title: The effects of medial synovial plica excision with and without lateral retinacular release on adolescents with anterior knee pain.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Childrens Hospital, Harvard Medical School, Boston, MA, USA. Dennis.kramer@childrens.harvard.edu.|, 300 Longwood Ave, Boston, MA, 02115, USA. Dennis.kramer@childrens.harvard.edu.
authors.forename: Dennis E
authors.initials: DE
authors.lastname: Kramer
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Childrens Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Kalish
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Childrens Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Matthew V
authors.initials: MV
authors.lastname: Abola
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Childrens Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Kramer
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Childrens Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Yi-Meng
authors.initials: YM
authors.lastname: Yen
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Childrens Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Mininder S
authors.initials: MS
authors.lastname: Kocher
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Childrens Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Lyle J
authors.initials: LJ
authors.lastname: Micheli
keywords: Knee arthroscopy; Patellofemoral syndrome; Pediatric sports medicine; Plica