Evaluation of soft tissue release in mild-to-moderate medial knee osteoarthritis in the presence of medial synovial plica, using clinical and MRI parameters

Abstract

Abstract Objective. To evaluate the clinical outcomes of an arthroscopic soft tissue release procedure for the treatment of mild to moderate knee osteoarthritis. Materials and methods. This study involved 40 subjects who underwent arthroscopic release in knee osteoarthritis including Kellgren–Lawrence grades 2 and 3 between January 2019 and January 2021. The Western Ontario and McMaster Universities (WOMAC) scores at baseline and at 6 months following surgery were recorded. Magnetic resonance imaging (MRI) was performed pre- and postoperatively (6 months). The parameters for patellar instability, including patellar tilt angle, bisect offset, tibial tuberosity–trochlear groove distance and the Insall–Salvati ratio, were measured preoperatively and postoperatively. Quantitative measurements of bone marrow lesions were also conducted. Results. The mean WOMAC score for pain and the total score improved statistically 6 months after surgery. The pain and overall scores improved significantly (reductions of 64.6% and 39.3%, respectively) at 6 months. Pain score improved from 7.0 ± 3.0 to 2.5 ± 2.8 (P < 0.05), with the total score improving from17.8 ± 10.3 to 10.8 ± 10.6 (P < 0.05). Bone marrow lessions decreased from 8503 mm3 to 2250 mm3 (P < 0.05). Patellar tilt decreased from 5.11 to 4.24 (P < 0.05). The Insall–Salvati ratio decreased significantly from 1.13 ± 0.13 to 1.08 ± 0.12 (P < 0.05). Conclusion. Overall, the results suggest that soft tissue release has clinical symptoms and structure-modifying effects in patients with knee osteoarthritis.