scholarly journals 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

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0004
Author(s):  
Hasan Bombaci ◽  
Suavi Aydoğmuş ◽  
Tolga Keçeci ◽  
Çağdaş Deniz Gündüz
Keyword(s):  
English Literature ◽  
Femoral Condyle ◽  
Cartilage Damage ◽  
Medial Femoral Condyle ◽  
Meniscus Tear ◽  
Type I ◽  
Medial Condyle ◽  
Medial Side ◽  
Medial Plica ◽  
Flexion Extension

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.

scholarly journals How Does Delayed Excision of Symptomatic Medial Plica Affect the Outcomes?

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0018
Author(s):  
Hasan Bombaci ◽  
Mehmet Kuyumcu ◽  
Tamer Coskun ◽  
Emre Kaya
Keyword(s):  
Femoral Condyle ◽  
Weight Bearing ◽  
Medial Femoral Condyle ◽  
Time Range ◽  
Small Series ◽  
Chondral Damage ◽  
Medial Plica ◽  
Flexion Extension ◽  
Group 2 ◽  
Group 1

Objectives: Medial plica (MP) is usually asymptomatic, however has the potential to cause impingement on the medial femoral condyle when it is prominent or thickened. The incidence of MP has been reported up to 79.9%. Very few of them become symptomatic over time. Due to delay in seeking medical assistance or extended conservative treatment, surgery may be delayed in some of the patients and this might cause increased chondral damage. The purpose of this study is to compare the outcomes of patients who received early surgery with patients undergoing delayed surgery one year after the onset of symptoms. Methods: Sixteen knees of the 14 patients (7 male, 7 female), who underwent arthroscopic MP excision between 2007 and 2011 were included in this retrospective study. In six patients had right, six patients had left and in two patients had both knees involved. Plicas, which were seen in patients with ligament injury were excluded from the study. Mean age was 42.9 years (range; 23-62). All patients complained of pain but some had mechanical symptoms such as friction during flexion-extension. Patients were evaluated with visual analogue scale (VAS) and Lysholm scores pre-operatively and at the last examination. The knees which were operated on within the first year (range; 1-12 months) after being symptomatic were grouped as Group 1 and the ones operated on after that time (range; 18-180 months) Group 2. More advanced chondral lesions were in the second group. Two groups were compared statistically by using “paired t test” in terms of VAS and Lysholm scores at the last control examination. Results: All patients had cartilaginous degeneration of various degrees on the surface medial femoral condyle facing the MP. Pre-operative (5.62±1.66) and final follow-up mean VAS (2.31±2.02) scores and mean Lysholm scores (65.62±13.82 and 83.43±15.51, respectively) were significantly different (p<0.005). Mean VAS score was 2.00 (±2.39) in Group 1 and 2.62 (±1.68) in Group 2 at final evaluation. Mean Lysholm scores were 81.25 (±20.04) and 85.62 (±10.16) respectively for Groups 1 and 2. Both of these differences were not statistically significant(p>0.05). Conclusion: All patients obtained satisfactory outcomes after arthroscopic MP excision. MP is usually asymptomatic but, when it is large and its free edge impinges on the superior anteromedial and medial portion of the medial femoral condyle, it might cause chondral damage leading to full thickness cartilage lesions. When it becomes symptomatic, chondral damage quite often is already advanced. This small series revealed that, even late arthroscopic excision of the MP relieves symptoms but, chondral damage persists even though the patient becomes asymptomatic. The reasons of this might be; 1) the region of lesion is outside of weight bearing zone or 2) the origin of pain might be stretched MP before excision.

scholarly journals Transcutaneous Treatment with Vetdrop® Sustains the Adjacent Cartilage in a Microfracturing Joint Defect Model in Sheep

2013 ◽  
Vol 7 (1) ◽  
pp. 57-66 ◽  
Author(s):  
M Sidler ◽  
N Fouché ◽  
I Meth ◽  
F von Hahn ◽  
B von Rechenberg ◽  
...  
Keyword(s):  
Cartilage Defect ◽  
Femoral Condyle ◽  
Cartilage Damage ◽  
Recovery Period ◽  
Scoring Systems ◽  
Defect Model ◽  
Medial Condyle ◽  
Stifle Joint ◽  
The Right ◽  
Adjacent Cartilage

The significance of the adjacent cartilage in cartilage defect healing is not yet completely understood. Furthermore, it is unknown if the adjacent cartilage can somehow be influenced into responding after cartilage damage. The present study was undertaken to investigate whether the adjacent cartilage can be better sustained after microfracturing in a cartilage defect model in the stifle joint of sheep using a transcutaneous treatment concept (Vetdrop®). Carprofen and chito-oligosaccharids were added either as single components or as a mixture to a vehicle suspension consisting of a herbal carrier oil in a water-in-oil phase. This mixture was administered onto the skin with the aid of a specific applicator during 6 weeks in 28 sheep, allocated into 6 different groups, that underwent microfracturing surgery either on the left or the right medial femoral condyle. Two groups served as control and were either treated intravenously or sham treated with oxygen only. Sheep were sacrificed and their medial condyle histologically evaluated qualitatively and semi-quantitatively according to 4 different scoring systems (Mankin, ICRS, Little and O’Driscoll). The adjacent cartilage of animals of group 4 treated transcutaneously with vehicle, chito-oligosaccharids and carprofen had better histological scores compared to all the other groups (Mankin 3.3±0.8, ICRS 15.7±0.7, Little 9.0±1.4). Complete defect filling was absent from the transcutaneous treatment groups. The experiment suggests that the adjacent cartilage is susceptible to treatment and that the combination of vehicle, chitooligosaccharids and carprofen may sustain the adjacent cartilage during the recovery period.

Transplantation of Aggregates of Autologous Synovial Mesenchymal Stem Cells for Treatment of Cartilage Defects in the Femoral Condyle and the Femoral Groove in Microminipigs

2019 ◽  
Vol 47 (10) ◽  
pp. 2338-2347 ◽  
Author(s):  
Shimpei Kondo ◽  
Yusuke Nakagawa ◽  
Mitsuru Mizuno ◽  
Kenta Katagiri ◽  
Kunikazu Tsuji ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Cartilage Regeneration ◽  
Medial Femoral Condyle ◽  
Cartilage Defects ◽  
Control Group ◽  
Osteochondral Defects ◽  
Medial Condyle ◽  
Femoral Groove ◽  
Articular Cartilage Regeneration

Background: Previous work has demonstrated that patients with cartilage defects of the knee benefit from arthroscopic transplantation of autologous synovial mesenchymal stem cells (MSCs) in terms of magnetic resonance imaging (MRI), qualitative histologic findings, and Lysholm score. However, the effectiveness was limited by the number of cells obtained, so large-sized defects (>500 mm2) were not investigated. The use of MSC aggregates may enable treatment of larger defects by increasing the number of MSCs adhering to the cartilage defect. Purpose: To investigate whether transplantation of aggregates of autologous synovial MSCs with 2-step surgery could promote articular cartilage regeneration in microminipig osteochondral defects. Study Design: Controlled laboratory study. Methods: Synovial MSCs derived from a microminipig were examined for in vitro colony-forming and multidifferentiation abilities. An aggregate of 250,000 synovial MSCs was formed with hanging drop culture, and 16 aggregates (for each defect) were implanted on both osteochondral defects (6 × 6 × 1.5 mm) created in the medial femoral condyle and femoral groove (MSC group). The defects in the contralateral knee were left empty (control group). The knee joints were evaluated at 4 and 12 weeks by macroscopic findings and histology. MRI T1rho mapping images were acquired at 12 weeks. For cell tracking, synovial MSCs were labeled with ferucarbotran before aggregate formation and were observed with MRI at 1 week. Results: Synovial MSCs showed in vitro colony-forming and multidifferentiation abilities. Regenerative cartilage formation was significantly better in the MSC group than in the control group, as indicated by International Cartilage Repair Society score (macro), modified Wakitani score (histology), and T1rho mapping (biochemical MRI) in the medial condyle at 12 weeks. Implanted cells, labeled with ferucarbotran, were observed in the osteochondral defects at 1 week with MRI. No significant difference was noted in the modified Wakitani score at 4 weeks in the medial condyle and at 4 and 12 weeks in the femoral groove. Conclusion: Transplantation of autologous synovial MSC aggregates promoted articular cartilage regeneration at the medial femoral condyle at 12 weeks in microminipigs. Clinical Relevance: Aggregates of autologous synovial MSCs could expand the indications for cartilage repair with synovial MSCs.

scholarly journals Calcaneal Plate for Medial Femoral Condyle Fractures—Is This It? A Clinical Case

2021 ◽  
Vol 07 (02) ◽  
pp. e59-e61
Author(s):  
Rómulo Silva ◽  
Elsa Moreira ◽  
Ricardo Branco ◽  
Filomena Ferreira ◽  
Margarida Areias ◽  
...  
Keyword(s):  
Open Reduction ◽  
Clinical Case ◽  
Articular Surface ◽  
Femoral Condyle ◽  
Plate Fixation ◽  
Femoral Fractures ◽  
Medial Femoral Condyle ◽  
Medial Condyle ◽  
Osteosynthesis Material ◽  
Anatomic Reduction

AbstractManagement of unicondylar femoral fractures is mainly done by open reduction and internal fixation. Anatomic reduction in the articular surface is paramount in this type of lesion. Medial condyle fractures lack specific osteosynthesis material for fixation.We report a case resolved with the sparsely documented technique using calcaneal plate fixation.

scholarly journals Cartilage damage after acl rupture; “Barcode-like lesion” at the medial femoral condyle

2012 ◽  
Vol 20 ◽  
pp. S244-S245
Author(s):  
M. Kobayashi ◽  
R. Arai ◽  
H. Harada ◽  
H. Tsukiyama ◽  
Y. Mizuno
Keyword(s):  
Femoral Condyle ◽  
Cartilage Damage ◽  
Medial Femoral Condyle ◽  
Acl Rupture

Vascular and Bone Regeneration of the Donor Site After Corticoperiosteal Flap From the Medial Femoral Condyle

Hand ◽  
2020 ◽  
pp. 155894472093029
Author(s):  
Matteo Guzzini ◽  
Domenico Lupariello ◽  
Giuseppe Argento ◽  
Leopoldo Arioli ◽  
Andrea Ferretti
Keyword(s):  
Magnetic Resonance ◽  
Blood Supply ◽  
Upper Limb ◽  
Femoral Condyle ◽  
Donor Site ◽  
Medial Femoral Condyle ◽  
Recipient Site ◽  
Medial Condyle ◽  
Genicular Artery

Background: The aim of this study was to evaluate the morbidity and regeneration of descending genicular artery and bone on the donor site, the medial condyle of the femur, after harvesting the corticoperiosteal flap and to report the clinical, functional, and radiographic outcomes of the treatment of atrophic nonunions of upper limb with corticoperiosteal vascularized flap at 5-year follow-up. Methods: From January 2011 to January 2018, 36 patients (average age of 45.8 years) were enrolled and evaluated with clinical and radiographic follow-up (average time of 66 months). In 20 patients, magnetic resonance angiography was also performed preoperatively and postoperatively to investigate the fate of the descending genicular artery after harvesting the corticoperiosteal flap. Results: Radiographic evaluation demonstrated a success rate of 94.4% (average time of bone healing of 5.2 months). At the recipient site, clinical evaluation showed excellent results in 75% to 80% of cases, and at the donor site, no statistical differences were found between before and after surgery clinical condition. In all patients who underwent magnetic resonance imaging, images showed a complete recovery of the blood supply of the medial femoral condyle. Conclusions: Medial condyle corticoperiosteal flap represents a valid choice for the treatment of upper limb nonunions. This technique brings a very low morbidity on the donor site, with complete restoration of blood supply and bone tissue. The limit of this flap is its low mechanical support, which suggests performing this technique especially for the treatment of upper limb nonunions.

scholarly journals An acquired plica-induced notch in the medial femoral condyle in a patient with medial patellar plica syndrome: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sung-Jae Kim ◽  
Yong Gon Koh ◽  
Yong Sang Kim
Keyword(s):  
Articular Surface ◽  
Femoral Condyle ◽  
Cartilage Damage ◽  
Arthroscopic Surgery ◽  
Medial Femoral Condyle ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Articular Facet ◽  
Plica Syndrome ◽  
Preoperative Magnetic Resonance

Abstract Background An inflamed and thickened medial patellar plica (MPP) caused by repeated mechanical irritation from trauma or overuse leads to impingement between the anterior medial femoral condyle and the medial articular facet of the patella and produces pain or clicking, which is known as MPP syndrome. In patients with MPP syndrome, cartilage damage may occur depending on the shape of the MPP and the duration of the impingement. Case presentation Preoperative magnetic resonance imaging in a 17-year-old male patient with MPP syndrome showed a hypertrophic MPP along with an abnormal notch in the articular surface of the medial femoral condyle. We considered that the impinged hypertrophic plica between the anterior medial femoral condyle and the medial articular facet of the patella resulted in cartilage damage on the articular surface of the medial femoral condyle. However, during arthroscopic surgery, we found that the cartilage of the notch, which was located beneath the MPP, was completely intact. We concluded that this abnormal notch had developed gradually in the MPP without cartilage damage. Conclusions Surgeons should be mindful that acquired plica-induced notches in the articular surface of the medial femoral condyle can present in patients with MPP syndrome.

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