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Surgical Dislocation of the Hip through Lateral Approach for the Treatment of Synovial Chondromatosis

INTRODUCTION: Synovial chondromatosis is a condition where the cells lining a joint form benign cartilaginous tumors. This benign cartilage metaplasia results in the formation of multiple intra-articular loose bodies within a joint. CASE REPORT: This case is a 59-year-old female that presented with...

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Autores principales: Parikh, Sarthak, Hunter, Mitchell, Heidemann, Eric, Forro, Stephen, Davis, Ty, Corces, Arturo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499051/
https://www.ncbi.nlm.nih.gov/pubmed/36199936
http://dx.doi.org/10.13107/jocr.2022.v12.i03.2738
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author Parikh, Sarthak
Hunter, Mitchell
Heidemann, Eric
Forro, Stephen
Davis, Ty
Corces, Arturo
author_facet Parikh, Sarthak
Hunter, Mitchell
Heidemann, Eric
Forro, Stephen
Davis, Ty
Corces, Arturo
author_sort Parikh, Sarthak
collection PubMed
description INTRODUCTION: Synovial chondromatosis is a condition where the cells lining a joint form benign cartilaginous tumors. This benign cartilage metaplasia results in the formation of multiple intra-articular loose bodies within a joint. CASE REPORT: This case is a 59-year-old female that presented with constant, severe left hip pain that was localized to the groin and began 2 years ago. There were severe limitation of hip flexion, extension, pain on internal rotation, and a half inch left leg shortening. Radiographs demonstrated multiple round opacities surrounding the left femoral neck. MRI showed numerous, small rounded intra-articular loose bodies, measuring about 5–6 mm each within the left hip joint. SURGICAL TECHNIQUE: A lateral approach toward the hip was used to perform an osteotomy at the portion of the greater trochanter. The hip capsule was identified and an S-shaped incision was then made through the capsule. Repetitive hip dislocations allowed for improved visualization making further removal of the difficult fragments much easier. The capsule was closed and the osteotomy was reattached. Range of motion was found to be significantly improved compared to preoperatively. No further fixation was necessary and the patient’s subcutaneous tissue was closed in normal fashion. CONCLUSION: The technique used in our case involves a lateral approach with a trochanteric flip osteotomy to preserve the medial femoral circumflex artery and external rotators. This is similar to the approach described by Ganz in 2001 who used a posterior approach. Following the approach, the hip is then dislocated and exposed anteriorly with full visualization of the joint with a gap of about 11 cm between the femoral head and acetabulum. Surgical dislocation allows for the removal of difficult chondromas and osteophytes around the femoral head-and-neck junction. Multiple studies support the idea of surgical dislocation as an exceptional treatment method for SC.
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spelling pubmed-94990512022-10-04 Surgical Dislocation of the Hip through Lateral Approach for the Treatment of Synovial Chondromatosis Parikh, Sarthak Hunter, Mitchell Heidemann, Eric Forro, Stephen Davis, Ty Corces, Arturo J Orthop Case Rep Case Report INTRODUCTION: Synovial chondromatosis is a condition where the cells lining a joint form benign cartilaginous tumors. This benign cartilage metaplasia results in the formation of multiple intra-articular loose bodies within a joint. CASE REPORT: This case is a 59-year-old female that presented with constant, severe left hip pain that was localized to the groin and began 2 years ago. There were severe limitation of hip flexion, extension, pain on internal rotation, and a half inch left leg shortening. Radiographs demonstrated multiple round opacities surrounding the left femoral neck. MRI showed numerous, small rounded intra-articular loose bodies, measuring about 5–6 mm each within the left hip joint. SURGICAL TECHNIQUE: A lateral approach toward the hip was used to perform an osteotomy at the portion of the greater trochanter. The hip capsule was identified and an S-shaped incision was then made through the capsule. Repetitive hip dislocations allowed for improved visualization making further removal of the difficult fragments much easier. The capsule was closed and the osteotomy was reattached. Range of motion was found to be significantly improved compared to preoperatively. No further fixation was necessary and the patient’s subcutaneous tissue was closed in normal fashion. CONCLUSION: The technique used in our case involves a lateral approach with a trochanteric flip osteotomy to preserve the medial femoral circumflex artery and external rotators. This is similar to the approach described by Ganz in 2001 who used a posterior approach. Following the approach, the hip is then dislocated and exposed anteriorly with full visualization of the joint with a gap of about 11 cm between the femoral head and acetabulum. Surgical dislocation allows for the removal of difficult chondromas and osteophytes around the femoral head-and-neck junction. Multiple studies support the idea of surgical dislocation as an exceptional treatment method for SC. Indian Orthopaedic Research Group 2022-03 2022-03 /pmc/articles/PMC9499051/ /pubmed/36199936 http://dx.doi.org/10.13107/jocr.2022.v12.i03.2738 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Parikh, Sarthak
Hunter, Mitchell
Heidemann, Eric
Forro, Stephen
Davis, Ty
Corces, Arturo
Surgical Dislocation of the Hip through Lateral Approach for the Treatment of Synovial Chondromatosis
title Surgical Dislocation of the Hip through Lateral Approach for the Treatment of Synovial Chondromatosis
title_full Surgical Dislocation of the Hip through Lateral Approach for the Treatment of Synovial Chondromatosis
title_fullStr Surgical Dislocation of the Hip through Lateral Approach for the Treatment of Synovial Chondromatosis
title_full_unstemmed Surgical Dislocation of the Hip through Lateral Approach for the Treatment of Synovial Chondromatosis
title_short Surgical Dislocation of the Hip through Lateral Approach for the Treatment of Synovial Chondromatosis
title_sort surgical dislocation of the hip through lateral approach for the treatment of synovial chondromatosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499051/
https://www.ncbi.nlm.nih.gov/pubmed/36199936
http://dx.doi.org/10.13107/jocr.2022.v12.i03.2738
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