by Nicholas Dodds
A typical story from a patient with typical plica syndrome.
Knees are funny things - most people know a little bit about cartilage, some a bit more about ligaments but what about a plica?
When I first developed pain along the inside of my left knee, there was no obvious cause – other than cycling quite a bit. A succession of GPs and physiotherapists suggested a variety of diagnoses. The only way to stop the pain from recurring was not to exercise – not a satisfactory solution! Given the persistent nature of the pain and having followed the usual advice, I feared my painful knee was here for good.
One day on my commute I was knocked off my bicycle, hurting both knees. The accident presented me with an opportunity and I was referred to Mr McDermott. The results of an MRI scan showed there was nothing structurally wrong with my knees, which was good news. However, I was told that MRI scans don’t show everything, and after carefully discussing my options I chose surgery to find out once and for all if there was something that could be done with my left knee.
Surgery confirmed that the knee was in a good state, but with one rather notable exception; I had a large (medial) plica inside the joint. It was explained that this is basically a remnant of foetal tissue, like a shelf sticking out from the lining of the knee. The plica had been rubbing inside my knee, becoming inflamed and painful – I had been suffering from ‘plica syndrome’.
The plica was removed through keyhole surgery (a knee arthroscopy), as a simple small day case procedure. Thankfully, the surgery resolved the source of my pain.
Nick cycling the Etape du Tour 2010 after his knee surgery --
110 miles with some truly epic climbs in the Pyrenees, in 10 hours.
I think of a plica as an ‘appendix of the knee’ – it has no use, it shouldn’t really be there and if persistent pain develops then it can be removed surgically. For me at least, this proved to be the best option. It’s unfortunate that sometimes it takes an operation to confirm the presence of a plica – few GPs or physiotherapists would suggest it; you are more likely to be told (not necessarily incorrectly I might add) that your knee pain is a result of some other cause.
Surgery completely resolved my knee pain, and once I had recovered from the operation I was able to enjoy pain-free cycling again, even riding stages of the Tour de France!
Mr Nicholas Dodds