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

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

To 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.

Methods

35 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.

Results

The 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.

Conclusion

Arthroscopic 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 evidence

Level IV, prospective case series with no control group.

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Authors and Affiliations

  1. Klinik für Orthopädie, Heinrich-Heine-Universität Düsseldorf, Universitätsklinik Düsseldorf, Moorenstr 5, 40225, Düsseldorf, Germany

    Martin Hufeland, Loren Treder, Hannes Kenji Kubo, Rüdiger Krauspe & Thilo Patzer

  2. Heinrich-Heine-Universität Düsseldorf, Koordinierungszentrum für Klinische Studien (KKS), Düsseldorf, Germany

    Pablo Emilio Verde

  3. Schön-Klinik Düsseldorf, Fachzentrum für Schulter, Ellenbogen, Knie und Sportorthopädie, Düsseldorf, Germany

    Thilo Patzer

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  1. Martin Hufeland
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  2. Loren Treder
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  3. Hannes Kenji Kubo
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  4. Pablo Emilio Verde
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  5. Rüdiger Krauspe
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  6. Thilo Patzer
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Correspondence to Martin Hufeland.

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M. Hufeland, L. Treder, H. K. Kubo, P. E. Verde, R. Krauspe and T. Patzer declare that they have no conflict of interest.

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Hufeland, M., Treder, L., Kubo, H.K. et al. Symptomatic medial synovial plica of the knee joint: an underestimated pathology in young patients. Arch Orthop Trauma Surg 139, 1625–1631 (2019). https://doi.org/10.1007/s00402-019-03249-w

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  • DOI: https://doi.org/10.1007/s00402-019-03249-w

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