Arthroscopic treatment of symptomatic lateral synovial plica of the knee

Abstract

Introduction: Synovial plicae are often observed when performing arthroscopic surgery, but their pathological nature and the necessity for treatment are still controversial. There are few reports regarding lateral synovial plicae because it is considered extremely rare. The purpose of this study was to report the clinical outcomes of athletes with symptomatic lateral synovial plicae who underwent arthroscopic surgery. Methods: Ten patients with lateral synovial plica underwent arthroscopic surgery. Of the 10 patients, 5 were male and 5 were female, and their average age was 19.1 years. The chief symptoms were anterolateral knee pain, limited range of motion due to pain, and catching. All patients failed nonoperative management. Results: The average period between the onset of lateral synovial plica syndrome and the knee surgery was 5.6 months. The average follow-up period after surgery was 8.4 months. The arthroscopic findings revealed that a plica-like structure existed in the lateral patellofemoral joint. After surgery, pain and limited range of joint motion were improved in all cases and catching and locking disappeared. No complications were observed; however, the pain relapsed after surgery in one patient who had slow onset. In this patient, another resection of the synovial plica provided symptomatic improvement. Conclusions: Arthroscopic resection of symptomatic lateral synovial plicae was performed with good results. Lateral synovial plica syndrome is a rare condition. However, when treating athletes with anterolateral knee pain, lateral synovial plicae should be considered.