Another Cause of locking knee -A new anterior inferior coronal patellar plica

It has been recently demonstrated that finding of locking and giving way do not delineate a cartilage tear:
September 9, 2018
Knee Meniscus Signs Do not Help in Diagnosis
https://newpainmuse.org/2018/09/09/knee-meniscus-signs-do-not-help-in-diagnosis/

To emphasize that they state ” clicking, giving way, and pseudolocking have been reported in approximately 50% of all patients who present with a painful medial plica irritation.”

This is one previously unidentified disorder that can cause recurrent painful locking.

Surgeon. 2018 Aug;16(4):195-201. doi: 10.1016/j.surge.2017.05.003.
A new anterior inferior coronal patellar plica.
Sadile F et al.
https://www.ncbi.nlm.nih.gov/pubmed/28602482

new plica

  • 1% of knee arthoscopies
  • not visible by MRI or CT
  • over 1/2 will be torn
  • “plica triggers shooting pain when the patient stands up from a sitting position, and painful snapping or locking of the knee.”
  • it covers the knee coming up like a child’s bib
  • excision relieves it.

Comment – I see more medial plicas than I would have thought and now there is another one

 

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