Kim Sung-Jae, Lee Doo-Hyung, Kim Tae-Eun
Department of Orthopaedic Surgery and the Arthroscopy & Joint Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Arthroscopy. 2007 Dec;23(12):1303-8. doi: 10.1016/j.arthro.2007.06.016.
This study investigated whether the mediopatellar plica (MPP) test developed by the authors could be used preoperatively to predict MPP pathology found at arthroscopy.
Between January 1999 and August 2004, 65 patients (66 knees, group I) with anteromedial knee pain were examined using the MPP test before undergoing an arthroscopic procedure. In the control group, 101 patients (106 knees, group II) with lateral tibiofemoral joint line pain were examined by the MPP test. After arthroscopic excision of a thickened MPP, the visual analogue scale and the Lysholm scoring scale were recorded during follow-up.
Of the 172 knees evaluated, the sensitivity, specificity, and positive and negative predictive value for the MPP test were 89.5%, 88.7%, 78.7%, and 94.4%, respectively. The accuracy value was 89.0%. Thirteen knees (7.6%) were categorized as false positives, 7 knees had fat pad synovial fringe entrapments, 5 knees had localized synovitis, and 1 knee had a focal cartilage lesion on the medial femoral condyle. In 53 knees diagnosed with pathologic MPP entrapment in group I, the mean postoperative VAS was 1.3 (range, 0 to 4) and the mean postoperative Lysholm score was 91.4 (range, 74 to 100), while all knees showed a negative MPP test after the mean follow-up of 48.1 months (range, 24 to 96 months).
The MPP test is reliable to predict the pathologic MPP entrapment, and arthroscopic excision of pathologic MPP shows satisfactory clinical results.
Level III, diagnostic study of nonconsecutive patients without consistently applied gold standard.
本研究调查了作者开发的髌内侧皱襞（MPP）试验是否可在术前用于预测关节镜检查时发现的MPP病变。
1999年1月至2004年8月期间，65例（66膝，I组）膝前内侧疼痛患者在接受关节镜手术前使用MPP试验进行检查。在对照组中，101例（106膝，II组）胫股外侧关节线疼痛患者接受了MPP试验检查。在关节镜下切除增厚的MPP后，在随访期间记录视觉模拟评分和Lysholm评分量表。
在评估的172膝中，MPP试验的敏感性、特异性、阳性和阴性预测值分别为89.5%、88.7%、78.7%和94.4%。准确性值为89.0%。13膝（7.6%）被归类为假阳性，7膝有脂肪垫滑膜边缘卡压，5膝有局限性滑膜炎，1膝在内侧股骨髁有局灶性软骨损伤。在I组中诊断为病理性MPP卡压的53膝中，术后平均VAS为1.3（范围0至4），术后平均Lysholm评分为91.4（范围74至100），而在平均48.1个月（范围24至96个月）的随访后，所有膝的MPP试验均为阴性。
MPP试验可可靠地预测病理性MPP卡压，关节镜下切除病理性MPP显示出满意的临床效果。
III级，对未连续应用金标准的非连续患者的诊断性研究。
