# Management of Primary Synovial Osteochondromatosis in the Ankle Joint With a Combined Posterior-Anterior Arthroscopic Procedure: A Case Report

## TL;DR

A combined arthroscopic approach with complete synovectomy effectively managed a rare ankle joint condition in a young patient, with no recurrence after one year.

## Contribution

Demonstrates the effectiveness of a combined posterior-anterior arthroscopic approach for treating ankle PSO.

## Key findings

- Complete symptom relief was achieved after the surgical intervention.
- No recurrence was observed at the 12-month follow-up.
- Pathological examination confirmed the diagnosis of stage III PSO.

## Abstract

Primary synovial osteochondromatosis (PSO), a seldom-seen synovial proliferative disease involving chondral metaplasia, presents a unique challenge when affecting the ankle joint. Controversy exists regarding whether a combined posterior-anterior approach with total synovectomy is necessary to avert recurrence or malignancy.

An 18-year-old Caucasian male presented to the outpatient clinic with clinical and imaging findings indicative of a stage III PSO. The surgical intervention involved a combined posterior-anterior arthroscopic approach with the removal of multiple loose bodies and complete synovectomy, resulting in complete relief of symptoms without recurrence at the 12-month follow-up. Pathological examination confirmed the diagnosis.

The management of PSO in the ankle joint using a combined posterior-anterior arthroscopic approach with complete synovectomy demonstrated effectiveness in this case. Regular follow-ups are essential for monitoring long-term outcomes and detecting potential recurrence or malignant transformation.