Archives of Orthopaedic and Trauma Surgery

, Volume 139, Issue 11, pp 1625–1631 | Cite as

Symptomatic medial synovial plica of the knee joint: an underestimated pathology in young patients

  • Martin HufelandEmail author
  • Loren Treder
  • Hannes Kenji Kubo
  • Pablo Emilio Verde
  • Rüdiger Krauspe
  • Thilo Patzer
Arthroscopy and Sports Medicine



To prospectively evaluate the outcome of arthroscopic resection of a symptomatic medial plica in patients under 30 years with evaluating the influence of sports, knee trauma and plica type.


35 consecutive patients (38 knees), mean age 16.2 ± 4.7 years (9–26 years), 28 females (73.7%) were prospectively included. Patients with any additional surgical procedures or cartilage lesions > ICRS grade I were excluded. The influence of trauma to the knee, level of sport and the morphologic plica type on the outcome was evaluated in addition to standard knee scores before and 20.1 ± 9.3 months (12–44 months) after surgery.


The Knee Injury and Osteoarthritis Outcome Score improved significantly from 50.2 ± 19.1% (12.5–94.6) to 80.7 ± 15.3% (48.2–100; p < 0.001). The Tegner Activity Scale improved significantly from 2.2 ± 1.5 (0–6) to 4.9 ± 1.7 (3–10; p < 0.001) and the Kujala Anterior Knee Pain Scale improved significantly from 52.6 ± 16.6 (16–86) to 80.7 ± 16.5 (46–100; p < 0.001). The level of pain in the knee decreased from 7.9 ± 2.0 (1–10) to 3.1 ± 2.6 (0–9; p < 0.001) at follow-up on a numeric rating scale (0–10). Neither trauma to the knee, high impact sport, cartilage lesions to the medial femoral condyle nor the plica type or associated ICRS grade I cartilage lesion to the medial femoral condyle had a significant effect on the outcome parameters.


Arthroscopic resection of a symptomatic medial plica provides excellent clinical results in young patients. Trauma, high impact sports, ICRS grade I cartilage lesions to the medial femoral condyle or the plica type are not associated with a poorer outcome.

Level of evidence

Level IV, prospective case series with no control group.


Knee Arthroscopy Medial plica Synovial shelf Plica syndrome 


Compliance with ethical standards

Conflict of interest

M. Hufeland, L. Treder, H. K. Kubo, P. E. Verde, R. Krauspe and T. Patzer declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik für OrthopädieHeinrich-Heine-Universität Düsseldorf, Universitätsklinik DüsseldorfDüsseldorfGermany
  2. 2.Heinrich-Heine-Universität Düsseldorf, Koordinierungszentrum für Klinische Studien (KKS)DüsseldorfGermany
  3. 3.Schön-Klinik Düsseldorf, Fachzentrum für Schulter, Ellenbogen, Knie und SportorthopädieDüsseldorfGermany

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