How is a synovectomy performed?
Dr. Patel typically utilizes the arthroscopic approach when performing a synovectomy for pigmented villonodular synovitis (PVNS). To begin, the patient is placed under general anesthesia and situated in the appropriate position. Once stable, Dr. Patel creates several small incisions surrounding the hip joint. A small camera (arthroscope) is inserted through a portal and the images are transmitted to a television monitor for Dr. Patel to methodically examine the bones, tendons, cartilage, and ligaments of the hip joint. Any other conditions, such as loose bodies or soft tissue damage, are documented during this examination as well. When the area of inflamed synovial lining is identified, specialized surgical instruments are then introduced into the hip joint. These tools allow Dr. Patel to meticulously excise and remove the inflamed portions of the synovial lining and limit the amount of damage to the surrounding structures. This arthroscopic approach is most successful for performing a partial synovectomy to treat localized PVNS. The corrections for any other hip conditions documented during the exam can be conducted at this time.
In the event of diffuse or complex PVNS, Dr. Patel may prefer open surgery over an arthroscopic repair. The open surgical approach involves a slightly larger incision that enables Dr. Patel to visualize the entire hip joint while completing the necessary revisions. Dr. Patel may occasionally combine both the arthroscopic and open surgical techniques to provide a better outcome for the patient. Complex and more extensive disease cases may require radiation.