All knee Topics

What is Plica Removal?

Plica removal (also called plica excision or plica resection) is an arthroscopic surgical procedure performed to remove damaged portions of the membrane that protects the knee joint.

Key statistics about Plica Removal

  • Medial plica are present in the knees of up to 70% of individuals[1]
  • 80-90% of patients who undergo plica removal experience significant improvement in symptoms[2]
  • 65% of patients who undergo plica removal are able to return to sport following the procedure[3]

Why is Plica Removal Performed?

Plica removal is necessary when a plica becomes irritated and inflamed, causing pain and swelling, and affecting knee joint function. This condition is known as plica syndrome.

Typically there are four synovial plicae in each knee. The medial plica on the inside of the knee is most likely to sustain damage due to the movement of the patella. This condition is called medial plica syndrome.

Knee Anatomy

The knee joint is formed by three bones: the femur (thigh bone), the tibia (shin bone), and the patella (knee cap).

The synovium (also called the synovial membrane) is a thin layer of tissue that surrounds and protects the knee joint. A plica is a fold in the synovium that allows the membrane to move freely as the knee bends.

3D rendering of the knee with colored regions highlighting the Femur, Patella, Tibia, and Synovium

Who needs Plica Removal?

Plica syndrome typically is caused by repetitive knee movement and overuse, knee injury, or underlying conditions of the knee.

Plica removal is necessary to address the pain, instability, and limited knee joint function associated with plica syndrome that cannot be treated with nonsurgical measures.

How is Plica Removal performed?

  • The surgeon will make small incisions around the knee joint and the arthroscope will be inserted into one of the incisions.
  • Saline solution is pumped into the joint to expand it and improve visualization.
  • Images from the arthroscope are sent to a video monitor where the surgeon can see inside the joint.
  • The affected plica is removed.
  • Finally, the saline solution is drained, instruments are removed, and the incisions are closed using sutures.

What are the risks of Plica Removal?

It is uncommon to experience complications from plica removal but potential risks may include:

  • Infection
  • Blood clots
  • Nerve or blood vessel damage

How long does it take to recover from Plica Removal?

  • 24 hours after surgery
    Most patients are able to return home the same day as their procedure. A physical therapy routine will be established by the surgeon and physical therapist, and pain medication may be prescribed.
  • 1-3 days after surgery
    Your surgeon may advise you not to put weight through the affected leg. The knee should be iced and elevated.
  • 2 weeks after surgery
    Any non-dissolvable sutures are removed and bruising and swelling begin to subside.
  • 4-6 weeks after surgery
    Most patients are fully recovered from plica removal.

What are the results of Plica Removal?

Plica removal is a safe and effective procedure performed to alleviate the symptoms of patients suffering from plica syndrome. 80-90% of patients who undergo plica removal experience significant improvement in symptoms[1].

Kramer, D.E., Kalish, L.A., Abola, M.V., Kramer, E.M., Yen, Y., Kocher, M.S., & Micheli, L.J. (2016). The effects of medial synovial plica excision with and without lateral retinacular release on adolescents with anterior knee pain. Journal of Children’s Orthopaedics. 10, 155-162.
Gerrard, A.D. & Charalambos, P.C. (2018). Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes. Knee Surgery and Related Research. 30(4), 356-363.
Al-Hadithy, N., Gikas, P., Mahapatra, A.M., & Dowd, G. (2011). Review article: Plica syndrome of the knee. Journal of Orthopaedic Surgery. 19(3), 354-358.
Last edited on October 27th, 2023 5:35 pm