Plica Syndrome

Plica is nothing but pleats of synovial tissue normally found in all Knees. There are four Plica (Synovial folds) normally present in the Knee Joint.

Most often than not only the Medial Plica may become symptomatic. The Medial Plica attaches to the lower end of the Patella (kneecap) and runs sideways to attach to the lower end of the thigh bone at the inner side of the Knee Joint.


The Medial Plica becomes symptomatic when it is irritated by certain movements of the Knee.

Knee Plica

Plica Syndrome

The Predisposing Factors are:

  • Teenage athletes
  • Blunt or twisting Knee injury
  • Repetitive Knee flexion-extension e.g. rowing, swimming, cycling.

Clinical Features:

  • Pain on the inner side of the Patella
  • Snapping sensation on Knee flexion


  • MRI
  • Arthroscopy


Conservative Management:

  • Rest
  • Ice
  • Anti-inflammatory medications
  • Local cortisone injection

Surgical Management:

This is recommended when conservative measures fail and there is intolerable pain and discomfort.

The Symptomatic Plica is excised under the guidance of an Arthroscope.