Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr;10(2):155-62.
doi: 10.1007/s11832-016-0724-x. Epub 2016 Apr 1.

The effects of medial synovial plica excision with and without lateral retinacular release on adolescents with anterior knee pain

Dennis E Kramer  1   2 , Leslie A Kalish  3 , Matthew V Abola  3 , Elizabeth M Kramer  3 , Yi-Meng Yen  3 , Mininder S Kocher  3 , Lyle J Micheli  3
Affiliations

The effects of medial synovial plica excision with and without lateral retinacular release on adolescents with anterior knee pain

Dennis E Kramer et al. J Child Orthop. 2016 Apr.

Abstract

Objectives: To describe the functional outcomes in patients aged ≤18 years with anterior knee pain treated with medial plica excision with or without lateral release.

Methods: We identified 135 patients including 30 bilateral cases (165 knees) with a mean ± SD age of 15.1 ± 2.0 years. Patient and surgical information was recorded and a follow-up athletic questionnaire and an International Knee Documentation Committee (IKDC) Subjective Knee Evaluation form were sent out. Statistical analysis evaluated predictors of residual pain, reoperation, return to sports, IKDC score and satisfaction with surgery.

Results: At a final mean follow-up of 4.4 years (range 2-7.5), 36 % of patients were pain free, 46 % had mild residual pain and 18 % had pain not improved from surgery. Reoperation was more likely following isolated plica excision (7/41; 17 %) versus plica excision with lateral release (8/124; 6 %), although not statistically significant, P = 0.06. Mean IKDC score (107 knees) was 76.9 ± 17.8 (range 31-100). Most patients (86/99; 87 %) were satisfied with surgery and were able to return to sports (104/120; 87 %).

Conclusions: While most patients were satisfied and able to return to sports following plica excision with or without lateral release, residual symptoms were common.

Keywords: Knee arthroscopy; Patellofemoral syndrome; Pediatric sports medicine; Plica.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
a Arthroscopic view of the left knee from the anterolateral portal showing a fibrotic medial plica (asterisk) over the medial trochlea (T). b An arthroscopic basket begins to excise the plica (asterisk) which is impinging between the patella (P) and trochlea (T). c An oscillating shaver is used to complete the resection leaving a thin rim (asterisk)
Fig. 2
Fig. 2
Kaplan−Meier survivorship curve for return to sports
Fig. 3
Fig. 3
Kaplan−Meier survivorship curve for reoperation
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Johnson DP, Eastwood DM, Witherow PJ. Symptomatic synovial plicae of the knee. J Bone Joint Surg Am. 1993;75(10):1485–1496. - PubMed
    1. Thabit G, 3rd, Micheli LJ. Patellofemoral pain in the pediatric patient. Orthop Clin North Am. 1992;23(4):567–585. - PubMed
    1. Shea KG, Pfeiffer R, Curtin M. Idiopathic anterior knee pain in adolescents. Orthop Clin North Am. 2003;34(3):377–383. doi: 10.1016/S0030-5898(03)00009-9. - DOI - PubMed
    1. Al-Hadithy N, Gikas P, Mahapatra AM, Dowd G. Review article: plica syndrome of the knee. J Orthop Surg (Hong Kong) 2011;19(3):354–358. - PubMed
    1. Kim SJ, Choe WS. Arthroscopic findings of the synovial plicae of the knee. Arthroscopy. 1997;13(1):33–41. doi: 10.1016/S0749-8063(97)90207-3. - DOI - PubMed

LinkOut - more resources