Medial plica syndrome: A review of the literature

Abstract

Knee pain is a very common complaint seen in the clinical setting. A torn medial meniscus, osteochondral defects, inflammation, or an irritated medial plica are some of the most common causes of medial knee pain. Plicae are synovial invaginations that are believed to be remnants of the embryological development of the knee. They have a potential to become inflamed and symptomatic. Diagnosis of medial plica syndrome involves physical exam and imaging studies, but the current gold standard is arthroscopy and therefore a definitive diagnosis cannot be made until surgery. As such, medial plicae are the most commonly missed diagnoses in the knee as it is purely a clinical diagnosis. Medial plica syndrome can be treated with physiotherapy, corticosteroid injections, or surgery. Overall, good outcomes have been seen following diagnosis and treatment of medial plica syndrome, with patients returning to their preferred levels of activity. This article reviews the topic of medial plica syndrome.

Evaluation and management of knee pain in young athletes: overuse injuries of the knee

“…Embryologically the knee develops from three separate compartments, namely, medial, lateral and suprapatellar (28). Synovial plicae are believed to be the remnants of these synovial compartments.…”

“…Synovial plicae are believed to be the remnants of these synovial compartments. Suprapatellar, infrapatellar, medial (most common) and lateral plicae are normally found in the knee (28). Pain related to plica is related to the inflammation of the medial plica.…”

“…Three types of mechanisms are related to symptomatic plica in young athletes, direct trauma to the medial aspect of the knee and patella, injury to the plica as it is entrapped between the medial patellar facet and the medial condyle, and overuse injuries with the knee in flexion and with repeated external rotation of the tibia (28,29).…”

“…Treatment of symptomatic plica is a short period of rest, non-steroidal antiinflammatory drugs (NSAIDs), and return to usual activities and sports in a period of a few weeks (28). Some plicae remain symptomatic and require excision at arthroscopy with a thorough examination of the knee and treatment of any associated chondral or meniscal injuries which are found (28).…”

“…Some plicae remain symptomatic and require excision at arthroscopy with a thorough examination of the knee and treatment of any associated chondral or meniscal injuries which are found (28).…”