Plica excision is an arthroscopic surgical procedure to remove a symptomatic plica, which is a fold of synovial tissue within the knee joint. Plicae are remnants of embryologic development when the knee joint initially forms as three separate compartments that later merge into one cavity. In most people, these folds resorb completely during fetal development, but in approximately 50-70% of the population, one or more plicae persist into adulthood. While usually asymptomatic, plicae can become thickened, fibrotic, and inflamed due to trauma, overuse, or repetitive flexion-extension activities, leading to significant pain and dysfunction. The medial plica is most commonly symptomatic, located along the inner aspect of the kneecap. When inflamed, it rubs against the femoral condyle (thigh bone) causing pain, catching, and sometimes a snapping sensation. Dr. Kumar diagnoses plica syndrome through a combination of clinical examination findings (tenderness along the medial border of the patella, pain with flexion-extension, positive plica test) and MRI confirmation showing thickened synovial tissue. The condition often mimics other knee pathologies like meniscus tears or patellar cartilage damage, making accurate diagnosis crucial. Arthroscopic plica excision is indicated when conservative treatment with rest, anti-inflammatory medications, physical therapy, and activity modification fails to provide relief after 3-6 months. During the procedure, Dr. Kumar uses high-definition arthroscopy to visualize the inflamed plica and removes it completely using specialized cutting instruments and radiofrequency devices. The excision is performed carefully to avoid damage to the underlying articular cartilage of the femoral condyle, which often shows an indentation or "groove" from chronic plica rubbing. Associated pathology such as synovitis, chondromalacia, or small meniscal tears can be addressed in the same surgical session. One of the significant advantages of plica excision is the rapid relief of symptoms following surgery. Since plicae are vestigial structures with no functional role in normal knee mechanics, their removal does not compromise joint stability or function. Most patients notice immediate improvement in pain and catching symptoms. Physical therapy focuses on regaining full range of motion and strengthening the quadriceps and hamstrings to support the knee during return to activities. Dr. Kumar achieves excellent results with plica excision, reporting 85-90% of patients experiencing complete resolution of symptoms. Success rates are highest in patients with true plica syndrome without significant arthritis or other knee pathology. The procedure is performed as outpatient day surgery using local or regional anesthesia with sedation. Athletes typically return to sport within 4-6 weeks, and office workers resume desk duties within days. Complications are rare and include the standard arthroscopy risks of infection, stiffness, and recurrent symptoms if a portion of the plica regenerates.