Tenosynovial giant cell tumor of the hip: a systematic review and institutional case series with Meta-analysis of recurrence and patient-reported outcomes

Background Tenosynovial giant cell tumors (TGCT) are rare, locally aggressive neoplasms of the synovium, most frequently affecting the knee and less commonly the hip. Due to its deep anatomy and weight-bearing function, hip TGCT may follow a distinct clinical course. This study evaluates clinical presentation, treatment outcomes, recurrence patterns, and patient-reported outcomes in hip TGCT. Methods A systematic literature search in PubMed, Embase, and Cochrane Library (January 2000–May 2025) identified studies including ≥5 patients with hip TGCT reporting recurrence, complications, functional outcomes or patient-reported outcomes. A random-effects meta-analysis assessed recurrence risk across treatment modalities. Additionally, 23 patients of two retrospective institutional cohorts were analyzed, including PROMIS-CAT assessment. Results Seventeen studies comprising 269 patients were included. The mean age was 32 years and 58% were female. At diagnosis, 48% of patients with available cartilage data demonstrated advanced degeneration (grade ≥ 3). No statistically significant differences in recurrence risk were observed between treatment strategies; arthroscopic synovectomy, open synovectomy, and total hip arthroplasty. However, comparisons were limited by heterogeneous patient selection and follow-up duration. Arthroplasty was associated with the highest complication rate (33%), primarily aseptic loosening (19%). In the institutional cohort, 21.7% experienced recurrence and 29.4% required conversion to THA. Recurrences and conversions occurred exclusively in D-TGCT. PROMIS-CAT pain interference scores remained elevated (mean T-score 63.4 ± 11.1). Conclusion Hip TGCT shows substantial cartilage damage at diagnosis and persistent postoperative morbidity. While recurrence rates appear comparable between surgical strategies, arthroplasty carries a higher complication burden in this predominantly young population. Prospective multicenter studies with standardized outcome reporting are required to optimize treatment strategies.