Arthroskopische Diagnostik und Therapie synovialer Erkrankungen

Synovial disorders are amongst the most common indications for hip arthroscopy. Arthroscopic intervention has been reported for symptomatic synovial plicae, synovial chondromatosis, pigmented villonodular synovitis (PVNS) and rheumatoid arthritis. In comparison to radiologic imaging one major advantage is the ability to inspect, biopsy and treat during one procedure. In contrast to an arthrotomy hip arthroscopy avoids the potential risks of an extensive surgical exposure and prolonged rehabilitation. Nevertheless hip arthroscopy cannot be promoted as curative in all synovial disorders. In patients with localized synovitis, impinging synovial folds and, to a certain extent, PVNS a curative therapy and “restitutio ad integrum” can be achieved. The goal of hip arthroscopy in patients with synovial chondromatosis and rheumatoid arthritis is to enable the correct diagnosis and to provide symptomatic relief and improve joint function. Success or failure of arthroscopic treatment depends on proper patient selection and a correct arthroscopic technique.