The disorders of the knee joint with symptomatic medial patellar plica syndrome

Objective:To discuss the pathogenesis of symptomatic medial patellar plica(MPP)syndrome and the relationship between MPP and meniscus injury or chondropathy and analyze the features of MPP and its role in the development of osteoarthritis.Methods:Arthroscopy was performed on 53 medial patellar plica(48 patients) by a single arthroscopic surgeon between September 2002 and July 2005,there were 13 male(13 knees) and 35 female(40 knees) in this group,the average age was 56 years,duration of disease varied from 1 month to 10 years(average 26 months),and all plica were excised.The pre-and post-operative knee joint functions were assessed with Lysholm knee joint function score.The relationship between the clinicl symptoms and impairment were analyzed,then the diagnostic accordance was calculated.The position,characters,type of symptomatic synovial plica and position,grading of chondromalacia were observed by arthroscopy respectively.The relationship between MPP and meniscus injury or chondropathy was also analyzed.Statistics work was done with SPSS 13.0 statistical software.Results: The femoral groove-type chondropathy and round-like chondropathy were two common types of articular cartilage defect.The cartilage dgeneration of medial femoral condyle in unweight loading area was 54.29%,medial femoral trochlea was 40.00% and the medial side of articular surface of patella was 5.71%.All patients were followed up for an average time of 28 months(from 17 months to 4 years).The score of Lysholm was raised from(41.00±7.03) to(85.00±8.01),and no case had recrudesced.Conclusion:The clinical features of symptomatic MPP syndrome are nonspecific,but it can be easily diagnosed by arthroscopy.Medial patellar plica plays a mechanical role in the development of medial femoral chondropathy,excision of plica is confirmed to be a prophylactic procedure to the cartilage damage.