Relationship of medial plica and medial femoral condyle during flexion

Knee health promotion option for knee osteoarthritis: A preliminary report of a concept of multidisciplinary management

“…Furthermore, we found two distinct foci of cartilaginous lesions on the facing medial femoral condyle in almost all of the patients with medial plica [4]. Our further studies not only disclosed the kinematic relationship between the medial plica with the medial femoral condyle during knee motion in vivo [5], but also implied the close interplay between this structure and the medial femoral condyle [6]. More recently we have found [7,8] that the repeated injuries elicited by this abrasion phenomenon might trigger interleukin-1β (IL-1β) production in medial plica, thus enhancing the expression of matrix metalloproteinase-3 (MMP-3).…”

“…1, which we call the "knee health promotion option (KHPO)", was implemented for the treatment of OA knees based on the findings of our previous research [4][5][6][7][8] regarding MAS as a cause of knee OA and the clinical outcome of ACRFP [10].…”

Knee Health Promotion Option for Osteoarthritic Knee: Cartilage Regeneration is Possible

“…In 2006, we reported that in patients with medial compartment osteoarthritic knees, the prevalence of medial plica was significantly higher than that of others and that two distinct foci of cartilaginous lesion were found on the facing medial femoral condyle in almost all of the patients who had the structure of medial plica (Lyu SR and Hsu CC, 2006). Our further study disclosed the kinematic relationship of the medial plica with the medial femoral condyle during knee motion in vivo (Lyu SR, 2007). In that study, it was revealed that all medial plicae, regardless of their size, would move reciprocally and would keep in touch with the medial femoral condyle and therefore might cause some degree of abrasion on the facing medial femoral condyle during knee motion.…”

“…The main theme of ACRFP is to remove any abnormal abrasion or impingement phenomenon and reestablish soft tissue balance in medial compartment and patellofemoral joint. For knees demonstrating medial abrasion phenomenon, medial release (Lyu SR, 2008) was performed to relieve the tension and abrasion between the tight, fibrotic and hypertrophied medial plica and the adjacent medial femoral condyle that have been described in previous studies (Lyu SR and Hsu CC, 2006;Lyu SR, 2007;Lyu et al, 2010). On the other hand, in knees demonstrating lateral compression syndrome over patellofemoral joint, percutaneous lateral capsular release that has the benefits of tension release and denervation (Calpur OU et al, 2005;Paulos LE et al, 2008) was added.…”

“…This study also found that the Young's modulus of the medial plica was positively correlated with the severity of the plica lesion and the patient's age. In the second study (Lyu SR, 2007), the inner margins of the medial plicae of 30 knees were located by inserting needles percutaneously under direct vision during arthroscopic examination. The topographic changes of the margins of these plicae during knee motion were recorded by fluoroscopy and analyzed.…”