Analysis of long-term results of operative treatment of pathologically thickened mediopathellar synovial knee fold

A. A. Ochkurenko, A. G. Yeltsin, D. S. Mininkov, Alexander V. Gorokhvodatsky, Anton P. Kurpyakov
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Abstract

BACKGROUND: The mediopatellar synovial fold (MPSF) of the knee joint is normally a thin and elastic structure, but under the influence of various factors, the MPSF thickens and turns into a fibrous cord, which injures nearby structures and clinically manifests with pain. One of the effective methods of treating MPSF in pediatric patients is an arthroscopic excision of the fold. AIM: Evaluation of long-term results of arthroscopic treatment of patients with pathologically thickened MPSF of the knee joint. MATERIALS AND METHODS: There was conducted an analysis of primary medical documentation, which included the study of hospital records and case histories of 73 patients. The survey questionnaires (based on VAS and WOMAC scales) were sent to these patients. Responses were received from 35 patients who were included in the study. RESULTS: When evaluating the long-term results of surgical intervention in 35 operated patients in 29 (82.1%) patients, it was found out that there were no exacerbations in postoperative period and, at the time of the data collecting, there weer no complaints for the pain syndrome. Dysplasia of the femoral condyle of type A and B was diagnosed in these patients. At the time of the evaluation, 6 (18.9%) patients had pain syndrome with decreased function of the knee joint. In these patients, dysplasia of the femoral condyle corresponded to type C in 4 cases, types D and B in 1 case. CONCLUSION: At the early stages of the disease, it is necessary to carry out a detailed differential diagnosis to identify the pathology of the knee joint. Attention should be paid to the combination of a pathologically thickened MPSS with dysplasia of the femoral condyle, which can lead not only to complications of conservative therapy and ineffectiveness of surgery, but also to the development of patellofemoral arthrosis.
病理性增厚的纵隔滑膜膝褶手术治疗的远期疗效分析
背景:膝关节内侧髌滑膜褶(MPSF)在正常情况下是一个薄而有弹性的结构,但在各种因素的影响下,MPSF增厚并变成纤维束,损伤附近结构,临床表现为疼痛。治疗小儿MPSF的有效方法之一是关节镜下的折叠切除。目的:评价关节镜下治疗病理性增厚的膝关节MPSF患者的长期疗效。材料和方法:对73例患者的医院记录和病例史进行了初步医学文献分析。采用VAS和WOMAC量表对患者进行问卷调查。我们收到了35名参与研究的患者的回复。结果:对29例(82.1%)患者中35例手术患者的手术干预远期效果进行评价,发现术后无加重,收集资料时无疼痛综合征主诉。在这些患者中诊断为A型和B型股骨髁发育不良。在评估时,6例(18.9%)患者有膝关节功能下降的疼痛综合征。在这些患者中,4例股骨髁发育不良为C型,1例为D型和B型。结论:在疾病早期,有必要进行详细的鉴别诊断,以确定膝关节的病理。应注意病理性增厚的MPSS合并股骨髁发育不良,这不仅会导致保守治疗的并发症和手术无效,而且还会导致髌股关节病的发展。
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