Johnson D P, Eastwood D M, Witherow P J
Hospital for Sick Children, Bristol, England.
J Bone Joint Surg Am. 1993 Oct;75(10):1485-96. doi: 10.2106/00004623-199310000-00009.
Forty-five knees (thirty patients) with a specific diagnosis of synovial plica syndrome, and without any other known lesion, were randomized to be treated with either diagnostic arthroscopy alone or arthroscopy and division of all plicae. The diagnosis of synovial plica syndrome had been made on the basis of intermittent pain in the anterior aspect of the knee, painful clicking with activity, giving-way, and a palpable, tender plica. The patients were selected for arthroscopy only if the symptoms had continued unabated after a course of physical therapy. At the time of follow-up, improvement had occurred in only six (29 per cent) of the twenty-one knees in which the plicae had not been divided, in contrast with twenty (83 per cent) of the twenty-four knees in which they had been divided (p < 0.001). Ten (48 per cent) of the knees in which arthroscopic division had not been done were treated with another arthroscopic operation. Seven of these ten knees improved after the subsequent division of the plicae (p < 0.01). We concluded that synovial plicae of the knee may be a definite cause of anterior pain in children and adolescents.
45个膝关节（30例患者）被明确诊断为滑膜皱襞综合征，且无其他已知病变，被随机分为两组，分别接受单纯诊断性关节镜检查或关节镜检查及所有皱襞切除术。滑膜皱襞综合征的诊断基于膝关节前方的间歇性疼痛、活动时疼痛性弹响、打软腿以及可触及的压痛性皱襞。仅当经过一个疗程的物理治疗后症状仍未缓解时，患者才被选作关节镜检查。随访时，未行皱襞切除术的21个膝关节中仅有6个（29%）有所改善，而行皱襞切除术的24个膝关节中有20个（83%）有所改善（p<0.001）。未行关节镜下皱襞切除术的10个膝关节（48%）接受了另一次关节镜手术。这10个膝关节中有7个在随后的皱襞切除术后得到改善（p<0.01）。我们得出结论，膝关节滑膜皱襞可能是儿童和青少年膝关节前方疼痛的明确原因。
