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.
| Location | Medial side of the knee joint, along the medial wall of the joint next to the medial edge of the patella |
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A normal embryological remnant of synovial membrane with no important mechanical role. When thickened and fibrotic it can catch between the medial patellar facet and the medial femoral condyle and cause anterior knee pain.
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.
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.
Progressive articular cartilage damage to the medial patellar facet from chronic medial plica impingement, visible arthroscopically as linear chondral abrasion at the medial facet.
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