The superolateral approach: a better view of the medial patellar plica.

When attempting to perform medial patellar plica surgery, the arthroscopist often finds that the three standard portals, namely, central, inferolateral, and midpatella lateral, offer poor visualization, awkward instrumentation, or both. This article suggests and describes the superolateral approach as a better arthroscopic portal for medial patellar plica surgery; while affording a sweeping, unobstructed view of the entire plica, this approach enables the arthroscopist to utilize the midpatella lateral portal for effective and convenient excision, with no damage to articular surfaces. The superolateral approach also offers excellent visualization of the suprapatellar pouch, the suprapatellar plica, and the patellofemoral joint. We further recommend the use of an infusion pump to improve knee distension, as well as the use of arthroscopic electrocoagulation to minimize postoperative hemarthrosis.