成人髌内侧滑膜皱襞的形态和症状性皱襞的诊治

目的关节镜术中比较成人膝关节髌内侧滑膜皱襞和症状性皱襞的形态学特点，探讨滑膜皱襞综合征的诊治。方法210例成人患者施行关节镜术，155例膝关节存在髌内侧滑膜皱襞，其中38例确诊为髌内侧滑膜皱襞综合征，髌内侧滑膜皱襞的形态依照Sakakibara分型法分成A、B、C、D等4型，比较分析髌内侧滑膜皱襞形态特点和发生率，症状性皱襞采用关节镜下滑膜皱襞切除术。结果非症状髌内侧滑膜性皱襞以A型和B型皱襞多见，症状髌内侧滑膜性皱襞以B、C、D型皱襞多见。症状性髌内侧滑膜性皱襞各型髌内侧滑膜皱襞的发生率在性别和别侧差异无显著性（P〉0．05），36例髌内侧滑膜皱襞综合征随访6～19个月，2例失访，疗效优良率86．1％。结论成人髌内侧滑膜皱襞形态具有多样性，各种类型的滑膜皱襞都可能产生症状，其中B、C和D型皱襞易于产生症状；关节镜技术是诊治症状性皱襞的重要手段，症状性皱襞经行关节镜下皱襞切除术疗效确切。

The morphological characteristics of the mediopatellar plica and the diagnosis and treatment of symptomatic mediopatellar plica in adult

Objective To compare the morphological characteristics of the mediopatellar plica and symptomatic mediopatellar plica in adult knee joint and to explore the diagnosis and treatment of symptomatic mediopatellar plica. Methods Arthroscopy was performed on 210 patients in which knee mediopatellar plicae was found in 155 patients. The mediopatellar plica was classified as A,B,C and D types according to the Sakakibara classification. The morphological characteristics and the incidences of mediopatellar plica were compared among the different groups. 38 patients of symptomatic plica without other intraarticular abnormality received arthroscopic resection. Results Type A and B were seen frequently in non-symptomatic mediopatellar plica knee(P<0.01).Type B, C and D were seen frequently in symptomatic mediopatellar plica knee(P<0.05). Excellent results were obtained in 36 cases after an average 11 month follow-up except 2 attrition cases. Conclusion The mediopatellar plica of the knee has too many anatomical variations in adult. Type A, B, C and D are likely to produce symptoms. Type B, C and D have a significant association with syndrome. Arthroscope plays an important role in the diagnosis and treatment of the symptomatic mediopatellar plica of the knee. Arthroscopic resection of the plica shows excellent results.