Tindel N L, Nisonson B
Department of Orthopedic Surgery, Lenox Hill Hospital, New York, New York.
Orthop Clin North Am. 1992 Oct;23(4):613-8.
The plica syndrome is an uncommon pathologic entity diagnosed far too often in the setting of concomitant pathology. Medial patellar pain is more likely to be related to patellofemoral maltracking than to plica syndrome. Likewise, anteromedial joint line tenderness is more likely to be related to a meniscal tear than to a pathological plica. An accurate history and physical examination aided by appropriate ancillary tests to confirm the diagnosis are essential to avoid unnecessary surgical treatment. Conservative measures are very effective and must be emphasized before any operative procedure. When arthroscopy is indicated, a thorough examination of the entire knee joint is necessary. A plica may or may not be present. When a pathological plica is found, excision is rewarded with excellent results. Unfortunately, many normal plicae are removed simply because they are present and not because they are symptomatic or pathologic. This leads to persistent symptoms because of misdiagnosis, as well as possible complications secondary to the operation.
滑膜皱襞综合征是一种罕见的病理情况，却常在合并其他病变时被过度诊断。髌内侧疼痛更可能与髌股关节轨迹异常有关，而非滑膜皱襞综合征。同样，关节线前内侧压痛更可能与半月板撕裂有关，而非病理性滑膜皱襞。准确的病史和体格检查，辅以适当的辅助检查以确诊，对于避免不必要的手术治疗至关重要。保守治疗措施非常有效，在任何手术操作之前都必须予以强调。当需要进行关节镜检查时，对整个膝关节进行全面检查是必要的。滑膜皱襞可能存在，也可能不存在。当发现病理性滑膜皱襞时，切除可获得极佳效果。不幸的是，许多正常的滑膜皱襞被切除仅仅是因为它们存在，而不是因为它们有症状或病理性改变。这会因误诊导致持续症状，以及手术可能引发的并发症。
