Arthroscopic Treatment of Tenosynovial Giant Cell Tumor of the Hip With Concomitant Femoracetabular Impingement Syndrome.

Background: Tenosynovial giant cell tumor (TGCT) is a benign but locally aggressive proliferative disorder of the synovium. TGCT of the hip is destructive to the joint and is a risk factor for early total hip arthroplasty (THA). Open synovectomy has previously been the gold-standard treatment. However, hip arthroscopy has emerged as a less invasive approach for the management of TGCT of the hip. Indications: Arthroscopic management of TGCT of the hip is indicated when there is either confirmed TCGT on biopsy or strong suspicion for TCGT based on clinical and radiologic findings, minimal-to-no arthritis, a lesion that is accessible and resectable arthroscopically, and an available trained hip arthroscopist. Technique Description: The patient is positioned supine on a post- or postless traction table. Anterolateral and mid-anterior portals are created in standard fashion. An interportal capsulotomy is created sharply between the 2 portals, and traction sutures are placed for improved visualization. Defects of the central compartment are addressed, then an arthroscopic scalpel is used to extend the vertical limb of the capsulotomy for creation of a T-type capsulotomy. An arthroscopic grasper is used to mobilize the TGCT lesion. The concomitant CAM-type deformity is then resected using a high-speed burr. The remaining TGCT lesion is then resected, followed by meticulous synovectomy using a shaver and electrocautery. The capsule is then plicated using high-molecular-weight sutures. Results: Numerous case series have supported the arthroscopic management of TGCT of the hip, showing improved and excellent patient reported outcomes, low rates of THA conversion, low rates of recurrence, and low complication rates. Discussion/Conclusion: Hip arthroscopy can be an effective, minimally invasive surgical technique for the arthroscopic management of TGCT of the hip. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.