Plica Syndrome
Problems that occur acutely and are related to a plica are relatively rare. More often, on the other hand, painful and inflammatory changes occur as part of insidious processes. Friction can cause damage to the joint cartilage.
Plica syndrome, or shelf syndrome, is usually caused by overexertion or excessive stress on the knee joint. Possible causes can be sports such as jogging, ball sports, dancing or even cycling, as these involve high stress in the form of frequent stretching and bending of the knee joint. Other causes include injuries, instability in the knee joint, inflammatory processes in the area of the joint lining, and muscle imbalance.
As a result of these processes, the mucosal fold becomes swollen and inflammatory reactions develop, which can lead to a remodelling of connective tissue and thus to a hardening and thickening of the mucosal fold. The occurring pain is often localized to the inside of the knee and described as load-dependent. Under stress, a feeling of pressure or tension is created, which is perceived as very unpleasant.
In most cases, the mediopatellar plica is responsible for the pain. When the knee joint is bent, it is trapped between the inner thigh roll and the kneecap and can be felt as a hardened, painful cord between the thigh and the kneecap. As a result of recurrent inflammatory changes and entrapments of the plica, the knee joint may be restricted in movement and blocked, joint effusions and recurrent pain may occur.
It is also possible that the joint stiffens and that a loud cracking sound is heard when the knee is bent. In order to be able to treat a plica syndrome correctly, it is important to assess the severity of the condition. A distinction is made between conservative and surgical procedures with regard to therapy.
Initially, one tries to treat the plica syndrome conservatively. Here, in addition to anti-inflammatory medication, physical protection, cooling pads, massages, and exercises to build up muscles are used. The most important thing is to reduce the existing overloading of the joint. If no improvement is achieved with the conservative therapy options, one can consider whether surgical removal of the plica can relieve the pain and improve the symptoms.If too much damage to the joint cartilage has already manifested itself, there may be no improvement even after removal of the plica.