Medial Patellar Plica

plica synovialis mediopatellaris

The medial patellar plica is the most clinically significant synovial fold of the knee, running obliquely from the suprapatellar pouch along the medial synovial wall to the infrapatellar fat pad. It passes medial to the patella and may impinge between the medial patellar facet and the medial femoral condyle during knee flexion.

Region: Knee

Biomechanics

Function & Actions

A synovial remnant with no function in the normal knee; becomes a source of anterior knee pain when fibrotic and thickened.

Clinical Relevance

Clinical Notes

Medial plica syndrome presents as anterior medial knee pain with a painful snap or click at 45-70 degrees of flexion, reproduced by the plica test (pressure over the medial retinaculum during flexion). MRI may show a thickened plica but arthroscopy remains the gold standard. Arthroscopic plica resection is curative in symptomatic cases that fail conservative treatment. Medial plica thickening can cause medial patellar chondropathy from repeated impingement.

Pathology

Common Injuries & Conditions

Medial Plica Syndrome

Anterior medial knee pain from fibrotic medial patellar plica impingement between the medial patellar facet and medial femoral condyle, producing a snap at 45-70 degrees flexion and treated by arthroscopic plica resection.

Plica-Related Medial Patellar Chondropathy

Progressive articular cartilage damage to the medial patellar facet from chronic medial plica impingement, visible arthroscopically as linear chondral abrasion at the medial facet.