Retinacular band excision improves outcome in treatment of plica syndrome

Mild symptoms usually continue after excision of the medial patellar plica. We noticed that the palpable tender cord, located on the anteromedial aspect of the knee in patients with plica syndrome, did not disappear completely after excision of the synovial fold. Beneath all plicae, a retinacular band was visible, and only after excisions of this band did the cord become impalpable. We conducted a study to determine the role of these medial retinacular bands in the symptomatology of the disorder. Twenty-four knees of 22 patients diagnosed with medial patellar plica syndrome were divided into two groups. In the first group, arthroscopic excision of the synovial plica was performed. In the second group, retinacular bands beneath the plica were additionally excised. When Lysholm scores were compared, we found that the second group showed significantly greater improvement. We believe that the retinacular bands play a role in the symptomatology and the pathophysiology of plica syndrome and that excision improves the outcome.