Evaluation of the effect of arthroscopic medial plica excision on anterior knee pain and treatment outcomes

Objective: The purpose of our study is to investigate the clinical outcomes of patients who underwent medial plica excision during arthroscopy for anterior knee pain, to evaluate the impact of concurrent additional pathologies on treatment outcomes, and to understand the relationship between osteoarthritis and medial plica excision. Methods: Out of 903 knee arthroscopies performed in our clinic, plica was identified in 316 cases. Among these, 160 patients met our inclusion criteria and were included in the study. We thoroughly evaluated various parameters from these 160 patients, including range of motion, Visual Analog Scale score, Kujala score, Lysholm score, Tegner score, and Cincinnati score. We categorized patients who underwent medial plica excision into several groups: those who also had microfracture, those who underwent partial meniscectomy, those who only had medial plica excision, those with osteoarthritis, and those without osteoarthritis. We conducted cross-comparisons between these groups to analyze the data comprehensively. Findings: All patient groups who underwent medial plica excision benefited from the treatment. Of the patients, 28 (17.4%) underwent microfracture, 79 (49.4%) underwent partial meniscectomy, and 53 (33.1%) had only medial plica excision. Patients were categorized based on their Kellgren-Lawrence (KL) osteoarthritis grade as follows: 29 (18.1%) KL-0, 72 (45%) KL-1, 39 (24.4%) KL-2, and 20 (12.5%) KL-3. While partial meniscectomy and microfracture did not significantly affect the clinical success of medial plica excision, the surgical success rate decreased as the grade of osteoarthritis increased. Conclusion: This study observed that the medial patellar plica can cause damage to the cartilage, meniscus, and ligaments within the knee. Medial patellar plica excision resulted in clinically significant improvements in all patients. Arthroscopic medial plica excision is a viable method for the treatment of anterior knee pain.