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Plica syndrome is caused by irritated, inflamed, and swollen joint tissue folds in the knee. It can be caused by injury or overuse and is common in athletes. Symptoms include pain, stiffness, and clicking sounds. Treatment includes rest, pain relievers, and surgery if necessary.
Plica syndrome is a fairly common cause of knee pain and instability. It occurs when folds of joint tissue called plicae become irritated, inflamed, and swollen. A person can develop plica syndrome following a direct injury or as a result of chronic overuse of the joint. Most cases are mild and temporary, and people are able to return to normal activity levels after about four weeks of rest. If the tissue in the fold is severely damaged, however, you may need surgery and a lengthy rehabilitation program to make a full recovery.
Plica tissue plays an important role in the development of knee structures while a fetus is in the womb. Most of the plica tissue deteriorates to make room for tendons, cartilage, and bone in the second trimester, and the plica remnants form four small creases in the knee. The crease closest to the inside of the knee joint is usually the one implicated in plica syndrome. Problems occur when a person puts too much pressure on the knee, either from excessive running and bending or from a sudden twist or impact. Athletes, very active people, and traffic accident victims are more likely to experience plica syndrome.
Symptoms of plica syndrome depend on the severity and nature of the lesion. The irritated tissue can cause the inside of the joint to become tender, painful, and stiff. You may be able to hear a pop or click when you bend your knee. If major damage has occurred, it can be very painful to bear weight on the affected leg. Occasionally, redness and swelling accompany other symptoms.
It is important to visit a doctor whenever painful symptoms develop to get an accurate diagnosis. A doctor can perform a physical exam to determine whether the pain is caused by inflamed skinfold tissue or a more serious problem, such as a bone fracture or torn tendon. MRI scans are often done to confirm soft tissue inflammation in the knee.
Most patients with relatively minor symptoms are instructed to rest and freeze their knees for several weeks. Over-the-counter pain relievers and anti-inflammatory drugs can also help reduce symptoms. If the pain is severe at the time of the exam, your doctor may decide to inject a corticosteroid solution directly into the joint. It’s important to give your knee ample time to recover before returning to activity to avoid further injury.
Arthroscopic surgery is only needed if a person fails to improve with conservative treatment. An experienced orthopedic surgeon can remove or reinforce damaged plica tissue from the joint. It may take up to six months to recover from surgery, during which time a person needs plenty of rest and guided physical therapy. Surgery for plica syndrome is usually very successful, and most patients are eventually able to return to normal activity levels.
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