The Plica Syndrome

Tindel, Nathaniel L.; Nisonson, Barton

doi:10.1016/s0030-5898(20)31775-2

Cited by 53 publications

(12 citation statements)

References 14 publications

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“…During fetal development, the knee is separated into three compartments by synovial membranes [10, 18, 19]. At about 4–5 months of embryonic development, these partitions resorb to form a single cavity.…”

Section: Discussionmentioning

confidence: 99%

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Synovial shelves of the knee: association with chondral lesions

Christoforakis

Sanchez-Ballester

Hunt

et al. 2006

Knee Surg Sports Traumatol Arthrosc

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The objectives of the present study were to evaluate whether synovial shelves of the knee are associated with increased incidence of chondral lesions and to determine which types of plica are associated with significant articular damage. Data were collected prospectively from 1,000 consecutive knee arthroscopies. Of these patients, 321 (32.1%) were found to have synovial shelves of the knee. Patients details (age, sex, duration of symptoms, injuries, and possible mechanism of injury), operative details (types and number of portals, equipment used), intra-articular findings (articular, meniscal and synovial lesions, and stability characteristics) and procedures performed were recorded on a special database. Synovial shelves of the knee were recorded using a modification of the Sakakibara classification. Articular lesions were noted on anatomic articular maps of the different functional zones using a functional zoning system that presaged the current ICRS system. An increased incidence of articular lesions was found in patients with synovial shelves, in comparison with patients without shelves (94.7 vs. 81% respectively; P < 0.001). Patients with larger and more fibrotic shelves were found to have increased incidence of cartilage lesions, in comparison with patients with type smaller and less fibrotic shelves (96.5 vs. 86.4%, respectively; P = 0.002), as well as cartilage lesions with bigger size (84 vs. 71.4%, respectively; P = 0.02). Patella (P < 0.001), and specific areas (P < 0.001) of the medial femoral condyle, were areas with increased incidence of cartilage lesions, in patients with synovial shelves. In conclusion, synovial shelves of the knee are associated with an increased incidence of cartilage lesions. Larger shelves, particularly with chronic inflammation are associated with more frequently occurring and larger articular lesions. Areas with increased incidence of chondral lesions, in patients with plicae, include particularly the lower patella and the non-weight-bearing medial femoral condyle.

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Section: Discussionmentioning

confidence: 99%

“…The most common symptoms associated with plica include anterior knee pain as well as swelling, giving way, clicking, catching, locking, or pseudolocking of the knee [12, 18]. The symptoms are thought to be due to the plica ‘bowstringing’ across the femoral condyle during flexion [11].…”

Section: Introductionmentioning

confidence: 99%

Synovial shelves of the knee: association with chondral lesions

Christoforakis

Sanchez-Ballester

Hunt

et al. 2006

Knee Surg Sports Traumatol Arthrosc

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“…A tight lateral retinaculum may worsen medial plica contact by providing a lateral restraint/pull to the plica throughout knee range of motion. Other authors have associated pathologic medial plica formation with lateral patellofemoral tilt or tracking [1, 14, 37, 38].…”

Section: Discussionmentioning

confidence: 99%

The effects of medial synovial plica excision with and without lateral retinacular release on adolescents with anterior knee pain

Kramer

Kalish

Abola

et al. 2016

Journal of Children's Orthopaedics

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ObjectivesTo describe the functional outcomes in patients aged ≤18 years with anterior knee pain treated with medial plica excision with or without lateral release.MethodsWe identified 135 patients including 30 bilateral cases (165 knees) with a mean ± SD age of 15.1 ± 2.0 years. Patient and surgical information was recorded and a follow-up athletic questionnaire and an International Knee Documentation Committee (IKDC) Subjective Knee Evaluation form were sent out. Statistical analysis evaluated predictors of residual pain, reoperation, return to sports, IKDC score and satisfaction with surgery.ResultsAt a final mean follow-up of 4.4 years (range 2–7.5), 36 % of patients were pain free, 46 % had mild residual pain and 18 % had pain not improved from surgery. Reoperation was more likely following isolated plica excision (7/41; 17 %) versus plica excision with lateral release (8/124; 6 %), although not statistically significant, P = 0.06. Mean IKDC score (107 knees) was 76.9 ± 17.8 (range 31–100). Most patients (86/99; 87 %) were satisfied with surgery and were able to return to sports (104/120; 87 %).ConclusionsWhile most patients were satisfied and able to return to sports following plica excision with or without lateral release, residual symptoms were common.

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“…48,49 Mediopatellar plica and suprapatellar plica cause symptoms occasionally. 24,50 Although it is generally agreed that the infrapatellar plica does not cause symptoms, 17,24,50 we have experiences with pathologic infrapatellar plica with limitation in knee extension in three cases. 51,52 On the physical examinations, these patients revealed flexion contractures of 20 to 25 degrees and atrophy of the thigh musculature.…”

Section: Infrapatellar Plicamentioning

confidence: 88%

“…Blunt trauma, localized hemorrhage, and joint laxity can create symptomatic synovial plica. 23,24 Whatever the reason, as a result, the synovium loses its elasticity, thickens, and becomes inflammatory. This inflammatory process eventually causes fibrosis of the synovial plica followed by serious intra-articular disturbances.…”

Section: Patella Plica Syndromementioning

confidence: 99%

Patella Plica Syndrome

Kim

Anterior Knee Pain and Patellar Instability

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The Plica Syndrome

Cited by 53 publications

References 14 publications

Synovial shelves of the knee: association with chondral lesions

Synovial shelves of the knee: association with chondral lesions

The effects of medial synovial plica excision with and without lateral retinacular release on adolescents with anterior knee pain

Patella Plica Syndrome

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