International Medical Case Reports Journal (Mar 2022)
Is There a Relationship Between Quadriceps Tendinopathy and Suprapatellar Plica? An Observational Case Series
Abstract
Håkan Alfredson,1 Lorenzo Masci,2,3 Christoph Spang4,5 1Department of Community Medicine and Rehabilitation, Sports Medicine, Umeå University, Umeå, Sweden; 2Institute of Sports Exercise and Health, University College Hospital London, London, UK; 3Sports & Exercise Medicine, Queen Mary University of London, London, UK; 4Department of Integrative Medical Biology, Anatomy Section, Umeå University, Umeå, Sweden; 5Private Orthopaedic Spine Center, Würzburg, GermanyCorrespondence: Håkan Alfredson, Department of Community Medicine and Rehabilitation, Sports Medicine, Umeå University, Umeå, 90187, Sweden, Tel +46 702288441, Email [email protected]: Chronic painful quadriceps tendinopathy is a relatively rare condition known to be difficult to manage. Conservative management is first-line treatment and if that fails open intra-tendinous revision surgery followed by a long rehabilitation period is used. There is sparse research on etiology and new treatment methods. This observational study aimed to evaluate the intra-articular findings in patients with chronic painful quadriceps tendinopathy resistant to conservative management.Patients and Methods: Seven male athletes (mean age 33 years, range 22– 40) suffering from chronic painful quadriceps tendinopathy in altogether 10 tendons, not responding to conservative management including heavy strength training, were included. Clinical examination and ultrasound scanning were used for diagnosis. Arthroscopy was used for evaluation of the inside of the knee.Results: In all 10 knees, there were obliterating major plica formations in the suprapatellar pouch.Conclusion: Obliterating plica formations in the suprapatellar pouch may be involved in the aetiology and pathology in quadriceps tendinopathy.Keywords: quadriceps, tendinopathy, suprapatellar, plica, surgery