Course Description:

Plicae are extraneous inward folds of the synovial membrane within the knee that failed to be reabsorbed during embryologic development. While plicae are common (found in 50% of the population) and usually not pathological, trauma or repetitive activity may result in an inflammatory state or hypertrophic fibrosis. Of the four commonly found plicae in the knee, the medial plica is most susceptible to injury and inflammation. Symptoms of a dull ache over the anteromedial knee above the joint line may be experienced. Snapping with a painful arc between 30° and 60° is also common. But the most characteristic sign of a plica syndrome is the presence of a tender palpable cord over the anteromedial knee. Younger men and women who are physically active are equally susceptible to developing plica syndrome. Repetitive knee motion (e.g. stair climbing or cycling) may aggravate the condition. The diagnosis is usually made clinically, though diagnostic testing may be performed to rule out concomitant knee pathologies. Conservative treatment is usually prescribed initially, with rates of improvement between 20% and 60%. If unsuccessful, arthroscopic resection may be indicated with success rates as high as 88%