Kan Hiroyuki, Arai Yuji, Nakagawa Shuji, Inoue Hiroaki, Hara Kunio, Minami Ginjiro, Inoue Atsuo, Kanamura Hitoshi, Ikoma Kazuya, Fujiwara Hiroyoshi, Kubo Toshikazu
Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Int Orthop. 2015 Dec;39(12):2489-94. doi: 10.1007/s00264-015-2782-y. Epub 2015 Apr 22.
This study was designed to evaluate the characteristics of patients with medial plica syndrome and associated cartilage damage.
The study subjects included 44 patients with 57 knees arthroscopically diagnosed with medial plica syndrome. Subjects were divided into those with severe cartilage damage, defined as International Cartilage Research Society (ICRS) stage 2 or higher, and those with mild cartilage damage, defined as ICRS stage 1 or lower. Local findings, period from onset to surgery, arthroscopic findings, and postoperative results were compared in the two groups.
The shapes of the medial synovial plica were types C and D of the Sakakibara classification in the severe group, and types A, B, and C in the mild group. Patellar ballottement tended to be more common in the severe than in the mild group (P = 0.059). The duration from onset to surgery was significantly longer in the severe than in the mild group (29.0 vs. 11.6 months, P = 0.043). Postoperative results were significantly better in the mild than in the severe group (P = 0.0017).
The shape of the medial synovial plica and the duration between symptom onset and surgery were associated with cartilage damage. Surgical treatment should be considered when the medial synovial plica covers part of the anterior aspect of the medial femoral condyle or ruptures, or when pain persists over a long period, thus reducing the potential for cartilage damage.
Level IV.
本研究旨在评估内侧皱襞综合征患者及相关软骨损伤的特征。
研究对象包括44例患者的57个膝关节，经关节镜诊断为内侧皱襞综合征。研究对象分为重度软骨损伤组（定义为国际软骨修复协会（ICRS）2期或更高分期）和轻度软骨损伤组（定义为ICRS 1期或更低分期）。比较两组的局部表现、从发病到手术的时间、关节镜检查结果及术后结果。
重度组内侧滑膜皱襞形态为原田分类的C型和D型，轻度组为A型、B型和C型。重度组髌股冲击试验比轻度组更常见（P = 0.059）。重度组从发病到手术的时间明显长于轻度组（29.0个月对11.6个月，P = 0.043）。轻度组术后结果明显优于重度组（P = 0.0017）。
内侧滑膜皱襞的形态及症状出现至手术的时间与软骨损伤有关。当内侧滑膜皱襞覆盖股骨内侧髁前部的一部分或破裂，或疼痛长期持续时，应考虑手术治疗，从而降低软骨损伤的可能性。
四级。
