In the first place, there are a number of congenital knee problems that a person can be born with. By the same token, an intraarticular congenital plica is an extra piece of connective tissue that rubs on the femoral condyle. In general, it is fairly common and has to do with the fact that there were compartments during fetal life, which were separated by membranes. To clarify, when part of such a membrane persists, we call them “plica”. For this reason, they can mimic a meniscal tear, when in reality the meniscus is normal.
During arthroscopy the orthopedic surgeon will usually divide the plica, when there is evidence that this has led to irritation of the femoral condyle. Hypermobility of a knee can be a serious cause for premature degenerative problems in a knee.
There are a number of inherited diseases that cause hypermobility of the knee joint and other joints such as the Marfan syndrome, the Ehlers-Danlos syndrome etc. The hypermobility can start in childhood, there can be recurrent knee cap dislocations, and hyaline cartilage damage from the hypermobility and recurrent micro-injuries from gymnastics or ballet lessons.
These activities should be avoided in these syndromes. Often these persons suffer from premature degenerative arthritis of the knees as these micro-injuries sum up to a premature degeneration of the joints.
References
1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 157.
2. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 4.
3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 270.
4. Wheeless’ Textbook of Orthopaedics:http://www.wheelessonline.com/ortho/arthritis
5. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders
6. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
7. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
