Synovial plica

The synovial membrane is the lining of the knee joint which secretes fluid into the joint to lubricate and nourish the cartilage. A synovial plica is a fold in the membrane which is abnormal and can become irritated and inflamed. The most common plica is on the inner side of the patella (kneecap). It can become inflamed as a result of a direct injury, or as part of an overuse phenomenon.

You will feel pain along the inside edge of the kneecap. You may be able to feel a tender thickened band of tissue in the same area. Sometimes there is a snapping sensation as the knee moves. The onset of symptoms can be gradual and it may be hard to recall what has brought it on. In the overuse injury situation the problem may only initially be evident after sports, but symptoms will gradually get more prominent at rest if nothing is done.

If you think you have this condition it is well worth getting it checked out by Mr Willis-Owen. It is best to treat this early before it gets too bad. Rest, ice, compression and elevation can be useful for flare ups. You should avoid any aggravating activities with may prolong the problem. It will generally not get better on its own unless diagnosed early and treated appropriately.

Treatment involves first confirming the diagnosis and establishing the underlying cause. Physiotherapy can sometimes help but the solution is often surgery. This is a minor arthroscopic (keyhole surgery) procedure to remove the plica. Mr Willis-Owen is very experienced in this problem.