Adachi Nobuo, Ochi Mitsuo, Uchio Yuji, Kawasaki Kenzo, Yamasaki Keiichirou
Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Arthroscopy. 2004 Nov;20(9):987-91. doi: 10.1016/j.arthro.2004.08.005.
Abstract We report the case of a professional baseball pitcher who achieved complete relief of an anterior knee pain after resection of a complete type of suprapatellar plica under arthroscopy. The 27-year-old male professional baseball pitcher had complained of right anterior knee pain while pitching for more than 2 years. On physical examination, the mobility of his patella was limited and he complained of tenderness along the joint line of his lateral patellofemoral joint. The preoperative patellofemoral axial radiograph showed osteophyte formation on the lateral edge of the patella. On preoperative magnetic resonance imaging, a septum dividing the suprapatellar pouch was found. Arthroscopy revealed obvious cartilaginous damage on the lateral facet of the patella and facing trochlea of the femoral condyle. There was a complete type of suprapatellar plica. The suprapatellar plica seemed to be anchoring the patella, which reduced the mobility of the patella. After resecting the complete type of suprapatellar plica under arthroscopy, the mobility of the patella was improved. Because his anterior knee pain while pitching reduced rapidly postoperatively, he could return to regular baseball. We consider that the main cause of his anterior knee pain was cartilaginous damage on the patella and the trochlea, which might be accelerated by the existence of the suprapatellar plica that reduced the mobility of the patella.
摘要 我们报告了一例职业棒球投手的病例，该患者在关节镜下切除完全型髌上皱襞后，前膝疼痛完全缓解。这位27岁的男性职业棒球投手在投球时右前膝疼痛已超过2年。体格检查时，其髌骨活动度受限，且在髌股外侧关节线处有压痛。术前髌股轴位X线片显示髌骨外侧边缘有骨赘形成。术前磁共振成像发现一个分隔髌上囊的隔膜。关节镜检查显示髌骨外侧小面和股骨髁滑车面对侧有明显软骨损伤。存在完全型髌上皱襞。髌上皱襞似乎固定了髌骨，从而降低了髌骨的活动度。在关节镜下切除完全型髌上皱襞后，髌骨活动度得到改善。由于术后投球时前膝疼痛迅速减轻，他能够恢复正常棒球运动。我们认为其前膝疼痛的主要原因是髌骨和滑车的软骨损伤，而髌上皱襞的存在降低了髌骨活动度，可能加速了这种损伤。
