What causes symptomatic plica syndrome?

Updated: Apr 20, 2020
  • Author: Tracy Lee Bigelow, DO; Chief Editor: Thomas M DeBerardino, MD  more...
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The etiology of symptomatic plica is unclear. Potential causes of inflammation include repetitive stress, a single blunt trauma, loose bodies, osteochondritis dissecans, meniscal tears, or other aggravating knee pathology. The most common symptomatic plica is medial plica; occasionally, suprapatellar plica may also be symptomatic. [15, 16, 17, 18, 19]

A popular theory for the initiation of inflammation is that the plica is converted to a bowstring, which causes it to contact the medial femoral condyle. During flexion of the knee, the plica causes an abrasion to the condyle, resulting in symptoms. Others contend that a plica need not contact the femoral condyle to cause symptoms.

One study found that the onset of symptoms was usually delayed until adolescence. Possible explanations include a decrease in tissue elasticity with age, and a biomechanical change resulting from a growth spurt.

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