Clinical Management of Medial Patellar Plica Syndrome: Mini Review from Diagnosis to Treatment

Author(s): Hassan Zmerly, Ibrahim Akkawi, Roberto Citarella, Marwan E. Ghoch*

Journal Name: Current Rheumatology Reviews

Volume 16 , Issue 1 , 2020


Become EABM
Become Reviewer
Call for Editor

Abstract:

Synovial plicae are thickenings of the synovial knee membrane; they are very frequent and often asymptomatic. However, they can become symptomatic due to idiopathic or secondary causes, like trauma and inflammation of the synovial tissue. Currently, synovial plicae are classified as infrapatellar, mediopatellar and suprapatellar. The prevalence of the mediopatellar plica over the other forms of plicae varies between 18% and 60%. The most reported symptom of the mediopatellar plica is pain located medial to the patella above the joint line. Magnetic Resonance Imaging (MRI) is the most useful examination to highlight the presence of the plica, its measurement and exact location. The treatment is initially conservative, i.e. medical treatment and physiotherapy, however when these fail, the plica should be removed surgically via arthroscopy.

In the current paper, we aim to report our clinical experience in the management of medial patellar plica syndrome by describing the clinical presentation and diagnosis of this condition as well as its treatment.

Keywords: Synovial plicae, medial patellar, plica syndrome, treatment, fibrosis, asymptomatic plica.

[1]
Patel D. Arthroscopy of the plicae--synovial folds and their significance. Am J Sports Med 1978; 6(5): 217-25.
[http://dx.doi.org/10.1177/036354657800600502] [PMID: 707680]
[2]
Pipkin G. Lesions of the suprapatellar plica. J Bone Joint Surg Am 1950; 32A(2): 363-9.
[http://dx.doi.org/10.2106/00004623-195032020-00015] [PMID: 15412178]
[3]
Sakakibara J. Arthroscopic study on Iino’s band (plica synovialis mediopatellaris). J Jap Orthop Assoc 1974; 50: 513.
[4]
Nakayama A, Sugita T, Aizawa T, Takahashi A, Honma T. Incidence of medial plica in 3,889 knee joints in the Japanese population. Arthroscopy 2011; 27(11): 1523-7.
[http://dx.doi.org/10.1016/j.arthro.2011.06.022] [PMID: 21924860]
[5]
Patel D. Plica as a cause of anterior knee pain. Orthop Clin North Am 1986; 17(2): 273-7.
[PMID: 3714211]
[6]
Pellacci F, Galli G, Lughi M, Zmerly H. “Le pliche sinoviali del ginocchio” Atti del 11° corso teorico-pratico di chirurgia artroscopica Pag. Bologna: La Fotocroma Emiliana Editrice 1996; pp. 56-63.
[7]
Barber FA. Fenestrated medial patella plica. Arthroscopy 1987; 3(4): 253-7.
[http://dx.doi.org/10.1016/S0749-8063(87)80119-6] [PMID: 3689523]
[8]
Yuan HF, Guo CA, Yan ZQ. Mediopatellar plica as a risk factor for knee osteoarthritis? Chin Med J (Engl) 2015; 128(2): 277-8.
[http://dx.doi.org/10.4103/0366-6999.149237] [PMID: 25591575]
[9]
Kan H, Arai Y, Nakagawa S, et al. Characteristics of medial plica syndrome complicated with cartilage damage. Int Orthop 2015; 39(12): 2489-94.
[http://dx.doi.org/10.1007/s00264-015-2782-y] [PMID: 25900367]
[10]
Vassiou K, Vlychou M, Zibis A, Nikolopoulou A, Fezoulidis I, Arvanitis D. Synovial plicae of the knee joint: The role of advanced MRI. Postgrad Med J 2015; 91(1071): 35-40.
[http://dx.doi.org/10.1136/postgradmedj-2013-132176] [PMID: 25476020]
[11]
Stubbings N, Smith T. Diagnostic test accuracy of clinical and radiological assessments for medial patella plica syndrome: A systematic review and meta-analysis. Knee 2014; 21(2): 486-90.
[http://dx.doi.org/10.1016/j.knee.2013.11.001] [PMID: 24280039]
[12]
Lee PYF, Nixion A, Chandratreya A, Murray JM. Synovial plica syndrome of the knee: A commonly overlooked cause of anterior knee pain. Surg J (N Y) 2017; 3(1): e9-e16.
[http://dx.doi.org/10.1055/s-0037-1598047] [PMID: 28825013]
[13]
Prejbeanu R, Poenaru DV, Balanescu AD, Mioc ML. Long term results after arthroscopic resection of medial plicae of the knee-a prospective study. Int Orthop 2017; 41(1): 121-5.
[http://dx.doi.org/10.1007/s00264-016-3313-1] [PMID: 27761630]
[14]
Kramer DE, Kalish LA, Abola MV, et al. The effects of medial synovial plica excision with and without lateral retinacular release on adolescents with anterior knee pain. J Child Orthop 2016; 10(2): 155-62.
[http://dx.doi.org/10.1007/s11832-016-0724-x] [PMID: 27038478]
[15]
Blok A, Weiss W, Dolata T, Szczepaniec M. Medial synovial plica. Ortop Traumatol Rehabil 2005; 7(4): 397-400.
[PMID: 17611459]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 16
ISSUE: 1
Year: 2020
Published on: 05 March, 2020
Page: [9 - 11]
Pages: 3
DOI: 10.2174/1573397115666181123182633
Price: $65

Article Metrics

PDF: 34
HTML: 3