What is Knee Plica Syndrome?

The knee is a made up of a variety of complex soft tissues. Enclosing the knee joint is a fold at its membrane known as the plica. The knee is encapsulated by a fluid-filled structure called the synovial membrane. Three of these capsules, known as the synovial plicae, develop around the knee joint throughout the fetal stage and are absorbed before birth.

However, during one research study in 2006, researchers found that 95 percent of patients undergoing arthroscopic surgery had remnants of their synovial plicae. Knee plica syndrome occurs when the plica becomes inflamed, generally due to sports injuries. This often takes place in the center of the kneecap, known as medial patellar plica syndrome.

What are the Symptoms of Knee Plica Syndrome?

The most common symptom of knee plica syndrome is knee pain, although a variety of health issues can also cause these symptoms. Knee pain associated with knee plica syndrome is generally: achy, instead of sharp or shooting; and worse when using stairs, squatting, or bending. Other symptoms of knee plica syndrome can also include the following: 

• a catching or locking sensation on the knee while getting up from a chair after sitting for an extended period of time,
• difficulty sitting for extended intervals,
• a cracking or clicking noise when bending or stretching the knee,
• a feeling that the knee is slowly giving out,
• a sense of instability on slopes and stairs,
• and may feel swollen plica when pushing on the knee cap.

What are the Causes of Knee Plica Syndrome?

Knee plica syndrome is commonly caused as a result of an excess of stress or pressure being placed on the knee or due to overuse. This can be brought on by physical activities and exercises which require the individual to bend and extend the knee like running, biking, or utilizing a stair-climbing machine. An automobile accident injury or a slip-and-fall accident can also cause knee plica syndrome.

Knee plica syndrome, commonly referred to as medial patellar plica syndrome, is a health issue which occurs when the plica, a structure which surrounds the synovial capsule of the knee, becomes irritated and inflamed. Knee plica syndrome can occur due to sports injuries, automobile accident injuries, and slip-and-fall accidents, among other types of health issues. The symptoms of knee plica syndrome may commonly be mistaken for chondromalacia patella. Diagnostic imaging can help diagnose the problem to continue with treatment.

Dr. Alex Jimenez D.C., C.C.S.T. Insight

How is Knee Plica Syndrome Diagnosed?

In order to diagnose medial patellar plica syndrome, the healthcare professional will first perform a physical examination. They will use the evaluation to rule out any other potential causes of knee pain, such as a torn meniscus, tendonitis, and broken bones or fractures. Be sure to talk to your doctor about any physical activities you participate in along with any recent health issues. The healthcare professional might also utilize an X-ray or MRI to have a better look at your knee. 

What is the Treatment for Knee Plica Syndrome? 

Most instances of medial patellar plica syndrome respond well to alternative treatment options, such as chiropractic care, physical therapy or even a physical activity or exercise plan at home. Chiropractic care uses spinal adjustments and manual manipulations to safely and effectively correct a variety of health issues associated with the musculoskeletal and nervous system. Moreover, chiropractic care and physical therapy can include a series of stretches and exercises to help restore strength, mobility, and flexibility to the hamstrings and quadriceps. These stretches and exercises are described below.

Quadriceps Strengthening

The medial plica is attached to the quadriceps, a major muscle on the thighs. An individual with weakened quadriceps has a higher chance of developing knee plica syndrome. You can strengthen your quadriceps by performing the stretches and exercises as follow:

• quadriceps sets or muscle tightening
• straight leg raises
• leg presses
• mini-squats
• biking, swimming, walking, or use an elliptical machine.

Hamstring Stretching

The hamstrings are the muscles which extend down the back of the thighs, from the pelvis to the shin bone. These help flex the knee. Tight hamstrings place more stress and pressure on the front of the knee, or the plica. A chiropractor or physical therapist will guide the patient through numerous stretches and exercises which may help unwind the nerves. As soon as the patient learns these moves, they may perform them a few times each day to keep the muscles relaxed.

Corticosteroid Injections

Some healthcare professionals may provide corticosteroid injections for the knee if the pain and inflammation causes a restriction in function. Corticosteroid injections can help temporarily reduce painful symptoms, however, it's essential for the patient to continue with treatment to heal knee plica syndrome. The painful symptoms may return when the corticosteroid burns off if not treated.

Surgery

If chiropractic care, physical therapy, or the treatment described above does not help heal knee plica syndrome, a procedure known as arthroscopic resection may be needed. To perform this process, the doctor will insert a small camera, called an arthroscope, via a tiny cut at the side of the knee. Small surgical instruments are then inserted through a second small cut to take out the plica or correct its position.

After surgery, your doctor will consult with a chiropractor or physical therapist for a rehabilitation program. Recovering from surgery for knee plica syndrome is dependent upon many factors, including the patient's overall health and wellness. The patient may recover within a few days in case the knee has been changed. Remember to wair a few weeks before returning to a routine levels of exercise and physical activity.

Living with Knee Plica Syndrome

Plica syndrome is generally easy to treat with chiropractic care, physical therapy, and other treatment approaches, as described above. Should you need surgery, the approach is minimally invasive and requires less recovery compared to a number of different types of knee surgery. Talk to your healthcare professional to determine the best treatment choice for your knee plica syndrome.

Curated by Dr. Alex Jimenez