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Synovium of the Knee



- See:
   - Bursae of the knee:
   - Pigmented Villonodular synovitis

- Discussion:
- synovial cavity is deepest layer of joint capsule & it often has several embryological invaginations called plica that persist into adult life;
   - these may cuase anterior knee symptoms,
- although synovium membrane is attached all around, above to articular margins of femur and below to articular margins of tibia, it is not
    everywhere coextensive w/ capsule or ligament and tendons;
- on lateral & medial sides of joint, it lies on inner surface of capsular ligament except where it is interrupted by attachments of meniscii
    and separated from capsule on lateral side by tendon of popliteus muscle;
    - it swings anteriorly, covering deep surface of tendons lateral to & above patella, & attaches to articular margins of patella;
- below the patella it covers deep surface of infrapatellar pad of fat that lies on the deep surface of the ligamentum patellae;
- on each side of infrapatellar fat, horizontal alar fold is identified;
- because of folds of synovial membrane, synovial cavity is not simple, short, cylindrical cavity;
    - behind and above the patella, it is single cavity that is usually continuous above w/ suprapatellar bursa between the tendon of quads &
         femur;
- below patella, synovial cavity is divided into lateral & medial compartments by the infrapatellar synovial fold;
- posteriorly, synovial cavity is divided into two compartments by fold that contains the cruciate ligaments;
- cruciate ligaments, meniscii, & infrapatellar fat pad are outside the synovial cavity;


Villous lipomatous proliferation of the synovial membrane (lipoma arborescens).

Synovectomy of the rheumatoid knee using intra-articular injection of dysprosium-165-ferric hydroxide macroaggregates.

A prospective clinical five year follow up study after open synovectomy of the knee joint in patients with chronic inflammatory joint disease. The prognostic power of clinical, arthroscopic, histologic and immunohistologic variables.



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