Journal Article

Standardized Image‐Based Arthroscopic Technique for Hip Synovial Chondromatosis: Long‐Term Patient Outcomes

Lin, Rongzhen, Fan, Mingyue, Bu, Ziheng, Hong, Jiachang, Zhu, Wei, Liu, Wei, Yu, Jianing, Huang, Junchao, An, Jinxi, Hu, Yongjun, Wu, Peng

2026

Overview

Objective Arthroscopic surgery is recommended for the treatment of hip synovial chondromatosis, as it allows patients to resume daily activities quickly and requires only a short rehabilitation period. Despite its advantages, there is currently no standardized protocol for arthroscopic hip synovectomy, and complete removal of intra‐articular loose bodies remains challenging. The objective of this study is to evaluate long‐term clinical outcomes of arthroscopic treatment for hip synovial chondromatosis using a standardized protocol based on clock‐face‐guided, imaging‐based lesion localization. Methods A consecutive cohort of patients undergoing arthroscopic treatment and diagnosed with synovial chondromatosis between June 2016 and July 2019 was included in the study. All patients underwent preoperative imaging‐guided localization of loose bodies followed by arthroscopic removal performed by a single surgeon, with a minimum postoperative follow‐up of 30 months. Preoperative and postoperative assessments included standard radiographs (x‐ray), three‐dimensional computed tomography (3D‐CT), magnetic resonance imaging (MRI), intraoperative arthroscopic images, visual analog scale (VAS) for pain, range of motion (ROM), modified Harris Hip Score (mHHS), and International Hip Outcome Tool (iHOT‐12). The percentage of patients achieving the minimal clinically important difference (MCID) was calculated to summarize and compare differences in clinical outcomes. Results Seventeen patients were enrolled, with a mean postoperative follow‐up duration of 71 months. No major complications were observed. Patients achieved weight‐bearing ambulation at a mean of 7 days postoperatively and were discharged at a median of 2.5 days (range: 1–3 days). PROs demonstrated significant improvements: VAS for pain decreased from 7.6 to 2.1, mHHS increased from 54.6 preoperatively to 89.4 postoperatively, and iHOT‐12 improved from 38.1 to 75.2 (all p < 0.001). At long‐term follow‐up, all patients met MCID thresholds for both mHHS and iHOT‐12 scores. Conclusion Arthroscopic treatment using a standardized protocol can result in favorable long‐term clinical outcomes. A clock‐face‐guided, imaging‐based arthroscopic protocol improves surgical orientation and facilitates complete removal of loose bodies in hip synovial chondromatosis, leading to favorable long‐term outcomes.

• Publisher: John Wiley & Sons Australia, Ltd,John Wiley & Sons, Inc,Wiley
• Subject: arthroscopy / Cartilage / Clinical / CT imaging / hip / Hip joint / Localization / Magnetic resonance imaging / Medical diagnosis / Medical research / Medicine, Experimental / Methods / Orthopedic surgery / Patients / Surgeons / Surgery / synovial chondromatosis