Weckström Maria, Niva Maria H, Lamminen Antti, Mattila Ville M, Pihlajamäki Harri K
Centre for Military Medicine, Research Department, Helsinki, Finland.
Knee. 2010 Mar;17(2):103-7. doi: 10.1016/j.knee.2009.07.010. Epub 2009 Sep 2.
The purpose of this study was to evaluate the long-term results of arthroscopic resection of a medial plica and to describe the usefulness of the clinical findings and MRI for preoperative diagnostics. From the baseline population of 172,777 military conscripts, thirty-three consecutive young adult patients with normal preoperative MRIs of the knee and a sole postoperative diagnosis of medial plica were treated with arthroscopic plica resection. Functional outcome was evaluated at a final follow-up in 25 patients with 34 knees with Kujala, Lysholm and visual analog scale (VAS) scores. Functional results were excellent to good in 17 patients, fair in three patients, and poor in 3 patients. The median Kujala score was 92 (25-100), the median Lysholm score 89 (26-100), and the median VAS 1.4 (0-8.8). Median follow-up time was 6.6 years (3.6-8.7 years). Most patients had no history of direct knee trauma preceding the symptoms. No statistically significant correlation was seen between MRI classification of the plica size or clinical findings compared to arthroscopic classification. Resection of the medial plica in a symptomatic knee has good to excellent functional long-term outcome in the majority of cases, and the procedure is not associated with postoperative complications. MRI and preoperative clinical examination seem to be unreliable in detecting medial plicae.
本研究的目的是评估关节镜下内侧皱襞切除术的长期效果,并描述临床检查结果和磁共振成像(MRI)在术前诊断中的作用。在172,777名应征入伍军人的基线人群中,连续33例术前膝关节MRI正常且术后唯一诊断为内侧皱襞的年轻成年患者接受了关节镜下皱襞切除术。对25例患者的34个膝关节进行了最终随访,采用库亚拉(Kujala)、利绍尔姆(Lysholm)评分和视觉模拟量表(VAS)评估功能结果。17例患者的功能结果为优至良,3例为中,3例为差。库亚拉评分中位数为92(25 - 100),利绍尔姆评分中位数为89(26 - 100),VAS评分中位数为1.4(0 - 8.8)。中位随访时间为6.6年(3.6 - 8.7年)。大多数患者在出现症状之前没有膝关节直接外伤史。与关节镜分类相比,皱襞大小的MRI分类或临床检查结果之间未发现统计学上的显著相关性。对于有症状的膝关节,内侧皱襞切除术在大多数情况下具有良好至优异的长期功能结果,且该手术与术后并发症无关。MRI和术前临床检查在检测内侧皱襞方面似乎不可靠。