Abstract
Anterior knee pain is a frequent, yet relevant, symptom since mediopatellar plicae are found in approximately 20% of normal knees. We report the rare case of a painful mediopatellar plica and cord-like structure complex covering the suprapatellar pouch in the knee joint. The patient was a 13-year-old girl who complained of left anterior knee pain with restricted range of motion that had started 1 year earlier. She underwent arthroscopic treatment after unsuccessful conservative therapy. Intraoperative findings included a Sakakibara classification Type B mediopatellar plica and band-like structure complex located in the suprapatellar pouch of the knee. As Type A and B plicae are generally asymptomatic, the cause of the pain in this case was presumed to be impingement of the mediopatellar plica by the cord-like band. The plica and band-like structure complex was resected and ablated by arthroscopy. The patient was pain-free several months postoperatively and could resume normal school life. Since she was an adolescent in her growth phase, it is possible that joint growth resulted in tension on the remnant of the plica connected with the band-like structure in the suprapatellar pouch, which then intruded into the medial aspect of the patellofemoral joint and resulted in her symptoms.
Highlights
The suprapatellar plica is a remnant of the embryologic synovial membrane between the suprapatellar pouch and the knee joint
This report describes the clinical outcome of a 13-year-old girl with a mediopatellar plica combined with a band-like structure in the suprapatellar pouch
To the best of our knowledge, there has been no such report of this combination leading to restricted range of motion (ROM) and knee joint pain (Figure 2)
Summary
A mediopatellar plica classified as Sakakibara Type B was observed in the suprapatellar pouch along with a band-like structure connected to the plica and covering the patellofemoral joint [1,2,3,4,5] (Figure 1a). At follow-up 2 months postoperatively, the patient reported no knee joint pain, and knee joint ROM was fully restored. Figure (1a): Arthroscopic image of a Sakakibara Type B mediopatellar plica in the suprapatellar pouch.
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