Brief outline of knee plica (Synovial plica)

The plica is a thin fibrous membrane that is left over from the fetal knee development. This plica once divided the knee into three separate compartments during fetal development but then became a part of the knee structure as the compartments became one protective cavity. When friction or a pinching between the femur and patella occurs, the plica may become inflamed, causing it to thicken, which in turn causes more friction, creating a vicious cycle. This is common when the knee is flexed and placed under stress.

Knee Plica

Cause of knee plica (Synovial plica)

Trauma to the flexed knee. Repetitive stress, especially with medial weight bearing such as in cycling.

Signs and symptoms of knee plica (Synovial plica)

Pain. Tenderness over the plica.

Complications if left knee plica (Synovial plica) unattended

The plica will continue to become inflamed and limit flexion activity in the knee if the condition is left unattended. The pain may also cause a change in gait or running form that could lead to other overuse injuries.

Treatment for knee plica (Synovial plica)

Reduction of activity. R.I.C.E. Anti-inflammatory medication. Anti-inflammatory injection. Lubricant injection.

Rehabilitation and prevention for knee plica (Synovial plica)

Strengthening the quadriceps and hamstrings will take pressure off the plica. Increasing the flexibility in these muscles will also relieve pressure that may be irritating the condition. Use of proper equipment, especially  running shoes, can eliminate the irritation and force the knee back into proper alignment during activity.

Long-term prognosis and surgery for knee plica (Synovial plica)

Once pain subsides a return a normal activity can be expected. Very rarely is arthroscopic surgery required to remove the plica. No adverse effects have been found from the removal of the plica, and a complete return to activity can be expected.

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