I have done physio for my plica for months and it still hurts. Do I need surgery?

Check the diagnosis and the programme first

Before surgery, it is worth asking two questions. Is the pain really coming from the plica? Kneecap pain, a meniscus tear, cartilage damage behind the kneecap or patellar tendon problems can all feel similar and would not improve with plica removal. And was the physiotherapy focused enough? Programmes that strengthen the quadriceps and hips, stretch the hamstrings and front of the thigh, and gradually reload the knee work better than generic exercises.

A steroid injection near the plica is sometimes used at this stage, both to treat it and to confirm that the plica is the source of pain.

Who is likely to benefit from surgery

• Pain and snapping clearly located at the inner front of the knee over a tender plica
• Symptoms lasting several months despite a good rehabilitation programme
• MRI and examination not showing another cause that better explains the pain
• Activities, work or sport limited enough that the person wants to proceed

What the operation involves

Plica resection is done by knee arthroscopy through two or three small keyhole incisions, usually as a day procedure. The surgeon confirms that the plica is thickened and rubbing, removes it, and inspects the rest of the knee, including the meniscus and cartilage, at the same time. The plica has no essential function, so removing it does not weaken the knee.

Recovery and return to activity

Most patients walk the same day, return to desk work within about a week, and return to running and sport over roughly four to eight weeks, depending on the knee and the sport. Swelling and stiffness in the first weeks are normal. Physiotherapy after surgery remains essential, because the muscle imbalance that irritated the plica can otherwise irritate the front of the knee again.

At Aman Hospital in Doha, Dr. Gelber reviews your history, previous scans and physiotherapy, and explains plainly whether surgery is likely to help. For cost and coverage, check with Aman Hospital and your insurer.