Patellar Impingement by Synovial Cord Following Anterior Cruciate Ligament Reconstruction

Masaaki Takahashi; Katsutoshi Miura; Daisuke Suzuki; Akira Nagano

doi:10.1055/s-0030-1247774

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2009; 22(4): 358-360
DOI: 10.1055/s-0030-1247774

Case Report

Patellar Impingement by Synovial Cord Following Anterior Cruciate Ligament Reconstruction

Masaaki Takahashi¹ , Katsutoshi Miura² , Daisuke Suzuki¹ , Akira Nagano¹

¹The Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
²The Department of Basic Nursing Health Science, Hamamatsu University School of Medicine, Hamamatsu, Japan

Abstract

ABSTRACT

We found a cordlike structure (synovial cord) in the patellofemoral joint causing patellar impingement in a 45-year-old man after anterior cruciate ligament (ACL) reconstruction. Arthroscopic examination revealed that a cylindrical cordlike soft tissue with a smooth surface extended between the medial and lateral capsule of the patellofemoral joint. The tissue histologically consisted of dense collagen fibers in parallel bundles covered with thin layers of synovial tissue; in addition, there was a proliferation of small vessel patches surrounded by hemosiderin-laden macrophages, which indicated bleeding episodes due to impingement in the patellofemoral joint. To our knowledge, this is the first case report of a synovial cord in the patellofemoral joint causing patellar impingement following ACL reconstruction.

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