichi Saotome, Kazuya Tamai, Yasumori Koguchi, Hiroya Sakai, Takehiko YamaguchiAbstract:Histologic and immunohistochemical studies of growth potential were performed on 53 surgically removed loose bodies representing 10 cases of primary synovial Osteochondromatosis, 37 bodies representing 12 cases of secondary synovial Osteochondromatosis, and five bodies representing five cases of osteochondral fracture. Loose bodies in primary synovial Osteochondromatosis were nodular, showing plump chondrocytes and irregular calcification, and all contained proliferative cell nuclear antigen-positive chondrocytes (labeling index: 42.5%; range: 36.0–52.0%). Other markers stained less frequently. Loose bodies in secondary synovial Osteochondromatosis showed uniform chondrocytes and annular calcification surrounding core tissue. Eighteen of 37 loose bodies showed proliferative cell nuclear antigen-positive chondrocytes, mostly peripherally. Chondrocyte labeling indices were less than 5% for proliferative cell nuclear antigen and other markers, although some connective tissue cells in the outer layer were stained. Loose bodies from osteochondral fractures were composed of articular cartilage, subchondral bone, and connective tissue; cartilage was negative for markers, whereas connective tissue contained positive cells. One specimen showed cartilaginous metaplasia of connective tissue. These results suggest that loose bodies have the potential for slow growth by proliferation of chondrocytes in primary synovial Osteochondromatosis and by metaplasia following proliferation of surrounding connective tissue in secondary synovial Osteochondromatosis.
Tetsuji Yamamoto - One of the best experts on this subject based on the ideXlab platform.
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A Rare Case of Synovial Osteochondromatosis of the Bicipital Radial Bursa
2017Co-Authors: Natsuko Fukuoka, Osamu Nakamura, Yoshio Kaji, Yoshiki Yamagami, Hideki Nishimura, Konosuke Yamaguchi, Tobiume S, Tetsuji YamamotoAbstract:Introduction: Synovial Osteochondromatosis of a bicipital radial bursa is a very rare condition. We report herein a case of synovial Osteochondromatosis of a bicipital radial bursa. Presentation of Case: A 52-year-old man presented with a 20-year history of a slowly enlarging mass on the left elbow. Radiographs revealed multiple oval calcified lesions in the anterior aspect of the elbow. A mass lesion was located in the bicipital radial bursa on magnetic resonance imaging (MRI) and computed tomography (CT). Surgical resection was performed. Histological examination of the excised tissue showed that the resected nodules comprised numerous hyaline cartilage-like areas surrounded by synovial membrane, suggesting synovial Osteochondromatosis of the bicipital radial bursa. At 4 years postoperatively, the clinical outcome is excellent with no recurrence. Discussion: Synovial Osteochondromatosis is usually an intra-articular condition. Extra-articular involvement may thus represent a diagnostic problem. MRI and CT are helpful in diagnosing and evaluating the nature, calcification, and location of the lesion. CT was particularly useful in evaluating the location of the lesion and the calcification using CT in this case. Bicipital radial bursitis is infrequent, with few reports describing this disease, and synovial Osteochondromatosis of the bicipital radial bursa is an extremely rare condition. Conclusion: A very rare case of synovial Osteochondromatosis of the bicipital radial bursa was described. In the case of a gradually enlarging calcifying mass in the elbow, synovial Osteochondromatosis of the bicipital radial bursa should be considered among the differential diagnoses.
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synovial Osteochondromatosis of the lisfranc joint a case report
Journal of Foot & Ankle Surgery, 2006Co-Authors: Ikuo Fujita, Keiji Matsumoto, Minetaka Maeda, Tomohiko Kizaki, Yoshiyuki Okada, Tetsuji YamamotoAbstract:Synovial Osteochondromatosis arising in the foot is a rare condition. We report a 69-year-old woman with synovial Osteochondromatosis of the Lisfranc joint. The patient presented with a 10-year history of left foot pain. Imaging studies showed multiple calcified masses around the Lisfranc joint. We performed a synovectomy and removal of the loose bodies in the dorsal, lateral, and plantar aspects of the Lisfranc joint by dislocating the bases of the fourth and fifth metatarsal bones. To our knowledge, this is only the second case report of synovial Osteochondromatosis involving the Lisfranc joint.
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infrapatellar bursal Osteochondromatosis associated with unresolved osgood schlatter disease a case report
Journal of Bone and Joint Surgery American Volume, 2005Co-Authors: Kazunari Ishida, Ryosuke Kuroda, Keizo Sato, Tetsuhiro Iguchi, Minoru Doita, Masahiro Kurosaka, Tetsuji YamamotoAbstract:Osgood-Schlatter disease is caused by an avulsion of a portion of the developing ossification center of the tibial tubercle in young athletes. Approximately 10% of ossicles fail to unite with the tibial tubercle, and patients with Osgood-Schlatter disease continue to have anterior knee pain brought on by even mild activity1. Patients usually become asymptomatic after skeletal maturity, although they have a prominent mass in the anterior aspect of the proximal part of the tibia. Synovial Osteochondromatosis is a benign condition that is characterized by the formation of multiple chondral or osteochondral nodules in the synovial membrane or intraarticular space. When this phenomenon occurs in the bursa around a joint, the condition is called bursal Osteochondromatosis. Most cases of synovial and bursal chondromatosis develop without any antecedent major trauma; however, rare cases in which the conditions have occurred following repeat minor trauma have been reported2-6. Some authors have reported the development of bursal Osteochondromatosis around an osteochondroma7-9. Fig. 1 Lateral radiograph of the right knee, showing an osseous mass attached to the tibial tubercle. The mass extends to the inferior aspect of the patella and is surrounded by several ossified fragments. We report the case of a patient who had infrapatellar bursal Osteochondromatosis in association with unresolved Osgood-Schlatter disease. The bursal Osteochondromatosis developed many years after the symptoms of Osgood-Schlatter disease had resolved. A careful review of the English-language literature revealed no similar cases. Our patient was informed that data concerning this case would be submitted for publication. Fig. 2 Computed tomography scan showing an osseous stalk arising from the tibial tubercle and several loose bodies. A thirty-one-year-old man visited our …
