Plica syndrome involves a fold of joint lining, called synovial tissue, that remains from embryological development. These bands of tissue may persist into adulthood and usually do not cause symptoms.
When a plica becomes thickened and inflamed, it can cause pain, catching, locking, or clicking in the knee.
What Is Plica Syndrome?
A plica is a fold of synovial tissue within the knee. During embryological development, bands of tissue divide the limbs into joints. Some of these bands may remain into adulthood.
Several types of plica may exist. When a plica becomes thickened, inflamed, and less elastic, it may pinch against the inner knee joint and inner patella, causing symptoms.
Causes and Risk Factors
Plica syndrome can result from direct trauma to the knee or from repetitive bending and straightening of the knee.
Risk factors include:
- Sports that require repeated, forceful straightening or bending of the knee, such as kicking and jumping
- Repeated knee injuries
- Sports in which the knee may receive direct injury, including volleyball, soccer, and football
- Activities that require prolonged kneeling
Symptoms
Common signs and symptoms include:
- Pain in the front of the knee, often toward the inside of the knee
- Pain with kneeling or squatting
- Pain after sitting for long periods
- Pain when rising from a seated position
- Pain when walking or running up or down stairs or hills
- Catching, locking, or clicking of the knee
- Pain and tenderness under the kneecap
Treatment
Initial treatment consists of medications and ice to relieve pain and reduce inflammation, stretching and strengthening exercises for the hamstrings and quadriceps, and modification of activities that produce symptoms.
These exercises may be performed at home, although referral to a physical therapist or athletic trainer may occasionally be recommended.
A cortisone injection may occasionally be recommended to reduce inflammation of the plica. Arch supports may also be recommended.
Surgery is not usually necessary and is generally reserved for symptoms that continue despite conservative treatment. Surgery to remove the plica is usually performed arthroscopically on an outpatient basis.
Recovery and Outcomes
Complete recovery usually occurs with proper treatment.
Potential complications include:
- Frequent recurrence of symptoms, resulting in chronically inflamed tissue and potentially a chronic problem
- Disability severe enough to reduce an athlete’s competitive ability
- Delayed healing or resolution of symptoms, particularly if activity is resumed too soon
- Risks of surgery, including infection, bleeding, injury to nerves resulting in numbness, weakness, or paralysis, continued pain, and rupture of the patellar tendon
When to See Dr. Chudik
If you are concerned about plica syndrome or your symptoms worsen, schedule an evaluation with Dr. Chudik.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.