{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T19:57:53Z","timestamp":1785182273655,"version":"3.55.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,12,10]],"date-time":"2022-12-10T00:00:00Z","timestamp":1670630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,12,10]],"date-time":"2022-12-10T00:00:00Z","timestamp":1670630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The synovial chondromatosis is an uncommon proliferative metaplastic process of the synovial cells that can develop in any synovial joint. An isolated primary chondromatosis of the posterior compartment of the knee is uncommon and few cases are reported in literature. Our purpose is to describe a rare case of primary chondromatosis of the knee posterior compartment and report the arthroscopic loose bodies excision through a difficult posteromedial portal, avoiding the use of the accessory posterior portal, most commonly reported for approaching this disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We report a rare case of a 35-year-old Caucasian male patient with diagnosis of chondromatosis of the posterior knee compartment. The radiographs showed multiple loose bodies of the posterior compartment. The MRI revealed minimal synovial hypertrophy areas, multiple osteophytes in the intercondylar notch, and loose bodies in the posteromedial compartment. The CT allowed us to assess the bony structures, the morphology of the intercondylar notch, and the presence osteophytes of the medial and lateral femoral condyles. The CT images were crucial to plan how to reach the posterior compartments of the knee through a trans-notch passage. The patient underwent arthroscopic surgery using anteromedial, anterolateral, and posteromedial portals. The tunneling through the intercondylar osteophytes was performed to allow the arthroscope to pass trans-notch. To avoid additional accessory posterior portals, we used a 70\u00b0 arthroscope to better explore the posterior knee compartment. The cartilage-like bodies were removed and synovectomy of the inflamed areas was performed. The clinical and radiological follow-up was 12\u00a0months and the patient showed excellent clinical outcomes, returning to his activities of daily living and sport activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our case report highlights the importance of the arthroscopic approach to treat synovial chondromatosis, despite the involvement of the posterior compartment of the knee. An optimal preoperative imaging allows to plan for the proper surgical procedure even in patients with severe osteoarthritis. Moreover, the adoption of an intercondylar notch tunneling and a 70\u00b0 arthroscope can help surgeons to better explore the posterior knee compartment, avoiding an accessory posterior trans-septal portal. Therefore, a synovectomy of the inflamed foci may be useful to prevent recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13256-022-03667-2","type":"journal-article","created":{"date-parts":[[2022,12,10]],"date-time":"2022-12-10T01:02:18Z","timestamp":1670634138000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The use of posteromedial portal for arthroscopic treatment of synovial chondromatosis of the knee: a case report"],"prefix":"10.1186","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1643-9515","authenticated-orcid":false,"given":"Luigi","family":"Zanna","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregorio","family":"Secci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Innocenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Giabbani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Civinini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Matassi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,10]]},"reference":[{"key":"3667_CR1","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1007\/s003830050627","volume":"15","author":"S Wagner","year":"1999","unstructured":"Wagner S, Bennek J, Gr\u00e4fe G, Schmidt F, Thiele J, Wittekind C, et\u00a0al. Chondromatosis of the ankle joint (Reichel syndrome). Pediatr Surg Int. 1999;15:437\u20139.","journal-title":"Pediatr Surg Int"},{"key":"3667_CR2","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1302\/0301-620X.70B5.3192585","volume":"70","author":"H Maurice","year":"1988","unstructured":"Maurice H, Crone M, Watt I. Synovial chondromatosis. J Bone Joint Surg Ser B. 1988;70:807\u201311.","journal-title":"J Bone Joint Surg Ser B"},{"key":"3667_CR3","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.O.00054","author":"JA Neumann","year":"2016","unstructured":"Neumann JA, Garrigues GE, Brigman BE, Eward WC. Synovial chondromatosis. JBJS Rev. 2016. https:\/\/doi.org\/10.2106\/JBJS.RVW.O.00054.","journal-title":"JBJS Rev"},{"key":"3667_CR4","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/S0968-0160(01)00084-9","volume":"8","author":"P Hallam","year":"2001","unstructured":"Hallam P, Ashwood N, Cobb J, Fazal A, Heatley W. Malignant transformation in synovial chondromatosis of the knee? Knee. 2001;8:239\u201342.","journal-title":"Knee"},{"key":"3667_CR5","doi-asserted-by":"publisher","first-page":"e71","DOI":"10.2106\/JBJS.CC.15.00284","volume":"6","author":"EF Temponi","year":"2016","unstructured":"Temponi EF, Mortati RB, Mortati GMH, Mortati LB, Sonnery-Cottet B, de Carvalho J\u00fanior LH. Synovial chondromatosis of the knee in a 2-year-old child: a case report and review of the literature. JBJS Case Connector. 2016;6:e71.","journal-title":"JBJS Case Connector"},{"key":"3667_CR6","doi-asserted-by":"publisher","first-page":"46","DOI":"10.4103\/oji.oji_17_17","volume":"1","author":"P Sarangi","year":"2017","unstructured":"Sarangi P, Kumar TS. Primary synovial chondromatosis of knee with both intra-articular and extra-articular involvement: a case report with delayed diagnosis. Oncol J India. 2017;1:46.","journal-title":"Oncol J India"},{"key":"3667_CR7","first-page":"282","volume":"124","author":"JW Milgram","year":"1977","unstructured":"Milgram JW. The classification of loose bodies in human joints. Clin Orthop Relat Res. 1977;124:282\u201391.","journal-title":"Clin Orthop Relat Res"},{"key":"3667_CR8","first-page":"391","volume":"7","author":"L Samson","year":"2005","unstructured":"Samson L, Mazurkiewicz S, Treder M, Wi\u015bniewski P. Outcome in the arthroscopic treatment of synovial chondromatosis of the knee. Ortop Traumatol Rehabil. 2005;7:391\u20136.","journal-title":"Ortop Traumatol Rehabil"},{"key":"3667_CR9","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3928\/01477447-20091124-22","volume":"33","author":"JP Jesalpura","year":"2010","unstructured":"Jesalpura JP, Chung HW, Patnaik S, Choi HW, Kim JI, Nha KW. Arthroscopic treatment of localized synovial chondromatosis of the posterior knee joint. Orthopedics. 2010;33:49.","journal-title":"Orthopedics"},{"key":"3667_CR10","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3928\/01477447-20091124-22","volume":"33","author":"JP Jesalpura","year":"2010","unstructured":"Jesalpura JP, Chung HW, Choi HW, Kim JI, Nha KW. Arthroscopic treatment of localized synovial chondromatosis of the posterior knee joint. Orthopedics. 2010;33:49.","journal-title":"Orthopedics"},{"key":"3667_CR11","first-page":"43","volume":"64","author":"A Sebaaly","year":"2016","unstructured":"Sebaaly A, Maalouf G, Bayyoud W, Bachour F. Synovial chondromatosis of the posterior compartment of the knee: a case report & literature review focusing on arthroscopic treatment. J Med Liban. 2016;64:43\u20136.","journal-title":"J Med Liban"},{"key":"3667_CR12","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1016\/j.knee.2011.10.003","volume":"19","author":"BS Kyung","year":"2012","unstructured":"Kyung BS, Lee SH, Han SB, Park JH, Kim CH, Lee DH. Arthroscopic treatment of synovial chondromatosis at the knee posterior septum using a trans-septal approach: report of two cases. Knee. 2012;19:732\u20135.","journal-title":"Knee"},{"key":"3667_CR13","doi-asserted-by":"publisher","first-page":"e435","DOI":"10.1016\/j.eats.2019.11.014","volume":"9","author":"JY Lee","year":"2020","unstructured":"Lee JY, Chia ZY, Jiang L, Ang B, Chang P. A review of the Gillquist Maneuver: modifications for a safer and easily reproducible approach for knee transintercondylar notch posterior compartment arthroscopy. Arthrosc Tech. 2020;9:e435\u20138.","journal-title":"Arthrosc Tech"},{"key":"3667_CR14","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1111\/j.1440-1673.2006.01669.x","volume":"51","author":"C Chong","year":"2007","unstructured":"Chong C, Kneebone A, Kirsh G. Radiotherapy in the management of recurrent synovial chondromatosis. Australas Radiol. 2007;51:95\u20138.","journal-title":"Australas Radiol"},{"key":"3667_CR15","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1007\/s00167-007-0292-1","volume":"15","author":"YH Pengatteeri","year":"2007","unstructured":"Pengatteeri YH, Park SE, Lee HK, Lee YS, Gopinathan P, Han CW. Synovial chondromatosis of the posterior cruciate ligament managed by a posterior\u2013posterior triangulation technique. Knee Surg Sports Traumatol Arthrosc. 2007;15:1121\u20134.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"3667_CR16","doi-asserted-by":"publisher","first-page":"2147","DOI":"10.1016\/j.arth.2017.02.040","volume":"32","author":"MT Houdek","year":"2017","unstructured":"Houdek MT, Wyles CC, Rose PS, Stuart MJ, Sim FH, Taunton MJ. High rate of local recurrence and complications following total knee arthroplasty in the setting of synovial chondromatosis. J Arthroplasty. 2017;32:2147\u201350.","journal-title":"J Arthroplasty"},{"key":"3667_CR17","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1302\/0301-620X.71B3.2722947","volume":"71","author":"MR Coolican","year":"1989","unstructured":"Coolican MR, Dandy DJ. Arthroscopic management of synovial chondromatosis of the knee. Findings and results in 18 cases. J Bone Joint Surg Br. 1989;71:498\u2013500.","journal-title":"J Bone Joint Surg Br"},{"key":"3667_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2021.07.001","author":"LJ Wengle","year":"2021","unstructured":"Wengle LJ, Hauer TM, Chang JS, Theodoropoulos J. Systematic arthroscopic treatment of synovial chondromatosis of the knee. Arthrosc Tech. 2021. https:\/\/doi.org\/10.1016\/j.eats.2021.07.001.","journal-title":"Arthrosc Tech"},{"key":"3667_CR19","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/s13018-018-0966-z","volume":"13","author":"B Chen","year":"2018","unstructured":"Chen B, Chen L, Chen H, Yang X, Tie K, Wang H. Arthroscopic removal of loose bodies using the accessory portals in the difficult locations of the knee: a case series and technical note. J Orthop Surg Res. 2018;13:258.","journal-title":"J Orthop Surg Res"},{"key":"3667_CR20","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1007\/s00167-007-0292-1","volume":"15","author":"YH Pengatteeri","year":"2007","unstructured":"Pengatteeri YH, Park SE, Lee HK, Lee YS, Gopinathan P, Han CW. Synovial chondromatosis of the posterior cruciate ligament managed by a posterior\u2013posterior triangulation technique. Knee Surg Sports Traumatol Arthr. 2007;15:1121\u20134.","journal-title":"Knee Surg Sports Traumatol Arthr"},{"key":"3667_CR21","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1302\/0301-620X49B3530","volume":"49","author":"TE Jeffreys","year":"1967","unstructured":"Jeffreys TE. Synovial chondromatosis. Br Editor Soc Bone Joint Surg. 1967;49:530\u20134. https:\/\/doi.org\/10.1302\/0301-620X49B3530.","journal-title":"Br Editor Soc Bone Joint Surg"},{"key":"3667_CR22","doi-asserted-by":"publisher","first-page":"567","DOI":"10.3109\/17453679008993585","volume":"61","author":"T Shpitzer","year":"2009","unstructured":"Shpitzer T, Ganel A, Engelberg S. Surgery for synovial chondromatosis: 26 cases followed up for 6 years. Acta Orthopaed Scand. 2009;61:567\u20139. https:\/\/doi.org\/10.3109\/17453679008993585.","journal-title":"Acta Orthopaed Scand"},{"key":"3667_CR23","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/S0749-8063(05)80088-X","volume":"10","author":"DJ Ogilvie-Harris","year":"1994","unstructured":"Ogilvie-Harris DJ, Saleh K. Generalized synovial chondromatosis of the knee: a comparison of removal of the loose bodies alone with arthroscopic synovectomy. Arthrosc J Arthrosc Relat Surg. 1994;10:166\u201370.","journal-title":"Arthrosc J Arthrosc Relat Surg"},{"key":"3667_CR24","doi-asserted-by":"publisher","first-page":"e1103","DOI":"10.1016\/j.eats.2020.12.009","volume":"10","author":"SK Chan","year":"2021","unstructured":"Chan SK, Lui TH. Arthroscopic management of synovial osteochondromatosis of the elbow. Arthrosc Tech. 2021;10:e1103\u20138.","journal-title":"Arthrosc Tech"},{"key":"3667_CR25","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/0749-8063(95)90094-2","volume":"11","author":"DJ Ogilvie-Harris","year":"1995","unstructured":"Ogilvie-Harris DJ, Weisleder L. Arthroscopic synovectomy of the knee: is it helpful? Arthrosc J Arthrosc Relat Surg. 1995;11:91\u20135.","journal-title":"Arthrosc J Arthrosc Relat Surg"},{"key":"3667_CR26","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/j.arthro.2007.08.034","volume":"24","author":"D Urbach","year":"2008","unstructured":"Urbach D, McGuigan FX, John M, Neumann W, Ender SA. Long-term results after arthroscopic treatment of synovial chondromatosis of the shoulder. Arthrosc J Arthrosc Relat Surg. 2008;24:318\u201323.","journal-title":"Arthrosc J Arthrosc Relat Surg"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03667-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-022-03667-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03667-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T02:29:44Z","timestamp":1679020184000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-022-03667-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,10]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["3667"],"URL":"https:\/\/doi.org\/10.1186\/s13256-022-03667-2","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,10]]},"assertion":[{"value":"28 October 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 December 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The patients accepted the proposed treatment and follow-up after adequate information and gave written consent. The study and follow-up, respecting the criteria of the Declaration of Helsinki, were approved by the Institutional Review Board of University of Florence, Aou Careggi CTO, Department of Orthopaedic Surgery. The Institutional Review Board accepted the proposal of the study, and the patient was properly informed before surgery about the treatment and follow-up visits after discharge.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Therefore, no benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"457"}}