Utoyo GA, Calvin C. Arthroscopic synovectomy for synovial hyperplasia in chronic knee gouty arthritis: A case report. World J Orthop 2024; 15(11): 1101-1108 [DOI: 10.5312/wjo.v15.i11.1101]
Corresponding Author of This Article
Ghuna A Utoyo, MD, Surgeon, Department of Orthopaedics and Traumatology, Dr. Hasan Sadikin General Hospital, Jalan Pasteur No. 38, Pasteur, Kecamatan Sukajadi, Bandung 40161, Jawa Barat, Indonesia. ghuna@unpad.ac.id
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Nov 18, 2024; 15(11): 1101-1108 Published online Nov 18, 2024. doi: 10.5312/wjo.v15.i11.1101
Arthroscopic synovectomy for synovial hyperplasia in chronic knee gouty arthritis: A case report
Ghuna A Utoyo, Calvin Calvin
Ghuna A Utoyo, Department of Orthopaedics and Traumatology, Dr. Hasan Sadikin General Hospital/Universitas Padjadjaran, Bandung 40161, Jawa Barat, Indonesia
Calvin Calvin, Department of Orthopaedics and Traumatology, St. Borromeus Hospital, Bandung 40132, Jawa Barat, Indonesia
Author contributions: Calvin C contributed to manuscript writing, editing, data collection, data analysis; Utoyo GA contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ghuna A Utoyo, MD, Surgeon, Department of Orthopaedics and Traumatology, Dr. Hasan Sadikin General Hospital, Jalan Pasteur No. 38, Pasteur, Kecamatan Sukajadi, Bandung 40161, Jawa Barat, Indonesia. ghuna@unpad.ac.id
Received: September 9, 2024 Revised: October 3, 2024 Accepted: October 20, 2024 Published online: November 18, 2024 Processing time: 67 Days and 0.3 Hours
Abstract
BACKGROUND
Chronic synovitis due to chronic knee gouty arthritis (KGA) resulting in synovial hyperplasia has not been documented in the current literature, and thus the optimal management for this condition remains unclear. This case report discusses a 34-year-old man with a history of chronic KGA who presented with recurrent knee effusion resulting from synovial hyperplasia.
CASE SUMMARY
A 34-year-old man presented to our outpatient clinic with a 5-year recurrent knee effusion and a history of chronic KGA. Symptoms persisted despite serial aspiration and urate-lowering medication (febuxostat 80 mg once daily) for 2 months. Diagnostic arthroscopy was performed due to the recalcitrant symptoms. Intraoperatively, tophi deposition and excessive thickening of the synovial membrane were observed. Synovial biopsy and partial synovectomy were performed, revealing chronic synovitis with synovial hyperplasia that was consistent with chronic KGA. At follow-up after 6 months, the patient reported no further episode of knee effusion.
CONCLUSION
Arthroscopic synovectomy for synovial hyperplasia in chronic KGA sufficiently eradicates the symptoms of recurrent knee effusion.
Core Tip: Recurrent knee effusion in cases of chronic knee gouty arthritis (KGA) that are refractory to conservative treatment should alert surgeons to the possibility of synovial structural alteration, such as synovial hyperplasia. Diagnostic arthroscopy should be considered in these cases to allow a definitive diagnosis. In our case, tophi deposition and excessive synovial membrane thickening were observed intraoperatively. Therefore, partial synovectomy was performed to address the excessive synovial tissue. At six months, no further episode of recurrent knee effusion. These findings suggest that an arthroscopic synovectomy was effective in managing synovial hyperplasia in the case of chronic KGA.
