J Knee Surg 2018; 31(06): 536-540
DOI: 10.1055/s-0037-1604440
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Results of Arthroscopic Synovectomy for Treatment of Synovial Lipomatosis (Lipoma Arborescens) of the Knee

Melih Malkoc
1   Department of Orthopedics and Traumatology, School of Medicine, Istanbul Medipol University, İstanbul, Turkey
,
Özgur Korkmaz
1   Department of Orthopedics and Traumatology, School of Medicine, Istanbul Medipol University, İstanbul, Turkey
› Author Affiliations
Further Information

Publication History

22 March 2017

20 June 2017

Publication Date:
24 July 2017 (online)

Abstract

Synovial lipomatosis (SL; lipoma arborescens) is a tumor-like condition with villous proliferation of the synovium. The exact etiology of SL is still unknown. The knee is the most commonly involved part. The goal of this retrospective study was to report the results of arthroscopic synovectomy in patients with SL in their knee joints as well as to emphasize the importance of considering this pathology when treating patients with recurrent knee joint effusions. In total, 21 patients (8 females and 13 males) were evaluated retrospectively from May 2009 to July 2014. The mean follow-up period was 29.13 (range, 12–61) months. The mean duration of compliance was 22.76 (range, 7–61) months. All patients were evaluated by Knee Society score pre- and postoperatively. The mean preoperative and last follow-up Knee Society scores were 67.82 and 88.23 points, respectively. There was a significant difference between the preoperative and postoperative Knee Society scores (p = 0.0001). Histopathological examinations showed that the subsynovial layer exhibited diffuse replacement by mature fat cells that had formed villous projections. In addition, infiltration of mononuclear inflammatory cells was observed at different stages. SL is a nondestructive and benign tumor pathology of the knee joint without a clearly identified etiology. The main difficulty in diagnosis is lack of clinical practice.

 
  • References

  • 1 Weitzman G. Lipoma arborescens of the knee. Report of 1 a case. J Bone Joint Surg Am 1965; 47: 1030-1033
  • 2 Hallel T, Lew S, Bansal M. Villous lipomatous proliferation of the synovial membrane (lipoma arborescens). J Bone Joint Surg Am 1988; 70 (02) 264-270
  • 3 Kloen P, Keel SB, Chandler HP, Geiger RH, Zarins B, Rosenberg AE. Lipoma arborescens of the knee. J Bone Joint Surg Br 1998; 80 (02) 298-301
  • 4 White EA, Omid R, Matcuk GR. , et al. Lipoma arborescens of the biceps tendon sheath. Skeletal Radiol 2013; 42 (10) 1461-1464
  • 5 Bejia I, Younes M, Moussa A, Said M, Touzi M, Bergaoui N. Lipoma arborescens affecting multiple joints. Skeletal Radiol 2005; 34 (09) 536-538
  • 6 Wolf RS, Zoys GN, Saldivar VA, Williams RP. Lipoma arborescens of the hip. Am J Orthop 2002; 31 (05) 276-279
  • 7 Ji JH, Lee YS, Shafi M. Spontaneous recurrent hemarthrosis of the knee joint in elderly patients with osteoarthritis: an infrequent presentation of synovial lipoma arborescens. Knee Surg Sports Traumatol Arthrosc 2010; 18 (10) 1352-1355
  • 8 Martín S, Hernández L, Romero J. , et al. Diagnostic imaging of lipoma arborescens. Skeletal Radiol 1998; 27 (06) 325-329
  • 9 Hoffa A. The influence of the adipose tissue with regard to the pathology of the knee joint. JAMA 1904; 43: 795-796
  • 10 Siva C, Brasington R, Totty W, Sotelo A, Atkinson J. Synovial lipomatosis (lipoma arborescens) affecting multiple joints in a patient with congenital short bowel syndrome. J Rheumatol 2002; 29 (05) 1088-1092
  • 11 Fraser AR, Perry ME, Crilly A, Reilly JH, Hueber AJ, McInnes IB. Lipoma arborescens co-existing with psoriatic arthritis releases tumour necrosis factor alpha and matrix metalloproteinase 3. Ann Rheum Dis 2010; 69 (04) 776-777
  • 12 Coll JP, Ragsdale BD, Chow B, Daughters TC. Best cases from the AFIP: lipoma arborescens of the knees in a patient with rheumatoid arthritis. Radiographics 2011; 31 (02) 333-337
  • 13 Checa A, O'Connor CR. Lipoma arborescens as an unusual cause of recurrent effusion in knee osteoarthritis: sonographic and arthroscopic appearance. J Clin Rheumatol 2010; 16 (02) 102-103
  • 14 Santiago M, Passos AS, Medeiros AF, Sá D, Correia Silva TM, Fernandes JL. Polyarticular lipoma arborescens with inflammatory synovitis. J Clin Rheumatol 2009; 15 (06) 306-308
  • 15 Oni DB, Oni G. Inflammatory synovitis due to underlying lipoma arborescens. Clin Rheumatol 2008; 27 (08) 1079
  • 16 Ikushima K, Ueda T, Kudawara I, Yoshikawa H. Lipoma arborescens of the knee as a possible cause of osteoarthrosis. Orthopedics 2001; 24 (06) 603-605
  • 17 Davies AP, Blewitt N. Lipoma arborescens of the knee. Knee 2005; 12 (05) 394-396
  • 18 Sailhan F, Hautefort P, Coulomb A, Mary P, Damsin JP. Bilateral lipoma arborescens of the knee: a case report. J Bone Joint Surg Am 2011; 93 (02) 195-198
  • 19 Xiao J, Xu Y, Wang J, Feng J, Shi Z. Bilateral knee lipoma arborescens combined with osteoarthritis in elderly patients. J Int Med Res 2011; 39 (04) 1563-1569
  • 20 Cil A, Atay OA, Aydingöz U, Tetik O, Gedikoğlu G, Doral MN. Bilateral lipoma arborescens of the knee in a child: a case report. Knee Surg Sports Traumatol Arthrosc 2005; 13 (06) 463-467
  • 21 Haasbeek JF, Alvillar RE. Childhood lipoma arborescens presenting as bilateral suprapatellar masses. J Rheumatol 1999; 26 (03) 683-686
  • 22 Marui T, Yamamoto T, Kimura T. , et al. A true intra-articular lipoma of the knee in a girl. Arthroscopy 2002; 18 (05) E24
  • 23 Rao S, Rajkumar A, Elizabeth MJ, Ganesan V, Kuruvilla S. Pathology of synovial lipomatosis and its clinical significance. J Lab Physicians 2011; 3 (02) 84-88
  • 24 Franco M, Puch JM, Carayon MJ, Bortolotti D, Albano L, Lallemand A. Lipoma arborescens of the knee: report of a case managed by arthroscopic synovectomy. Joint Bone Spine 2004; 71 (01) 73-75