Arthroscopic treatment of synovial chondromatosis of the ankle, an uncommon location: a case report
Andi Praja Wira Yudha Luthfi, Audie Djiady, Carmen Claude Margo, Frederika Frederika, Mitchel Mitchel, Erica KholinneIntroduction and importance:
Synovial chondromatosis (SC) is a rare benign metaplastic disorder characterized by the formation of intra-articular cartilaginous loose bodies. Although it commonly affects large joints, ankle involvement is uncommon and may lead to delayed diagnosis and progressive joint damage. Arthroscopic management of ankle SC has been infrequently reported.
Case presentation:
A 54-year-old active man presented with a 1-year history of progressive left ankle pain, crepitus, and restricted range of motion. Radiographs, computed tomography, and magnetic resonance imaging demonstrated multiple intra-articular loose bodies and an anterior tibial spur. The patient underwent arthroscopic loose-body removal, complete anterior synovectomy, and anterior tibial spur resection through standard anteromedial and anterolateral portals. Histopathological examination confirmed synovial chondromatosis. Early weight-bearing was initiated on postoperative day 1. At three-month follow-up, the patient achieved complete pain relief, full range of motion, and no radiographic evidence of recurrence. At six-month follow-up, he remained free of complaints. At 9-month follow-up, the patient remained asymptomatic, with no clinical evidence of recurrence.
Clinical discussion:
Complete removal of loose bodies and synovectomy are essential to minimize recurrence. Arthroscopic treatment offers excellent joint visualization, minimal soft tissue disruption, and rapid functional recovery in appropriately selected cases.
Conclusion:
This case highlights that SC should be considered in patients with chronic ankle pain and mechanical symptoms. Arthroscopic management can provide excellent short-term clinical outcomes while minimizing surgical morbidity.