The incidence of medial plica in the knees operated on because of reasons other than the medial plica alone and the cartilage damages caused by it

Abstract

Introduction:The aim of this study is to analyse the incidence of medial plica (MP) and the damage which has been caused on the medial femoral condyle in the 700 knee of 651 patients who were operated on because of the complaints resulting from intra-articular pathologies unrelated to the MP in particular.Patients and Methods:Medial plicas were detected in the 65 of 700 knees operated on consecutively because of the complaint of pain or catching in the knee. The mean age of 34 male and 28 female patients was 46 (range; 16-82). In 25 knees the lesions were in the right, 34 patients in the left side and in three patients, bilateral. The MP was classified according to the Sakakibara classification, the lesion caused by the MP on the medial femoral condyle, according to the Outerbridge classification. All medial plicas were excised arthroscopically.Results:Medial plicas were classified as type B in eight knees, type C in 52 and type D in five according to the Sakakibara classification. The cartilage lesion related to the MP were classified as type I in 12 knees, type II in 20 and type III in 24 according to the Outerbridge classification. There were no lesions present in nine knees.Discussion and Conclusion:Although the incidence of MP is much higher, the incidence of “MP syndrome” has been reported as 3.8% to 5.5% in the English literature. In the present study, we found that the incidence of MP was 9.28% associated with the rate of 86% type I-III cartilage damage related to the MP itself. Although the symptoms of MP are not specific, there may be some tenderness between the medial condyle and inferior-medial edge of patella. Furthermore a thickened cord-like plica can be palpated at the medial side of the patella, with crepitus or popping sensation during flexion –extension movement of the knee. If the patients suffer from meniscus tear or chondromalasia which affects at least two compartments of the knee, the symptoms of MP cannot be apparent primarily. These findings show that MP is quite significantly associated with other intra-articular pathologies in the knee. However, the common symptoms of MP with the long lasting pathologies in the knee (i.e chondromalasia unrelated to MP) can prevent early diagnosis which would prevent irreversible chondral pathologies developing at a later stage.