What is Plica Syndrome?
Plica syndrome is essentially an inflammed plica. It may be caused by:
- Repetitive knee straightening and bending,
- Blunt trauma or knee twisting,
- Fat pad irritation,
- Altered knee motion,
- Internal knee derangements such as meniscal tears.
This is particularly the case if you encounter persistent pain and weakness in the quadriceps muscles. Plica syndrome often does not always occur in isolation, but alongside other knee conditions such as meniscal injuries, patellar tendonitis and Osgood-Schlatter’s Disease.
What are the Symptoms of Plica Syndrome?
You may be suffering from Plica syndrome if you have:
- Anteromedial knee pain – esp medial femoral condyle.
- Visible and palpably tender plica.
- Audible clicking or snap during knee motion – painful arc 30 to 60 degrees.
- Positive Duvet test: pain eased by using a duvet between your knees to ease pain in bed.
- Pain with activities: ascending and descending stairs, squatting, rising from a chair and/or sitting for extended periods.
- Quadriceps atrophy is common for chronic cases.
How is Plica Syndrome Diagnosed?
Your physiotherapist will be able to clinically diagnose plica syndrome. It is important that you have your knee thoroughly assessed by a physiotherapist or sports doctor to exclude other knee pathologies, in particular meniscal injuries.
X-ray may be useful to rule out other associated pathologies but will not identify a plica. MRIs on the other hand will be able to identify plica inflammation. However, MRI is more useful for diagnosing other pathologies that may be related to the plica irritation. A comprehensive examination by your physiotherapist or sports physician is advisable.
Plica Syndrome Treatment in Singapore
Studies show that about 60% of patients with plica syndrome will recover successfully with conservative physiotherapy treatment within 6 to 8 weeks.
Your physiotherapy treatment will aim to:
- Reduce pain and inflammation.
- Improve patellofemoral (knee cap) alignment via taping, bracing and exercises.
- Normalize your muscle lengths.
- Strengthen your knee
- Strengthen your hip and lower limb muscles.
- Address foot biomechanics issues.
- Improve your agility and balance.
- Improve your lower limb function and quality of movement (e.g. walking, running, squatting, hopping and landing)
- Minimize your chance of re-aggravating your plica syndrome.
Should your symptoms persist beyond 3 to 6 months, arthroscopic knee surgery for a plica syndrome may be considered. The most successful surgery involves lateral retinacular release to allow the patella to track more medially and thereby alleviate plica irritation as it rolls over the medial femoral condyle. Success rates exceed 85%.
How to Prevent Plica Syndrome?
Since plica syndrome usually occurs concomitantly with other knee conditions, it is important to be proactive in managing your other knee injuries. This includes maintaining proper knee joint alignment, sufficient strength and flexibility in the muscles around the knee joint and the rest of your lower limb.
Ensuring that you wear adequate footwear that supports your foot structure. Also, weight-management can play a role on the pressure exerted on the lower limb joints, and thus should be factored in as a long-term preventative measure.