How Does a Hip Arthroscopy and Synovectomy for PVNS Work?

October 15, 2023

What is PVNS?

Pigmented Villonodular Synovitis (PVNS) is a non-cancerous tumor that develops in the thin membrane lining of the joints known as the synovium. It can affect any joint in the body, but it typically arises in the knee or hip joints, causing the synovium to overgrow and swell.

Moreover, PVNS can be quite painful, but since it is benign, it does not spread to other parts of your body. It can also be surgically removed with a Synovectomy. However, you are likely to feel stiffness, swelling, and limited mobility in the affected joint.

How is a Synovectomy Performed? (Hip Arthroscopy)

A synovectomy is a type of surgery that specializes in the removal of the synovium. In most cases, a synovectomy is performed through hip arthroscopy, allowing the surgeons an all-encompassing view of the tumor.

The procedure usually starts with anesthetizing the patient and preparing them for a minimally non-invasive arthroscopy. The surgeon first tries to locate the pigmented synovitis throughout the hip joint before moving on to the debriding and resecting process. After finding the problem, the surgeon will begin from the front of the hip joint capsule and then slowly move back, ensuring that the synovium is resected from throughout the hip.

Ligamentum teres is a muscle ligament that is often affected due to synovitis, which is why it must also be debrided so there is no excess inflammation surrounding the area. Next, the surgeon works on stabilizing the labrum tear — if there is any — by debriding it and removing the synovitis.

It is also important to note that between the surgery, the surgeon is likely to switch portals in the arthroscopy so that all angles covering the hip joint can be viewed properly. It also helps in knowing whether or not all areas of the synovium are resected, especially from the labrum. However, once the inner part of the hip joint is free of synovitis, the outer part is also cleared out. The surgeon takes their time to thoroughly check and debride the inflammation where required.

To wrap things up, a circumferential evaluation and synovectomy are performed to remove any remaining parts that may still contain the synovium. It is also important to note that the surgeon might extract a sample of the pigmented synovitis to gather a pathology review on it in case of PVNS.

Contact Us Today!

All in all, PVNS is a benign overgrowth that occurs in the thin lining of your joints. While this may not be something to worry about, it can be painful and limit your daily activities. In most cases, it is recommended to get a synovectomy to get rid of the inflamed tumor altogether. For more information on how synovectomy works and why it is performed through an arthroscopy channel, contact Dr. Mufaddal Gombera, MD, at (713) 794-3457 today.

Dr Gombera Cover

Dr. Gombera

Dr. Gombera, earned his medical degree from Baylor College of Medicine and completed his orthopedic surgery residency at the University of Michigan. Expanding his expertise, he undertook a sports medicine and arthroscopy fellowship at Northwestern University in Chicago. Recognized as a Super Doctors Rising Star and honored for patient care excellence at the University of Michigan, he holds multiple certifications and licenses, solidifying his dedication to delivering exceptional medical services.



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