The question has some flaws. Are we talking as treatment for recurrent patella dislocations or as observation of the an anatomical finding within the knee, the anteromedial plica?

In the former, there is no possibility to have normal biomechanics and mal-tracking in the same time. As soon as we have the latter the biomechanics are abnormal. Same applies with the anatomy. I can feel the question is taking the "normality" as only for the condylar joint but not the connection of it with the patello-femoral joint. To answer correctly the condition of the knee articulation has to be analysed and the correct for every case surgery to be administered. So the above question has one answer, if we take it as treatment of recurrent dislocations. The plication of the medial retinaculum can be administered as surgical treatment on some cases that it is indicated.

In the case of the latter (anteromedial plica) Mr Canavan's answer covered me.

Hi,

Here is a recent article

Arthroscopic lateral retinacular release, medial retinacular plication and partial medial tibial tubercle transfer for recurrent patellar dislocation.

Chen S, Zhou Y, Qian Q, Wu Y, Fu P, Wu H.

Int J Surg. 2017 Aug;44:43-48.

Very good question. The medial retinaculum/plica appears to not receive a lot of attention in the scientific literature. One may want to read the article in Clinical Biomechanics November 2007Volume 22, Issue 9, Pages 1013–1016 by Shaw-Ruey Lyu entitled "Relationship of medial plica and medial femoral condyle during flexion". Also, physical therapy treatment incorporating manual therapy, modalities, and an individualized therapeutic exercise program has also shown to be effective, in my experience, with individuals with medial plical irritaton. I hope this helps.

As there is mention of normal knee biomechanics , the medial plication can be a viable option in some if not all cases and may or may not accompany other procedures.

But the indicated cases may need to undergo comprehensive assessments for other procedures.

However, this can be a good standalone first procedure failing which other methods pose an option.

The question has some flaws. Are we talking as treatment for recurrent patella dislocations or as observation of the an anatomical finding within the knee, the anteromedial plica?

In the former, there is no possibility to have normal biomechanics and mal-tracking in the same time. As soon as we have the latter the biomechanics are abnormal. Same applies with the anatomy. I can feel the question is taking the "normality" as only for the condylar joint but not the connection of it with the patello-femoral joint. To answer correctly the condition of the knee articulation has to be analysed and the correct for every case surgery to be administered. So the above question has one answer, if we take it as treatment of recurrent dislocations. The plication of the medial retinaculum can be administered as surgical treatment on some cases that it is indicated.

In the case of the latter (anteromedial plica) Mr Canavan's answer covered me.

I fully agree with Dr Paul K Canavan answer.

its biomechanics is poorly understood and the article he recommended is of help.

Many studies have shown good to excellent results of medial retinacular plication with or without lateral retinacular release. Patellar instability in normal knee alignment it is possible to solve arthroscopically with medial retinacular plication with a needle-hole technique as less invasive technique.

Good tópic , is very inusual to have normal anatomy in chronic patellar instability, that is why I believe in 'a la cart' treatment popularized by the French school , diferent anatomies , diferent thecniques

With that concept in mine I still have indications for medial patellar reefing , but usually with other simultaneus thecnique