Classification of the suprapatellar septum considering ontogenetic development

doi:10.1016/0749-8063(92)90008-Y

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Volume 8, Issue 4, December 1992, Pages 459-464

https://doi.org/10.1016/0749-8063(92)90008-Y Get rights and content

Abstract

At the end of the 4th fetal month, the suprapatellar septum completely separates the knee joint cavity from the suprapatellar bursa. A perforation of the septum normally occurs at the end of the 5th fetal month. Mechanical factors, such as the pressure and friction of the quadriceps tendon on the condylar surface, are said to determine the form and extent of the perforation. Anatomic studies of adult knee joints revealed four variants in the further development of the suprapatellar septum, namely, a completely preserved septum (complete septum), a perforated septum with the communication between suprapatellar bursa and knee joint cavity differing in localization and number (perforated septum), a residual septum in the form of a fold that is almost always in a medial localization (residual septum), or a completely involuted septum (extinct septum). The clinical term “suprapatellar synovial plica” should not be used as a synonym for the expression “suprapatellar septum.” The suprapatellar synovial fold corresponds to the residual septum and thus is only one of the four types of the suprapatellar septum.

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Plicae around the knee are anatomically normal structures that are remnants of embryonic membranes and are generally asymptomatic. Synovial plica syndrome is known to cause knee symptoms; however, its pathological contribution has been rarely reported. This study aimed to investigate the clinical significance of suprapatellar plicae as well as the morphological characteristics of suprapatellar plicae in patients with knee symptoms who required arthroscopic treatment.
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Citation Excerpt :
It was seen that the joint space formed more rapidly on the lateral side, which may explain why the lateral plicae are seen so infrequently. A further study by Zidorn [5] looked specifically at the development of the suprapatellar bursa and found that it appeared as a slit between the quadriceps and femur towards the end of the fourth month. It had formed a perforation with the knee joint by the thirtieth week of gestation.
Synovial plicae around the knee are a relatively common occurrence but one that is rarely responsible for symptoms. The Plica syndrome has been well described but controversy still exists regarding its diagnosis and treatment.
We have reviewed and studied the published literature both past and present in detail regarding synovial plicae around the knee to provide a comprehensive and up-to-date review on the subject.
The aim is to outline previous significant research into the embryology and pathology of synovial plicae as well as providing a review of the current thinking on treatment options available for the different synovial plicae with reference to the evidence available.

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Classification of the suprapatellar septum considering ontogenetic development

Abstract

Arthroscopy

Arthroscopy

Lesions of the suprapatellar plica

J Bone Joint Surg [Am]

Knee injuries: the role of the suprapatellar plica and suprapatellar bursa in simulating internal derangements

Clin Orthop

Arthroscopy of the knee

Arthroscopy of the knee joint

Diagnostische Arthroskopie und arthroskopische Operationen am Kniegelenk

Farbatlas der Arthroskopie grosser Gelenke