BACKGROUND/AIMSThe present study was designed to determine the relationship between the time from anterior cruciate ligament injury to operation as well as the presence of pathologic plica. We also assessed the relationship between the presence of pathologic plica and plica-associated cartilage injury as well as preoperative anterior knee pain.MATERIAL and METHODSAll the data for this retrospective observational study was obtained from hospital records and arthroscopy videos. Preoperative complaints, such as giving-way episodes, anterior knee pain, and knee locking, and intraoperative findings, such as the presence and absence of the pathologic plica, cartilage injury, and meniscus lesion were evaluated. Patients operated within 3 mon of the injury and those operated ≥ 3 mon after the injury were classified into Group 1 and Group 2, respectively.RESULTSWe enrolled 76 patients; group 1 included 46 patients, and group 2 comprised 30 patients; all the patients underwent anterior cruciate ligament reconstruction. The rate of preoperative anterior knee pain and pathologic plica formation was significantly higher in group 2 (p<0.05) as compared to that in group 1. The reported preoperative anterior knee pain and cartilage injury in the pathologic plica positive group was significantly higher than that in the plica negative group (p<0.05).CONCLUSIONPathologic plica formation rate increases as the time period from anterior cruciate ligament injury to reconstruction increased. Preoperative anterior knee pain and intraoperative knee cartilage damage were more common in patients with pathologic plica. We recommend that pathologic plica investigation and resection be considered during anterior cruciate ligament reconstruction surgeries.