Symptomatic type D (separated) medial plica: clinical features and surgical results

The clinical presentation and results of surgery in 20 cases of symptomatic type D (separated) medial plica were reviewed. The group was composed of cases with a fenestration (14 knees), reduplication (two knees), and tear (four knees). Based on preoperative symptoms and clinical presentation, the patients were divided into two groups: the first group had symptoms localized to the medial compartment (11 knees), and the second group had symptoms and/or signs in the patellofemoral joint and/or lateral compartment (nine knees). The symptoms of the second group mimicked those of lateral meniscal tear or patella subluxation, and no definite preoperative diagnosis was possible. Two patients showed difficulty of full extension "active extension test." Excellent or good results were obtained with surgery in all patients after an average follow-up of 39 months. Although resection of the type D medial plica resulted in a favorable outcome, special attention should be made in preoperative diagnosis of this type of plicae.