Plica Syndrome

Overview

What is plica syndrome?

A plica is a fold in the membrane that protects your knee joint. Most people have four folds in each knee. Sometimes the plica located in the middle of your knee becomes irritated. This is called plica syndrome and it’s characterized by pain, swelling and instability.

What is medial plica syndrome?

Plica syndrome is also called medial plica syndrome. This is because the plica affected is located in the middle (medial) of the knee.

What’s the difference between plica syndrome and a torn meniscus?

A torn meniscus can cause many of the same symptoms as plica syndrome. However, these are two different conditions. A person with a torn meniscus usually has pain and tenderness at the joint line, while someone with plica syndrome is likely to have pain above the joint line. Magnetic resonance imaging (MRI) can be used to confirm your diagnosis.

Who does plica syndrome affect?

Plica syndrome is common among athletes, especially those who run or bike. However, the condition can also be the result of an injury from a fall, car accident or other type of trauma.

How common is plica syndrome?

According to many experts, about 10% of the population develops plica syndrome at some point. However, it is widely believed that plica syndrome goes undiagnosed in many instances since symptoms are similar to other knee problems.

How does plica syndrome affect my body?

People with plica syndrome often experience knee pain and localized swelling. There may also be clicking, popping or reduced range of motion.

Symptoms and Causes

Can an injury cause plica syndrome?

Yes. Plica syndrome may occur as a result of an accident, such as hitting your knee against the dashboard in a car crash. It also commonly develops in athletes who run or cycle.

What are the symptoms of plica syndrome?

People with plica syndrome typically have knee pain. Other common plica syndrome symptoms include:

  • A swollen knee.
  • A clicking or popping sound when bending or extending your knee.
  • Pain that worsens after bending, squatting or climbing stairs.
  • A catching sensation when standing after long periods of time.
  • Feeling unstable on slopes and stairs.
  • Difficulty sitting for long periods of time.
  • The ability to feel the swollen plica when pressing on your knee cap.

Diagnosis and Tests

How is plica syndrome diagnosed?

Your healthcare provider will begin with a physical examination. They’ll also ask questions about your symptoms and health history. In order to rule out other problems, such as tendinitis or a torn meniscus, your healthcare provider may recommend X-rays or magnetic resonance imaging (MRI).

Management and Treatment

How is plica syndrome treated?

In many cases, plica syndrome can be managed with non-surgical treatments. These include:

  • Rest: To promote healing, avoid activities that led to your flare-up.
  • Applying ice or cold compresses: Icing your knee helps reduce pain and inflammation. Apply a cold compress for 15 minutes every three hours.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications like ibuprofen and naproxen sodium help reduce inflammation and discomfort.
  • Steroid injections: Your healthcare provider may recommend corticosteroid injections to ease your knee pain.
  • Exercises to strengthen your quadriceps: People who have weak quadriceps are more likely to develop plica syndrome. Exercises that target your quadriceps can help reduce your risk.
  • Hamstring stretches: If your hamstrings are too tight, they can place extra stress on the front of your knee. Stretches that relax your hamstrings can help.

If non-surgical treatments don’t help, you may need a type of surgery called arthroscopic resection. During this procedure, your healthcare provider makes a small incision in your knee and inserts a small camera through it. Tiny surgical instruments are inserted through a second incision so the plica can be altered or removed.

Are there complications after arthroscopic resection surgery?

As with any surgery, complications can occur following arthroscopic resection. These may include:

To reduce your risk of post-surgical complications, talk to your healthcare provider about your medical history. You should also tell them about any medications or supplements you’re currently taking.

How long does it take to recover from arthroscopic resection surgery?

After arthroscopic resection surgery, most people need about six weeks to recover. Healing could take longer depending on the severity of your condition.

Prevention

How can I prevent plica syndrome?

Though you can’t prevent plica syndrome altogether, there are several things you can do to reduce your risk. For example:

  • Avoid overuse of your knee joint.
  • Be aware of your comfort level when incorporating new exercise routines.
  • Maintain strength and mobility in your legs, ankles and feet.

Outlook / Prognosis

What’s the outlook for people with plica syndrome?

Most of the time, plica syndrome is easy to manage with exercise and physical therapy. Even if you need surgery, the procedure is less invasive than other types of knee surgery.

Living With

When should I see my healthcare provider?

If you have pain and swelling — or if you’ve lost range of motion in your knee — call your healthcare provider to schedule an appointment. They can confirm your diagnosis and design a personalized treatment plan to meet your needs.

A note from Cleveland Clinic

Plica syndrome can be painful and keep you from the activities you enjoy. Fortunately, the condition can be successfully managed with prompt and proper care. Ask your healthcare provider how to ease your symptoms so you can enjoy life again.

Last reviewed by a Cleveland Clinic medical professional on 08/12/2021.

References

  • Casadei K, Kiel J. Plica Syndrome. (https://pubmed.ncbi.nlm.nih.gov/30570983/) 2021 Apr 19. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Accessed 9/1/2021.
  • Lee PYF, Nixion A, Chandratreya A, Murray JM. Synovial Plica Syndrome of the Knee: A Commonly Overlooked Cause of Anterior Knee Pain. (https://pubmed.ncbi.nlm.nih.gov/28825013/) Surg J (N Y). 2017 Feb 15;3(1):e9-e16. Accessed 9/1/2021.
  • Small NC. Complications in arthroscopic surgery performed by experienced arthroscopists. (https://pubmed.ncbi.nlm.nih.gov/3166663/) Arthroscopy. 1988;4(3):215-21. Accessed 9/1/2021.
  • Griffith CJ, LaPrade RF. Medial plica irritation: diagnosis and treatment. (https://pubmed.ncbi.nlm.nih.gov/19468899/) Current Review of Musculoskeletal Medicine. 2008 Mar;1(1):53-60. Accessed 9/1/2021.

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