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Journal ArticleDOI

Knee injuries: the role of the suprapatellar plica and suprapatellar bursa in simulating internal derangements.

01 May 1970-Clinical Orthopaedics and Related Research (Clin Orthop Relat Res)-Vol. 74, Iss: 70, pp 161-176
About: This article is published in Clinical Orthopaedics and Related Research.The article was published on 1970-05-01. It has received 80 citations till now. The article focuses on the topics: Plica syndrome & Bursitis.
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Journal ArticleDOI
TL;DR: The medial plica as mentioned in this paper is one of the most common synovial structures of the knee joint cavity and is often associated with pain, crepitus, snapping or popping, or effusion related to patellofemoral joint motion.

151 citations

Journal ArticleDOI
TL;DR: Embryologic and anatomic studies, cadaver dissections, clinical investigations, and arthroscopy have been reported in the Japanese, European, and English literature, highlighting the importance of folds in internal derangement of the knee.
Abstract: the knee joint. Embryologic and anatomic studies, cadaver dissections, clinical investigations, and arthroscopy have been reported in the Japanese, European, and English literature.4, 6, 9.12 The role played by such folds in internal derangement of the knee is controversial. Proper anatomic location and their terminology has been confusing and not well defmed. Even more confusing is the importance of such folds in internal derangement of the knee.

129 citations

Journal ArticleDOI
TL;DR: An embryologic study about the development of the human knee joint cavity was carried out with special attention to the formation of synovial plicae, using a total of 116 knees of embryos and fetuses.
Abstract: An embryologic study about the development of the human knee joint cavity was carried out with special attention to the formation of synovial plicae, using a total of 116 knees of embryos and fetuses. The incidence of synovial plicae in the fetal stage was also investigated. Formation of joint space starts at the middle of the interzone at around 8 weeks of gestation. Multiple small cavitations around the femoral condyle and patella coalesce to form larger cavitations. At around 10 1/2 weeks, the knee joint consists of a single cavity with synovial lining. At certain sites, such as at the medial part of patello-femoral and the infrapatellar regions, mesenchymal tissue strands remain. They may become plica. In the fetal stage from 11 to 20 weeks, an infrapatellar plica was found in 50% of specimens, a suprapatellar plica in 33%, and a mediopatellar plica in 37%. Only the infrapatellar plica showed a decrease in incidence.

110 citations

Journal ArticleDOI
TL;DR: It is concluded that synovial plicae of the knee may be a definite cause of anterior pain in children and adolescents.
Abstract: 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.

105 citations

Journal ArticleDOI
TL;DR: The diagnostic accuracy of the clinical examination for intraarticular injuries of the knee was documented by arthroscopy over a 6-month period and knees with acute lesions and those with a single diagnosis proved to be signifi cantly easier to diagnose.
Abstract: The diagnostic accuracy of the clinical examination for intraarticular injuries of the knee was documented by arthroscopy over a 6-month period. Two-hundred ninety patients (296 knees) were evaluated by history, physical examination, and standard radiographs. Supplemental diagnostic studies included 41 magnetic resonance images, 2 arthrograms, and 1 previous ar throscopy that had been recently performed.Overall, the correct diagnosis was made in 165 knees (56%), an incomplete diagnosis in 92 (31%), and an incorrect diagnosis in 39 (13%). There were only 2 knees (0.07%) with no discernable lesions. When a single lesion was present in the knee, the diagnosis was made correctly in 72% of cases. When more than 2 were discovered, the diagnosis was correct in only 30%. However, all individual lesions were diagnosed with an accuracy of greater than 90%.The lesions most difficult to diagnose were chondral fractures, fibrotic fat pads, tears in the anterior cruciate ligament, and loose bodies. Knees with acute les...

91 citations