Clinical Study of the Cases with and without Resection of the Painful Synovial Shelf and the Factors related to Residual Complaints

Abstract

Clinical results of cases with and without resection of the painful synovial shelf were compared and the factors related to residual complaints were investigated. The subjects comprised a total of 43 knees in 39 patients with synovial shelf syndrome (27 resected shelf knees in 25 patients and 16 unresected shelf knees in 14 patients) . Excellent or good results were obtained in 22 (82%) of the 27 resected shelf knees and in 9 (56%) of the 16 unresected shelf knees. Resection of the shelf thus yielded more favorable results. It did not relieve all complaints, though, and in more than half the resection cases, some difficulties remained. The type B (Sakakibata's classification) nonresected shelves, also showed very good results in several cases.
The factors relating to residual complaints included operation procedure (release or partial resection), patelao-femoral congruity, additional burdens of knee arthropathies due to aging and lesions in patellar and medial femoral condylar cartilage. In particular, problems in differential diagnosis with regard to the patellar subluxation syndrome seem to have substantial influence upon the therapeutic results in the synovial shelf syndrome.