High Rate of Local Recurrence and Complications Following Total Knee Arthroplasty in the Setting of Synovial Chondromatosis

Background: Synovial chondromatosis is a rare, monoarticular arthropathy due to synovial metaplasia. There is a paucity of data examining the outcome of total knee arthroplasty (TKA) in the setting of synovial chondromatosis. The purpose of this study is to investigate the outcome and function in patients undergoing TKA for management of synovial chondromatosis. Methods: Twenty patients who received TKA for synovial chondromatosis over a 25-year period were identified for analysis and followed for a mean of 7 years. There were 12 males and 8 females, with a mean age and body mass index of 63 years and 30.7 kg/m(2). Seventeen patients had "active" disease at the time of surgery. Results: The 5-year disease-free survival was 73%. Five patients sustained a recurrence that was treated with synovectomy and revision TKA (n = 2), observation (n = 2), and transfemoral amputation (n = 1) due to malignant degeneration to chondrosarcoma. One of the revision TKA patients underwent a transfemoral amputation 4 months later for recurrence. The overall rate of amputation was 10%. Nine patients (45%) sustained a complication, most commonly decreased knee motion (n = 7), leading to a revision TKA in 3 patients (15%). Mean preoperative knee range of motion was 73 degrees, which improved to 97 degrees postoperatively. The Knee Society Score and functional assessment improved from 35 and 42 preoperatively to 74 and 67 following TKA. Conclusion: TKA in the setting of synovial chondromatosis improves patient function and knee range of motion; however, there is a high rate of local recurrence and complications. (C) 2017 Elsevier Inc. All rights reserved.