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Pathologic infrapatellar plica.

Sung-Jae Kim1, Jin-Yong Kim, Jin Woo Lee

  • 1Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea. os@yumc.yonsei.ac.kr

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|March 13, 2003
PubMed
Summary

A thickened infrapatellar plica caused knee flexion contracture in an older patient. Surgical removal and notchplasty restored full knee extension, highlighting a rare cause of knee stiffness.

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Area of Science:

  • Orthopedic Surgery
  • Knee Arthroscopy
  • Musculoskeletal Disorders

Background:

  • Infrapatellar plica syndrome is a known cause of anterior knee pain and mechanical symptoms.
  • Pathological plicae are typically associated with younger, active individuals.

Observation:

  • A fenestrated infrapatellar plica was identified arthroscopically in a 57-year-old patient presenting with knee flexion contracture.
  • The plica was thickened, fibrotic, and adhered to the intercondylar notch and trochlea, limiting knee extension.

Findings:

  • Plica excision improved knee extension by 17 degrees, but full extension was not achieved.
  • Subsequent arthroscopic notchplasty successfully restored full knee extension.
  • This case represents the first reported instance of a pathological infrapatellar plica in an elderly patient.

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Implications:

  • This case expands the differential diagnosis for knee stiffness and flexion contracture in older adults.
  • It underscores the importance of considering plical abnormalities even in elderly patients.
  • Surgical intervention, including plicectomy and potentially notchplasty, can effectively manage symptomatic infrapatellar plicae.