Synovial plica syndrome is a condition resulting from a remnant of fetal tissue in the knee. In early fetal development, the knee is separated into compartments by membranes called synovial plica. These plica diminish in size during the second trimester. In adults, the plica exists and are called “synovial folds,” or plica. In some people, the synovial plica is more prominent and prone to irritation. Because of the difficulty diagnosing synovial plica syndrome, it can often be a somewhat controversial diagnosis and an overlooked source of chronic knee pain.
There are four plica synovial folds in the knee, but only one appears to be most problematic and this is called the medial plica. It attaches to the lower end of the knee cap and runs in a transverse sideways orientation to attach to the lower end of thigh bone or femur bone. If it becomes irritated over a long period by certain repetitive motions or kneeling, it can become inflamed, swollen and painful, leading to chronic knee pain. Occasionally, the medial patella plica can become thickened and trapped between the patella and the femur, causing painful clicking and locking. Although synovial plica syndrome can mimic a torn meniscus, it is rather an uncommon syndrome compared to a meniscal tear.
Synovial plica syndrome is best treated by resting the knee joint and taking anti-inflammatory medications. These physical and sports medicine measures are usually sufficient to allow the inflammation to settle down.
Injections for Plica Syndrome
- Steroid Injections – Injections can help reduce swelling and manage pain
- PRP Injections – PRP therapy may reduce pain and restore function
- Prolotherapy injections – Have been shown to reduce inflammation without using steroids