Short-term results after arthroscopic resection of synovial plicae in the radiohumeral joint: a case series of 64 procedures

Jens Brahe Pedersen; Pia Kjær Kristensen; Peter Mønsted; Theis Muncholm Thillemann

doi:10.1051/sicotj/2017021

Short-term results after arthroscopic resection of synovial plicae in the radiohumeral joint: a case series of 64 procedures

SICOT J. 2017:3:42. doi: 10.1051/sicotj/2017021. Epub 2017 Jun 7.

Authors

Jens Brahe Pedersen¹, Pia Kjær Kristensen², Peter Mønsted³, Theis Muncholm Thillemann⁴

Affiliations

¹ Regional Hospital Horsens, Sundvej 30, 8700 Horsens, Denmark.
² Department of Orthopedics, Regional Hospital Horsens, Sundvej 30, 8700 Horsens, Denmark.
³ Emergency Department, University Hospital of Aarhus, Nørrebrogade 44, 8000 Aarhus C, Denmark.
⁴ Department of Orthopedics, University Hospital of Aarhus, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark.

Abstract

Introduction: Painful Synovial Plicae (SP) in the posterolateral corner of the radiohumeral joint may be confused with lateral epicondylitis. The SP may impinge between the radial head and the humeral capitellum causing pain and snapping. The aim of this study was to evaluate the short-term results after arthroscopic plica resection of the elbow.

Methods: In this case series, we included a consecutive series of 64 arthroscopies (60 patients) with arthroscopic plica resection of the elbow. Inclusion criteria were six months of lateral elbow pain and unsuccessful conservative treatment. Patients had either ultrasonography verified plicae or pain on palpation of the plica. Patients were evaluated with an Oxford Elbow Score (OES) preoperatively, after three months and after mean 22 months (range: 12-31) of follow-up. Furthermore, baseline characteristics were recorded including, gender, age, body mass index (BMI), occupation, smoking and cartilage damage.

Results: The mean age was 44 years (range: 18-66). In 13 elbows, International Cartilage Repair Society (ICRS) grade 1 lesions were present in association with the plica. Preoperatively the mean OES was 19 (95% CI: 17-20). At three and 22 month follow-up the OES increased to 33 (95% CI: 30-36) and 35 (95% CI: 32-38), respectively (p < 0.001). Cartilage injury and gender did not affect the outcome. We reported no complications.

Discussion: Arthroscopic plica resection of the elbow indicates an improved OES after three and 22 months. A randomized prospective trial is needed to validate the effect of arthroscopic treatment of synovial elbow plicae.