Tokushukai Medical Group

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Orthopedic Surgery Disease:Derangement of Knee Joint

Pain caused by inner synovial flap inflammation developed from external injury.

Folded part found in articular capsule which covers knee joint is called as synovial flap. Among these flaps, inner synovial flap found near the inner edge of the patella looks as shelf when observed by arthroscope. When this shelf is large enough, shelf may be clipped or rubbed between patella (bone of the plate) and thighbone when knee is bent stretched at sports or external injury. So that inflammation is developed then pain occur. That is why it is called as Derangement of Knee Joint.

Knee stress by sports is one of cause.

In case large shelf is recognized, knee may repeatedly receive stress through sports, so that symptom becomes apparent because of external injury. As the symptom, there may be a case where strong pain occur from caught on feeling or sense of discomfort when knee is bent stretched.

Pay attention to snap off sound when knee is bent stretched.

The disease can be presumed from snap off sound at inside of patella or from pain itself when knee is bent stretched manually. Then shelf is drawn up by MRI examination and disease is diagnosed. It can be confirmed when shelf is clipped between patella and thighbone at the time of knee is bent stretched by arthroscope.

Firstly, preservation treatment shall be done by internal dosage or physical medicine.


Fig. 1 Side view of patellofemoral joint
Preservative treatment is performed in the way of local rest or reducing exercise volume amount or physical medicine like Oral anti-inflammatory drugs, external use medicine, ultrasonic or heat treatment. In case when pain remains, daily life is disturbed, difficult on work or sport activity, then surgery is considered. Generally, the surgery is pain relief with nothing is clipped between patella and thighbone with removing the shelf using arthroscope.

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