Total Hip Arthroplasty for Giant Hip Synovial Chondromatosis With Acetabular Involvement Complicated by Osteoarthritis: A 12-Year Follow-Up of a Case and Literature Review

Synovial chondromatosis (SC) is a rare benign synovial disorder. Giant hip SC with acetabular involvement in the setting of end-stage osteoarthritis remains exceptionally uncommon, with limited long-term evidence available. We report a 50-year-old woman with giant SC of the left hip and acetabular invasion (Kellgren–Lawrence grade IV osteoarthritis), treated with cementless total hip arthroplasty via the Moore posterior approach combined with lesion resection and synovectomy. At 12-year follow-up, the patient achieved a Harris Hip Score of 98, with complete pain relief, stable prosthesis fixation, and no recurrence or malignant transformation. In addition, a literature review of 203 reported hip SC cases (2018-2024) demonstrated recurrence and revision rates of 10.34% and 22.58%, respectively, following total hip arthroplasty. No previously reported cases described giant SC with acetabular involvement.