Definition
A plica is generally understood to be a fold of skin that is intended as a skin reserve during movement and which recedes again in the course of life. The mediopatellar plica is located in the area of the knee. A plica is generally defined as a skin fold that occurs in many organs of the human body.
The knee also has a plica that extends into the knee joint. Normally, a plica recedes over the course of a lifetime, but its base remains intact. Since a plica is a fold in the skin that has the necessary room to move, the skin can stretch at this point and can also be compressed, depending on the movement of the joint. In the knee, the existing skin fold is also known as a mediopatellar plica.
Location
The mediolateral plica extends from the side of the knee joint in the direction of the central knee joint and resembles the appearance of a muscle tendon rather than a skin fold. Due to the lack of space in the area of the knee, discomfort can always occur, especially if the plica has not receded as intended.
Complaints
Due to the close position of the skin fold to the cartilage of the knee joint as well as to the ligamentous apparatus, discomfort in the knee joint can occur, especially during movements. Pathological friction is responsible for this, which results from the lack of space in the knee joint. Overloading and permanent stress in the knee joint can lead to severe friction between the skin fold and the cartilage or ligaments.
Initially, no complaints are indicated, as cartilage and ligaments are very insensitive. However, as time goes on, the friction over the cartilage can become so great that it thins out and increasingly frees up space on the bone. As soon as this has taken place, the plica rubs directly on the sensitive bone, causing severe pain.
At this point, patients complain of such pain, especially after major stress (e.g. hiking in the mountains or climbing stairs, but also when cycling). At rest, no complaints are usually reported in the initial stage. As soon as pain occurs during movement or at rest, one speaks of the so-called plica syndrome.
The more cartilage is worn out, the more severe the complaints become under stress and can increasingly occur at rest. In severe cases, the friction, in addition to the wear and tear effect, also causes inflammatory processes in the knee joint, which in turn can lead to pain, but also to redness and swelling. In addition to the chronic problems associated with the plica syndrome, especially after long-term stress and overuse, acute complaints can also occur if the plica does not regress sufficiently.
In this case, the plica becomes trapped in the joint space and is acutely bruised. This leads to acutely severe pain in the knee joint and can also lead to impaired movement. Patients often adopt a relieving posture because of the new symptoms that have arisen, which, if the problem is not remedied, can also lead to incorrect loading.
