Arthroscopic synovectomy for synovial hyperplasia in chronic knee gouty arthritis: A case report

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.