Pathologic infrapatellar plica.

The fenestra type of infrapatellar plica was noted arthroscopically in a 57-year-old patient with flexion contracture of the knee. It was found to be thickened and fibrotic and to have lost its normal elasticity. The pathologic plica was impinged at the intercondylar notch and trochlea, blocking further extension beyond 25 degrees of knee flexion. After excising the plica, the knee gained a further extension of 17 degrees; however, full extension could not be obtained. The knee gained full extension after notchplasty on the roof at 2 months postoperatively. This is the first report of a pathological infrapatellar plica in an older patient.