• Arch Orthop Trauma Surg · Nov 2019

    Symptomatic medial synovial plica of the knee joint: an underestimated pathology in young patients.

    • Martin Hufeland, Loren Treder, Hannes Kenji Kubo, Pablo Emilio Verde, Rüdiger Krauspe, and Thilo Patzer.
    • Klinik für Orthopädie, Heinrich-Heine-Universität Düsseldorf, Universitätsklinik Düsseldorf, Moorenstr 5, 40225, Düsseldorf, Germany. mhufeland@gmail.com.
    • Arch Orthop Trauma Surg. 2019 Nov 1; 139 (11): 1625-1631.

    IntroductionTo prospectively evaluate the outcome of arthroscopic resection of a symptomatic medial plica in patients under 30 years with evaluating the influence of sports, knee trauma and plica type.Methods35 consecutive patients (38 knees), mean age 16.2 ± 4.7 years (9-26 years), 28 females (73.7%) were prospectively included. Patients with any additional surgical procedures or cartilage lesions > ICRS grade I were excluded. The influence of trauma to the knee, level of sport and the morphologic plica type on the outcome was evaluated in addition to standard knee scores before and 20.1 ± 9.3 months (12-44 months) after surgery.ResultsThe Knee Injury and Osteoarthritis Outcome Score improved significantly from 50.2 ± 19.1% (12.5-94.6) to 80.7 ± 15.3% (48.2-100; p < 0.001). The Tegner Activity Scale improved significantly from 2.2 ± 1.5 (0-6) to 4.9 ± 1.7 (3-10; p < 0.001) and the Kujala Anterior Knee Pain Scale improved significantly from 52.6 ± 16.6 (16-86) to 80.7 ± 16.5 (46-100; p < 0.001). The level of pain in the knee decreased from 7.9 ± 2.0 (1-10) to 3.1 ± 2.6 (0-9; p < 0.001) at follow-up on a numeric rating scale (0-10). Neither trauma to the knee, high impact sport, cartilage lesions to the medial femoral condyle nor the plica type or associated ICRS grade I cartilage lesion to the medial femoral condyle had a significant effect on the outcome parameters.ConclusionArthroscopic resection of a symptomatic medial plica provides excellent clinical results in young patients. Trauma, high impact sports, ICRS grade I cartilage lesions to the medial femoral condyle or the plica type are not associated with a poorer outcome.Level Of EvidenceLevel IV, prospective case series with no control group.

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