Abstract
Purpose
The medial plica (MP) is a normal anatomic structure consisting of a fold in the synovial layer of the joint. Arthroscopic resection is currently used as a gold standard procedure in patients with medial plica syndrome (MPS), but there are few prospective studies that analyze the long-term functional outcomes of plica resection.
Methods
The purpose of this prospective study was to evaluate the long-term results of arthroscopic resection of the medial plicae of the knee. Between 1999 and 2014 we included 267 patients that showed MRI evidence of MP out of the 5682 knee arthroscopies that we performed. We recorded pre and post-operative Tegner Lysholm knee scale scores (TLKSS) for up to 36 (3, 6, 12, 24, 36) months. The EQ-5D questionnaire was used to measure the patients’ generic health status.
Results
The mean values of the TLKSS were 68 (61–82) pre-operative, 87 (81–94) at the 3-month follow-up and 94 (92–97) at the 6-month follow-up. The long term results (TLKSS at 12, 24, and 36 months post-operatively) were 94.8 (91–98), 94.8 (90–97), and 94.5 (92–97) respectively. The EQ-5D and EQ-VAS showed significant improvement between each of the first three data registering moments (pre-operative, 3 and 6 month follow-up).
Conclusion
The quality of the treatment and the final functional result is directly influenced by the type of plica that creates the symptomatology. We have achieved good overall results for our patients, the ones with less cartilage damage having the fastest recovery time. The arthroscopic resection is a very good option for medial plicae that do not respond to conservative treatment, and it must be initiated as a first option when cartilage damage is suspected.
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References
Dupont JY (1997) Synovial plicae of the knee. Controversies and review. Clin Sports Med 16:87–122
Kim SJ, Choe WS (1997) Arthroscopic findings of the synovial plicae of the knee. Arthroscopy 13(1):33–41
Jackson RW, Marshall DJ, Fujisawa Y (1982) The pathologic medial shelf. Orthop Clin N Am 13(2):307–312
Nigam A, Shetty V (2012) The medial plica: a clinical perspective. Eur J Orthop Surg Traumatol 22:97–102
Blok A, Weiss W, Dolata T, Szczepaniec M (2005) Medial synovial plica. Ortop Traumatol Rehabil 7:397–400
Pipkin G (1971) Knee injury: the role of the suprapatellar plica and suprapatellar bursa in simulating internal derangements. Clin Orthop 74:161–176
Kim SJ, Jeong JH, Cheon YM, Ryu SW (2004) MPP test in the diagnosis of medial patellar plica syndrome. Arthroscopy 20(10):1101–1103
Sakakibara J (1974) Arthroscopic study on Iino’s band (plica synovialis mediopatellaris). J Jpn Orthop Assoc 50:513–522
Hardaker WT, Whipple TL, Bassett FH 3rd (1980) Diagnosis and treatment of the plica syndrome of the knee. J Bone Joint Surg Am 62:221–225
Flanagan JP, Trakru S, Meyer M, Mullaji AB, Krappel F (1994) Arthroscopic excision of symptomatic medial plica. A study of 118 knees with 1–4 year follow-up. Acta Orthop Scand 65:408–411
Dandy DJ (1990) Anatomy of the medial suprapatellar plica and medial synovial shelf. Arthroscopy 6(2):79–85
Fulkerson JP (2002) Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med 30(3):447–456
Amatuzzi MM, Fazzi A, Varella MH (1990) Pathologic synovial plica of the knee. Results of conservative treatment. Am J Sports Med 18(5):466–469
Kan H, Arai Y, Nakagawa S, Inoue H, Hara K, Minami G, Inoue A, Kanamura H, Ikoma K, Fujiwara H, Kubo T (2015) Characteristics of medial plica syndrome complicated with cartilage damage. Int Orthop 39(12):2489–2494
Schindler OS (2014) The Sneaky Plica’ revisited: morphology pathophysiology and treatment of synovial plicae of the knee. Knee Surg Sports Traumatol Arthrosc 22(2):247–262
Stubbings N, Smith T (2014) Diagnostic test accuracy of clinical and radiological assessments for medial patella plica syndrome: a systematic review and meta-analysis. Knee 21(2):486–490
Nakanishi K, Inoue M, Ishida T, Murakami T, Tsuda K, Ikezoe J, Nakamura H (1996) MR evaluation of mediopatellar plica. Acta Radiol 37(4):567–571
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Radu Prejbeanu, Dan V. Poenaru, Andrei Dan Balanescu, and Mihail-Lazar Mioc declare that they have no conflicts of interest.
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All procedures performed in this study were in accordance with the ethical standards of the SCJU Pius Brânzeu Research Committee and with the 1964 Helsinki declaration and its later amendments.
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Prejbeanu, R., Poenaru, D.V., Balanescu, A.D. et al. Long term results after arthroscopic resection of medial plicae of the knee—a prospective study. International Orthopaedics (SICOT) 41, 121–125 (2017). https://doi.org/10.1007/s00264-016-3313-1
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DOI: https://doi.org/10.1007/s00264-016-3313-1