Infrapatellar Coronal Plane Plica in a 60-Year-Old: A Case Report

Area of Science:

• Orthopedic Surgery
• Knee Anatomy
• Diagnostic Imaging

Background:

• Plicae are common intra-articular synovial folds in the knee.
• Infrapatellar plicae, particularly the 'Bib-like' variant, are infrequently reported.
• Symptomatic plicae can cause anterior knee pain and mechanical symptoms.

Observation:

• A 60-year-old patient presented with infrapatellar 'Bib-like' plica.
• Magnetic resonance imaging (MRI) revealed the plica impinging the infrapatellar fat pad.
• Associated articular cartilage loss was noted on the medial femoral condyle adjacent to the plica.

Findings:

• Arthroscopic excision of the symptomatic infrapatellar plica was performed.
• The patient experienced complete resolution of pre-operative start-up knee pain post-surgery.
• This represents the first reported case of this plica in a 60-year-old with associated cartilage damage.

Implications:

• Arthroscopic plica excision is an effective treatment for symptomatic infrapatellar plicae.
• Early diagnosis and intervention may prevent further cartilage damage.
• Highlights the importance of considering plica syndrome in older patients with knee pain and MRI findings.