Arthroscopic resection of the shelf (mediopatellar plica) in the knee under local anesthesia in outpatient clinic.

Forty-two knees with symptomatic mediopatellar plicae (shelves) were managed using the operative method under local anesthesia. Of these, thirty-one knees had isolated mediopatellar plicae, and eleven had other associated intra-articular pathologic condition, such as meniscal tear, lateral patellar tracking, osteochondritis dissecans, and minor osteoarthritic changes. The clinical results were excellent or good in thirty-seven (88%) patients, fair in five patients after an average follow-up of twenty-five months. No case showed deterioration after surgery. Because there are no definitive criteria for the indication of shelf resection, arthroscopic resection of the shelf under local anesthesia is recommended if there is any possibility of it being the cause of knee pain.