Morphologic variants of the proximal knee-joint cavity. An anatomical and radiological study

Zidorn, Tim; Schäfer, H

doi:10.1007/bf01794891

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…However, the most accepted theory establishes the development of menisci, cruciate ligaments, and a partitioned joint cavity in the 8 week fetus, with the subsequent fusion of the joint knee compartments and resorption of the synovial septum by the end 12th week. In cases of incomplete resorption of the synovial septum, residual mesenchymal tissues result in the knee plicae [ 5 , 6 11 , 12 , 13 , 19 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Reduplicated medial parapatellar plica: a case of a medial plica anatomical variation recalcitrant to conservative treatment

et al. 2022

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Purpose The current study aims to report the radiologic and clinical appearance of a rare anatomical variation of the knee medial synovial plica along with its response to conservative and surgical treatment. Case presentation This report portrays a 29-year-old male patient with anteromedial gradual onset right knee pain, aggravated when descending stairs or prolonged sitting. Physical examination revealed medial parapatellar local tenderness, a palpable click in this area when the knee was extended, and hamstring tightness. Magnetic resonance imaging showed a duplicated medial plica, characterized by a high-intensity signal of the infrapatellar fat pad medial portion, after which a presumptive diagnosis of medial plica syndrome was proposed. After conservative treatment failure, the patient underwent standard knee arthroscopy that revealed a superior low profile and an inferior high profile medial plica, and hypertrophy of the medial portion of the infrapatellar fat pad. Both plicae and fat pad were resected with a mechanical shaver until no contact between the femoral trochlea and the fat pad was observed during full range of motion. At 4 weeks postoperatively, symptoms completely resolved, and the patient was allowed to return to full activity with no recurrences at 1 year follow-up. Conclusions The current study presented a rare anatomical variation of the knee medial synovial plica that was symptomatic and recalcitrant to conservative treatment. This case report may be useful for radiologists and orthopaedic surgeons to differentiate this special plica type and consider its response to conservative and surgical treatment during patient management.

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Section: Discussionmentioning

confidence: 99%

Reduplicated medial parapatellar plica: a case of a medial plica anatomical variation recalcitrant to conservative treatment

et al. 2022

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“…In most (~85%) people, the suprapatellar bursa communicates with the knee joint. The suprapatellar bursa does not communicate with the knee joint in ~15% of people, remaining separated by an embryonic septum [ 5 , 6 ]. However, we included the suprapatellar bursa in the distal femur.…”

Section: Methodsmentioning

confidence: 99%

Defining the region of interest of the knee for perioperative volumetric assessment with a portable 3D scanner in orthopedic and trauma surgery

et al. 2022

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Background The aim of this study was to characterize three regions of interest (ROI) around the knee with a portable 3D scanner (Artec 3D scanner EVA). Soft tissue topography assessment with an optimized, precise, and reproducible method may assist surgeons when managing soft tissue swelling in the post traumatic setting. Methods 12 healthy volunteers (24 legs, 7 women, 5 man) were included in this study. The patient cohort showed a mean age of 27.1 years (SD±3), a mean weight of 70 kg (SD±13) and a mean height of 171 cm (SD±8.8). All scans were recorded by the same examiner in the same room and with the same scanner (Artec, 3 D scanner EVA). Three volume regions of interest (ROI) were defined: the distal femur (circumference measured between the of superior extent of the patella to 10 cm proximal), the knee joint (measured from the top of the patella to the tibial tuberosity) and the proximal tibia (tibial tuberosity to 10 cm distal). Results The mean volume of the right leg was 3.901 l (I. distal femur: 1.63 l, knee joint: 1.33 l, proximal tibia: 1.10 l) and mean volume of the left leg was 3.910 l (I. distal femur: 1.66 l, knee joint: 1.34 l, proximal tibia: 1.12 l). The volume difference between the right and left leg was 0.094 l (SD ± 0.083 l) The Wilcoxon-Mann-Whitney test showed no significant differences of the volumes between the right and left leg. Conclusions This study demonstrates that portable 3D scanning could be an accurate and reliable tool for orthopedics and trauma surgeons. Based on the ROIs of this pilot study, further studies are needed to test the significance for clinical applications for patients with an injured knee.

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“…There are also 4 types of remnant embryonic septum variants which influence the synovial fluid circulation between these bursae and intra-articular joint. [25,26] These bursal morphological variants may offer some insight into potential anatomical reasons for suboptimal procedure outcomes. If procedure failure is suspected for these anatomical reasons another knee injection (infra-patellar) may be considered.…”

Section: Pros and Cons Of Skip Foot-on Floor Mppb-lppb And Channels Injection Aspiration Summarymentioning

confidence: 99%

A Guide to Performing Seated, Foot-On-Floor Position Ultrasound Guided Knee Injections Targeting the Medial & Lateral Parapatellar Bursae & Their Channels

Inklebarger

DL²,

Nikiforos³

et al. 2022

ijmsci

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Ultrasound guided (USG) supra patellarbursa (SPB)knee aspirations-injections are a current standard practice, typically performed with the patient supine on a plinth, and with the knee flexedto around 30 degrees. This follows research that 30 degrees of knee flexion offers optimal SPB bursal resolution. However,in circumstances of pain-mobility issues affecting plinth transfer, an alternative seated, foot on floor or wheelchair pedal, knee-flexed 90 degrees procedure (SKIF)is proposed. This foot on floor position may facilitate a push-off counter resistance, facilitatingisometric quadriceps contraction enhanced suprapatellar bursa (SPB) viewing, along with improved resolution of thelesser describedmedial-lateral parapatellarbursae(MPPB-LPPB) and their communicating SPB recess channels. As the MPPB-LPPB interconnect to the medial-lateral SPB recesses but are located more superficially and centrifugal to the femoral condyles in areas devoid of underlying articular cartilage, their preferential SKIFinjection-aspiration,mayalso prevent cartilage needle stick injuries.alsoknown as the paracondylar gutters, the relatively superficial MPPB-LPPB position may likewise offer better image resolution, lessenneedle travel distances and needle trajectory re-directs, which may in turn enhance procedure safety, comfort, and speed. Though the medial-lateral SPB recesses have some mention in the literature, it would appear thatinter tri-bursal connecting channels linking the MPPB-LBBP to the SPB recesses have not previously been described.This report explores tri-bursal and inter-bursal channel anatomy, relevant to performing USG SKIF injections and also elucidates the method, potential advantages, and pitfalls of this novel technique.

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Morphologic variants of the proximal knee-joint cavity. An anatomical and radiological study

Cited by 7 publications

References 4 publications

Reduplicated medial parapatellar plica: a case of a medial plica anatomical variation recalcitrant to conservative treatment

Reduplicated medial parapatellar plica: a case of a medial plica anatomical variation recalcitrant to conservative treatment

Defining the region of interest of the knee for perioperative volumetric assessment with a portable 3D scanner in orthopedic and trauma surgery

A Guide to Performing Seated, Foot-On-Floor Position Ultrasound Guided Knee Injections Targeting the Medial & Lateral Parapatellar Bursae & Their Channels

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