Prejbeanu Radu, Poenaru Dan V, Balanescu Andrei Dan, Mioc Mihail-Lazar
1st Clinic of Orthopaedics and Traumatology, University of Medicine and Pharmacy "Victor Babes" Timisoara, Eftimie Murgu Square no. 2, Timisoara, 300041, Timis, Romania.
2nd Orthopedics and Traumatology Clinic, University of Medicine and Pharmacy "Victor Babes" Timisoara, Eftimie Murgu Square no. 2, Timisoara, Timis, 300041, Romania.
Int Orthop. 2017 Jan;41(1):121-125. doi: 10.1007/s00264-016-3313-1. Epub 2016 Oct 20.
The medial plica (MP) is a normal anatomic structure consisting of a fold in the synovial layer of the joint. Arthroscopic resection is currently used as a gold standard procedure in patients with medial plica syndrome (MPS), but there are few prospective studies that analyze the long-term functional outcomes of plica resection.
The purpose of this prospective study was to evaluate the long-term results of arthroscopic resection of the medial plicae of the knee. Between 1999 and 2014 we included 267 patients that showed MRI evidence of MP out of the 5682 knee arthroscopies that we performed. We recorded pre and post-operative Tegner Lysholm knee scale scores (TLKSS) for up to 36 (3, 6, 12, 24, 36) months. The EQ-5D questionnaire was used to measure the patients' generic health status.
The mean values of the TLKSS were 68 (61-82) pre-operative, 87 (81-94) at the 3-month follow-up and 94 (92-97) at the 6-month follow-up. The long term results (TLKSS at 12, 24, and 36 months post-operatively) were 94.8 (91-98), 94.8 (90-97), and 94.5 (92-97) respectively. The EQ-5D and EQ-VAS showed significant improvement between each of the first three data registering moments (pre-operative, 3 and 6 month follow-up).
The quality of the treatment and the final functional result is directly influenced by the type of plica that creates the symptomatology. We have achieved good overall results for our patients, the ones with less cartilage damage having the fastest recovery time. The arthroscopic resection is a very good option for medial plicae that do not respond to conservative treatment, and it must be initiated as a first option when cartilage damage is suspected.
内侧皱襞（MP）是关节滑膜层的一个正常解剖结构，由滑膜折叠而成。关节镜下切除术目前是内侧皱襞综合征（MPS）患者的金标准手术，但很少有前瞻性研究分析皱襞切除术的长期功能结果。
本前瞻性研究的目的是评估膝关节内侧皱襞关节镜下切除术的长期效果。1999年至2014年期间，在我们进行的5682例膝关节镜检查中，我们纳入了267例有MP的MRI证据的患者。我们记录了术前和术后长达36个月（3、6、12、24、36个月）的Tegner Lysholm膝关节评分量表（TLKSS）。使用EQ-5D问卷来测量患者的一般健康状况。
TLKSS的平均值术前为68（61 - 82），3个月随访时为87（81 - 94），6个月随访时为94（92 - 97）。长期结果（术后12、24和36个月的TLKSS）分别为94.8（91 - 98）、94.8（90 - 97）和94.5（92 - 97）。EQ-5D和EQ-VAS在前三个数据记录时刻（术前、3个月和6个月随访）之间均显示出显著改善。
产生症状的皱襞类型直接影响治疗质量和最终功能结果。我们的患者总体取得了良好的效果，软骨损伤较少的患者恢复时间最快。关节镜下切除术对于对保守治疗无反应的内侧皱襞是一个非常好的选择，并且当怀疑有软骨损伤时必须作为首选启动。
