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RESEARCH PAPER
The evaluation of surgical treatment results of medial plica syndrome
1
Department of Pediatric Orthopedic and Traumatology, Faculty of Medicine, Medical University of Bialystok, Poland
2
Department of Statistics and Medical Informatics, Faculty of Medicine, Medical University of Bialystok, Poland
Submission date: 2018-11-07
Final revision date: 2018-11-22
Acceptance date: 2018-11-22
Online publication date: 2020-03-20
Publication date: 2020-03-20
Corresponding author
Paweł Grabala
Department of Pediatric Orthopedic and Traumatology, Faculty of Medicine, Medical University of Bialystok, Waszyngtona 17, 15-274 Białystok, Poland. Tel.: +48 85 745 08 95.
Department of Pediatric Orthopedic and Traumatology, Faculty of Medicine, Medical University of Bialystok, Waszyngtona 17, 15-274 Białystok, Poland. Tel.: +48 85 745 08 95.
Pol. Ann. Med. 2020;27(1):27-33
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The medial plica of the knee is a thin inward fold of synovium which is quite often found during arthroscopic surgery, especially in adolescents. Its exact presence is a subject of wide discussion, and incidence reports ranging from 21% to even 95%.
Aim:
The purpose of this study was to evaluate the long-term results of arthroscopic resection of medial plica in adolescents and find the main symptoms in plica syndrome of a successful arthroscopic plica resection.
Material and methods:
Patients with hypertrophic medial plica were divided into 2 main groups, A and B. Group A (n = 26) suffered from pain associated with popping and clicking, catching, pseudo-locking and snapping. Group B (n = 23) suffered from pain only. Functional outcome indices (orthopaedic Tegner, Lysholm, and IKDC scores) were evaluated during this study.
Results and discussion:
Considerably better postoperative results were obtained for the patients of group A (Tegner score 8, Lysholm score 90, IKDC 90) vs. patients of group B (Tegner score 6, Lysholm score 68, IKDC score 68).
Conclusions:
Only anteromedial knee pain with popping, clicking, catching, pseudo-locking and snapping should be interpreted as a medial plica syndrome that will benefit from arthroscopic resection.
The medial plica of the knee is a thin inward fold of synovium which is quite often found during arthroscopic surgery, especially in adolescents. Its exact presence is a subject of wide discussion, and incidence reports ranging from 21% to even 95%.
Aim:
The purpose of this study was to evaluate the long-term results of arthroscopic resection of medial plica in adolescents and find the main symptoms in plica syndrome of a successful arthroscopic plica resection.
Material and methods:
Patients with hypertrophic medial plica were divided into 2 main groups, A and B. Group A (n = 26) suffered from pain associated with popping and clicking, catching, pseudo-locking and snapping. Group B (n = 23) suffered from pain only. Functional outcome indices (orthopaedic Tegner, Lysholm, and IKDC scores) were evaluated during this study.
Results and discussion:
Considerably better postoperative results were obtained for the patients of group A (Tegner score 8, Lysholm score 90, IKDC 90) vs. patients of group B (Tegner score 6, Lysholm score 68, IKDC score 68).
Conclusions:
Only anteromedial knee pain with popping, clicking, catching, pseudo-locking and snapping should be interpreted as a medial plica syndrome that will benefit from arthroscopic resection.
ACKNOWLEDGEMENTS
Linguistic help of Mr. Mark A. Nicholson, ASO is greatly appreciated.
FUNDING
This work was financed by own funds of all authors.
CONFLICT OF INTEREST
All of the authors declare no conflict of interest.
REFERENCES (27)
1.
Al-Hadithy N, Gikas P, Mahapatra AM, Dowd G. Review article: Plica syndrome of the knee. J Orthop Surg (Hong Kong). 2011;19(3):354–358. https://doi.org/10.1177/230949....
2.
Blok A, Weiss W, Dolata T, Szczepaniec M. Medial synovial plica. Ortop Traumatol Rehabil. 2005;7(4):397–400.
3.
Chow JC, Hantes M, Houle JB. Hypertrophy of the synovium in the anteromedial aspect of the knee joint following trauma: an unusual cause of knee pain. Arthroscopy. 2002;18(7):735–740. https://doi.org/10.1053/jars.2....
4.
Christoforakis JJ, Sanchez-Ballester J, Hunt N, Thomas R, Strachan RK. Synovial shelves of the knee: association with chondral lesions. Knee Surg Sports Traumatol Arthrosc. 2006;14(12):1292–1298. https://doi.org/10.1007/s00167....
5.
Dorchak JD, Barrack RL, Kneisl JS, Alexander AH. Arthroscopic treatment of symptomatic synovial plica of the knee. Long-term followup. Am J Sports Med. 1991;19(5):503–507. https://doi.org/10.1177/036354....
7.
Farkas C, Hargitai Z, Gáspár L, Kuki A, Csernátony Z, Szepesi K. Histological changes in the symptomatic mediopatellar plica. Knee. 2004;11(2):103–108. https://doi.org/10.1016/S0968-....
8.
Flanagan JP, Trakru S, Meyer M, Mullaji AB, Krappel F. Arthroscopic excision of symptomatic medial plica. A study of 118 knees with 1-4 year follow-up. Acta Orthop Scand. 1994;65(4):408–411. https://doi.org/10.3109/174536....
9.
Gerbino PG, Griffin ED, d’Hemecourt PA, et al. Patellofemoral pain syndrome: evaluation of location and intensity of pain. Clin J Pain. 2006;22(2):154–159.
10.
Griffith CJ, LaPrade RF. Medial plica irritation: diagnosis and treatment. Curr Rev Musculoskelet Med. 2008;1(1):53–60. https://doi.org/10.1007/s12178....
11.
Gurbuz H, Calpur OU, Ozcan M, Kutoglu T, Mesut R. The synovial plicae in the knee joint. Saudi Med J. 2006;27(12):1839–1842.
12.
Lyu SR, Hsu CC. Medial plicae and degeneration of the medial femoral condyle. Arthroscopy. 2006;22(1):17–26. https://doi.org/10.1016/j.arth....
13.
Stubbings N, Smith T. Diagnostic test accuracy of clinical and radiological assessments for medial patella plica syndrome: A systematic review and meta-analysis. Knee. 2014;21(2):486–490. https://doi.org/10.1016/j.knee....
14.
Hagino T, Ochiai S, Watanabe Y, et al. Usefulness of knee arthroscopy for diagnosis of knee pain in pediatric patients: comparison with preoperative clinical diagnosis. Arch Orthop Trauma Surg. 2013;133(5):669–673. https://doi.org/10.1007/s00402....
15.
Weckström M, Niva MH, Lamminen A, Mattila VM, Pihlajamäki HK. Arthroscopic resection of medial plica of the knee in young adults. Knee. 2010;17(2):103–107. https://doi.org/10.1016/j.knee....
16.
Johnson DP, Eastwood DM, Witherow PJ. Symptomatic synovial plicae of the knee. J Bone Joint Surg Am. 1993;75(10):1485–1496. https://doi.org/10.2106/000046....
17.
Maffulli N, Testa V, Capasso G. Mediopatellar synovial plica of the knee in athletes: results of arthroscopic treatment. Med Sci Sports Exerc. 1993;25(9):985–988.
18.
Sakakibara JO. Arthroscopic study on lino’s band. J Jpn Orthop Assoc. 1976;50:513–522.
19.
Nigam A, Shetty VD. The medial plica: a clinical perspective. Eur J Orthop Surg Traumatol. 2012;22(2):97–102.
20.
Protasiewicz-Fałdowska H, Surus R, Zielinska M, et al. Influence of myofascial taping application on postural stability in adolescents with pain in the anterior joint of the knee. Pol Ann Med. 2018;25(1):46–50. https://doi.org/10.29089/2017.....
21.
Topór M, Kowalski IM, Tomaszewski W. The influence of tensometric evaluation of the pain threshold on the nature of resistance exercising in disorders of the knee joint. Ortop Traumatol Rehab. 2005;7(5):521–527.
22.
Patel D. Plica as a cause of anterior knee pain. Orthop Clin North Am. 1986;17(2):273–277.
23.
Uysal M, Asik M, Akpinar S, Ciftci F, Cesur N, Tandogan RN. Arthroscopic treatment of symptomatic type D medial plica. Int Orthop. 2008;32(6):799–804. https://doi.org/10.1007/s00264....
24.
Luhmann SJ, Schoenecker PL, Dobbs MB, Gordon JE. Adolescent patellofemoral pain: implicating the medial patellofemoral ligament as the main pain generator. J Child Orthop. 2008;2(4):269–277. https://dx.doi.org/10.1007%2Fs....
25.
Mogil JS1, Bailey AL. Sex and gender differences in pain and analgesia. Prog Brain Res. 2010;186:141–157. https://doi.org/10.1016/B978-0....
26.
Petersen W, Ellermann A, Gösele-Koppenburg A, et al. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014;22(10):2264–2274. https://doi.org/10.1007/s00167....
27.
Rixe JA, Glick JE, Brady J, Olympia RP. A review of the management of patellofemoral pain syndrome. Phys Sportsmed. 2013;41(3):19–28. https://doi.org/10.3810/psm.20....
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