Issachar C. Padao
Victoriano Luna Medical Center, PhilippinesPresentation Title:
The correlation between patellar plicae and degeneration of the femoral condyle among military personnel
Abstract
Objective: To determine if there is a correlation between patellar plica syndrome and presence of osteochondral defect among patients who underwent diagnostic arthroscopy.
Methodology: This is a single-center, retrospective cohort involving patients who underwent diagnostic arthroscopy with or without primary ACL reconstruction, meniscectomy, and application of hyalofast scaffold done between January 1, 2018 and December 2020. A retrospective chart review was conducted on all patients admitted between 2018 and 2020 who underwent diagnostic arthroscopy of the knee. All charts that satisfied the inclusion criteria were included in the study. Inclusion for this study are (1) patients aged 18 to 56 years who underwent diagnostic arthroscopy, (2) patients with nonspecific anterior and anteromedial knee pain, (3) Patients who were diagnosed with degenerative osteoarthritis via physical exam/X-rays and (4) Patients who had complaints of persistent knee pain with no improvement despite conservative management. The following are the exclusion criteria (1) Patients who have history of significant knee trauma causing fracture of the tibio-femoral and patello-femoral joint and (2) patients who were diagnosed with septic arthritis and post traumatic arthritis. Patients’ demographic data, history, physical examination findings were gathered and tabulated.
Results: There were a total of 70 patients underwent diagnostic arthroscopy from January 2018 until December 2020. Overall, the prevalence rate of knee Patellar Plica syndrome in VLMC is 10%. There were no significant differences noted, in terms of age, gender, comorbidities, BMI, AND length of military service. However, patellar plica syndrome is significantly less associated with sports-related injuries (p = 0.007), and with other knee pathology (p<0.001). The most common type of patellar plica noted intraoperatively is mediopatellar plica (71%), followed by infrapatellar plica (29%). Anterior and/ anteromedial pain is the most common symptom of patellar plica syndrome (100%), followed by pain upon kneeling (71%). There were significantly less patients presenting with clicking or catching with patellar plica syndrome (p=0.003), and significantly more patients who have a positive mediopatellar test on physical examination (p=0.023). Osteochondral defect is associated with patellar plica syndrome, which is present in 86% of the cases, having a p= 0.001.
Conclusion: Patellar plica syndrome itself is rare in our setting accounting to only 10% prevalence rate. Despite this, statistical data gathered showed that osteochondral defect is indeed directly correlated to patellar plica noted intraoperatively.
Biography
Issachar C. Padao is a fellow of the Philippine Orthopedic Association. He is a graduate of the Department of Orthopedic Surgery at Victoriano Luna Medical Center, Armed Forces of the Philippines Health Service Command in Quezon City. He is a board-certified military orthopedic surgeon and is also a Flight Surgeon of the Philippine Air Force and is currently assigned at the Air Force City Hospital, Clark Air Base, Mabalacat, Pampanga.
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