Synovial Proliferative Disorders

Arthroscopy is appropriately indicated for a variety of synovial disorders. Rarely is it necessary for inflammatory conditions such as rheumatoid disease because of the efficacy of pharmacologic control. The 2 most commonly reported disorders are synovial chondromatosis and pigmented villonodular synovitis. These diseases are sometimes surprisingly elusive, and arthroscopy may aid in the diagnosis. Most of these cases can be effectively treated with arthroscopic synovectomy in addition to addressing other concomitant joint damage. Arthroscopy may sometimes still be successful, even with recurrent symptoms. Many of these disorders exhibit findings of secondary osteoarthritis, which may still progress despite effective arthroscopic intervention. This, in particular, highlights the advantage of the less-invasive arthroscopic approach compared with open procedures, when an arthroplasty may still be looming in the patient’s future. This report details the various synovial disorders that may be encountered as well as the indications, technique, outcomes, and expectations of arthroscopic intervention.