Arthroscopic Resection of Synovial Plica in Elbow

Yoo, Yon Sik

Abstract

Purpose: To report our experience with nine cases of pathologic synovial plica on radiohumeral joint which symptom of painful snapping elbow was improved by arthroscopic resection.
Materials and Methods
Between 1999 and 2004, 43 cases of elbow arthroscopy were performed by one surgeon. Eight patients with nine cases showed pathologic synovial plica in conjunction with snapping or posterolateral elbow pain. The mean age of eight patients (man: 7, woman: 1) was 29 years (range 16~56 years). All patients had a trial of conservative treatment at least six months (range 6~16 months). The diagnosis was confirmed before surgery in six cases and at the time of surgery in three cases. Pain, snapping, and subjective results were evaluated at least 12 months in the average (range 12~24).
Results
All patients showed a hypertropic lateral synovial plica with local synovitis. Seven of them had an associated lesion of chondromalacia on radial head. One of them was associated with radiocapitellar arthritis and had a wrapping over the radial head. Six patients experienced improved posterolateral pain at the end of study (VAS<1). However, the other two patients had occasional pain with activity. One of them persisted with mechanical symptoms, which was treated with additional arthroscopic procedure.
Conclusion
Synovial plica in elbow should be considered as an important entity of common elbow disease, especially when pain in the lateral aspect of the elbow with a snapping sensation during motion is featured in patients. The arthroscopic resection seems to be safe and efficient in the short and long term treatment of plica in the elbow joint.