Edorium Journal of

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Review Article
 
Plica syndrome and its embryological origins
Christopher L. Hoehmann
Third year medical student, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York, USA

Article ID: 100005O03HS2017
doi:10.5348/O03-2017-5-RA-1

Address correspondence to:
Westbury
Institute of Technology College of Osteopathic Medicine
New York 11568 USA, New York
USA

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How to cite this article
Hoehmann CL. Plica syndrome and its embryological origins. Edorium J Orthop 2017;3:1–12.


ABSTRACT

Plica syndrome is a pathologic process due to inflammation of synovial plicae. Synovial plicae are frequently asymptomatic, but can become diseased with trauma and overuse. Synovial plicae are embryologic remnants of the synovial lining of the knee. The mechanism of their existence is controversial. Many agree that plicae are vestigial septums that once separated the knee joint into three cavities during embryogenesis. A second theory details a failure to resorb the mesenchyme that once occupied the knee joint during cavitation. The variable morphology of plicae can present as suprapatellar, infrapatellar, lateral and mediopatellar, with the latter most commonly progressing to plica syndrome. Synovial plicae remain an interesting challenge to clinicians, as plica syndrome is a common condition with a wide differential diagnosis. Many physical examination techniques can be used in conjunction with a thorough history to elucidate the presence of plica syndrome. The diagnosis is made by exclusion, therefore a multitude of imaging modalities are necessary to rule out other causes of knee pain. Conservative treatment is recommended initially, however, its effectiveness is variable. Surgical intervention is a robust method for treating plica syndrome when conservative treatment fails. This brief review provides an overview of knee embryogenesis, pertinent information regarding the etiology and pathology of plica syndrome, as well as insight into the diagnosis and management of this condition.



Keywords: Arthroscopy, Knee embryogenesis, Knee pain, Orthopedic surgery, Plica syndrome, Synovial plica

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Acknowledgements
I would like to thank Joshua A. Cuoco for his critical review of the manuscript.

Author Contributions
Christopher L. Hoehmann – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Christopher L. Hoehmann et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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