What is a plica?
A plica, basically, refers to the remnants of tissue that have been left behind during the embryonic development of the knee joint. It does not have a specific purpose and is not present in everyone. However, if a person has plica in his or her knee joint, it can cause pain known as ‘Plica syndrome’.
The plica, situated on the inner side of the knee or the “medial plica,” is the synovial tissue that is most vulnerable to irritation and injury. When the knee is bent, the plica could be exposed to direct injury. It may also be injured due to overuse. Plica syndrome is a condition that occurs when the plica becomes irritated and inflamed.
Signs & Symptoms
- Pain in the knee localized next to the kneecap.
- Pain occurs when the joint is bent and worsens with exercise or physical activity.
- Swelling of the knee joint after prolonged physical activity
- Tenderness at the region where the plica is located.
Diagnosis of Plica syndrome is made by physical examination or at the time of arthroscopic surgery. A MRI scan may be done, but it is not often helpful in the diagnosis of plica syndrome.
Treatment for plica syndrome
The best treatment for plica syndrome is resting the knee joint and taking anti-inflammatory medications. Occasionally, a cortisone injection in the knee will also be helpful.
In certain cases, when these measures do not mitigate the symptoms, then surgical removal of the plica or Plica excision may be recommended.
What is Plica excision?
A Plica excision is a type of arthroscopic knee surgery that is used to reduce inflammation or pain in the knee joint. In this surgical procedure, a small incision in the knee enables the doctor to remove the plica and any inflamed tissue that causes pain. This surgical procedure is performed using an arthroscope, or a small fibre-optic camera, that is inserted into the knee along with certain other instruments to remove the inflamed tissue. Plica resection during arthroscopy is performed only if the plica is diagnosed to be the cause of symptoms.
Recovery and Rehabilitation
A controlled physical therapy and rehabilitation program is recommended for the patient following the surgery in order to strengthen the muscles around the knee and allow the joint to heal. Most patients can resume their normal activities within a few months.