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Case 2: Synovial Chondromatosis of Both Compartments

History and Preoperative Findings

A 56-year-old female patient was referred with a 2-year history of right hip pain. She reported frequent catching and locking episodes with giving-way episodes. When those occurred, she also complained of a sharp pain radiating into the anterior distal thigh. Otherwise she was asymptomatic. Radiographs revealed the characteristic findings of synovial chondromato-sis with small radiodense spots around the femoral neck and within the fossa acetabuli (Figure 11.14). The diagnosis was confirmed with a MR arthrogram showing chondromas within the peripheral and central compartment (Figure 11.15A,B). Hip arthroscopy for removal of the chondromas was indicated.

Hip Arthroscopy

The patient was placed supine on a fracture table for HA with traction. An anterolateral portal was established under fluoroscopy, and an additional posterolat-eral portal was placed under arthroscopic control (Figure 11.16). After the diagnosis of synovial chon-dromatosis was confirmed, four soft chondromas were found within the acetabular fossa and subsequently removed using a forceps and shaver (Figure 11.17). By sliding the 70-degree arthroscope distally to the posterior labrum, no chondromas were seen in the posterior area of the hip joint. The central compartment was then evacuated. An anterolateral portal to the peripheral compartment was established. Chondromas were immediately found in the medial neck and head area underneath the transverse ligament (Figure 11.18) and anterior neck area (Figure 11.19). For extraction of the chondro-

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