Plica Syndrome2016-10-12T12:39:55-04:00

Plica Syndrome

knee Blacksburg VA

What is Plica Syndrome?

Plica syndrome is often characterized by anterior knee pain, commonly found along the superomedial aspect of the knee. The plica is considered to be a structure in the knee lacking significant function or importance. Four plicae synovial folds are found in the knee, but only one causes pain or discomfort. This structure is called the medial plica. The medial plica attaches to the lower end of the patella (kneecap) and runs sideways to attach to the lower end of the thighbone at the side of the knee joint closest to the other knee.

A plica causes problems when it is irritated. This can occur over a long period of time, when the plica is irritated by certain exercises, repetitive motions, or kneeling. Activities that repeatedly bend and straighten the knee, such as running, biking, or use of a stair-climbing machine, can irritate the medial plica and cause plica syndrome.

Symptoms of Plica Syndrome

Plica syndrome is characterized by pain near the anteromedial (in front and toward the midline) side of patella (kneecap). Pain is associated with bending of the knee and is irritated after and during exercise. Generally, no other additional symptoms other than pain is present, but it can occasionally be accompanied by swelling of the knee after prolonged physical activity. Plica syndrome may be suspected when you have:

  • Anteromedial knee pain.
  • Visible and palpably tender plica.
  • Audible clicking or snap during knee motion.
  • Pain decreased by using a duvet between your knees to ease pain in bed.
  • Pain with activities such as ascending and descending stairs, squatting, rising from a chair and/or sitting for extended periods.
  • Quadriceps atrophy is common in chronic cases.

Nonoperative Treatment for Plica Syndrome

The conservative treatment approach for plica syndrome in athletes includes rest from strenuous or precipitating activities. The following treatments may also help relieve the discomfort associated with plica syndrome:

  • Physical therapy to strengthen and stretch the muscles and soft tissues around the knee.
  • Oral non-steroidal anti-inflammatory medications and steroid injections can help alleviate the symptoms of plica syndrome by decreasing the inflammation and synovitis. If symptoms of pain and swelling completely resolve, a gradual rehabilitation program is started with a controlled return to competition.
  • Steroid injections. 

Surgical Treatment for Plica Syndrome

If nonsurgical attempts to reduce your symptoms fail, surgery may be offered. Usually, an arthroscope is used to remove the plica. The small camera is inserted into the knee joint through a small incision. After the plica is located with the arthroscope, the surgeon can cut away the plica tissue and remove the structure. The area where the plica is removed heals back with scar tissue. There are no known problems associated with not having a plica.

Post surgical rehabilitation is helpful to strengthen and stretch the knee joint after surgery. A rehabilitation program can restore function to the knee and hasten the return of the daily activities you enjoy.

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