EVALUATION OF CLINICAL RESULTS OF SURGICAL RESECTION OF SYNOVIAL OSTEOCHONDROMATOSIS IN THE SHOULDER: A RETROSPECTIVE STUDY

Abstract

Synovial osteochondromatosis of the shoulder is a rare condition and its details remains unclear. Aim of this study was to evaluate the clinical results of surgical resection and histopathological characteristic of SOC of  the shoulder. Ten shoulders with SOC were retrospectively assessed for demographic characteristic, history of trauma, presence of osteochondral loose bodies, inferior humeral osteophytes and acromial spurs. Visual analog scores for pain and functional scores using Constant  scores were compared pre and post operatively. Resected lesions were histo-pathologically differentiated between primary and secondary SOC. The average age of patients was 39.8+/- 15.7 year;  four female and six patients was male in our study. Average duration of symptoms was 11.5+/-8.11 months. Three shoulders has osteochondral lesion in subacromial space (30%) and seven in glenohumeral joint (70%). Five shoulders (71%) show inferior humeral osteophytes out of seven shoulders with lesion in glenohumeral joint. All three shoulder (100%) with SOC in the subacromial space had spur formation. One shoulder have primary SOC while other nine had secondary SOC. Average  Visual analog scale pain score graded from 0 (no pain) to 100 mm( maximal pain) was 47.5+/-11.32 mm. The Constant score was improved from preoperative score 51.6+/-8.34 points to postoperative score 78.7+/-11.62. No case show recurrence of new loose bodies, acromial spur and inferior humeral osteophytes. Our study showed that resection of SOC successfully relieved the pain and clinical symptoms. Primary SOC is less common than secondary SOC and histopathological identification is needed to differentiate between both types. Thus further investigations required to determine long term prognosis SOC in the shoulder.

KEYWORDS: osteochondromatosis, shoulder joint, synovium