Objective Discuss the influence of the presence of medial patellar synovial folds on the clinical manifestations of knee osteoarthritis and articular cartilage degeneration. Methods The clinical data of 380 patients with arthroscopic surgery were collected and divided into groups according to whether there was a history of trauma and whether there were synovial folds. The data differences between groups were compared by Mann Whitney rank sum test and chi square test, and the correlation between each factor and the degree of cartilage injury was analyzed by ordinal multi classification logistic regression. Results Patients with synovial folds and osteoarthritis have significantly shortened the length of the disease course from the onset of symptoms to surgery. There are differences among multiple groups including gender ratio, body mass index, conservative treatment length, knee range of motion, and detection rate of loose bodies. The knee Outerbridge score of the trauma group and the non-traumatic group were positively correlated with age, BMI, length of disease, and free body. The score of the trauma group was positively correlated with the conservative treatment length, knee range of motion, and synovial fold. The score of the non-traumatic group was It is negatively correlated with men. There was no significant difference in the Lysholm score and the incidence of poor prognosis before operation and within one year after operation. Conclusion The existence of medial patellar synovial plica can significantly shorten the time of medical treatment, but it does not significantly affect the short-term prognosis of arthroscopic surgery. Synovial plica may aggravate injury of articular cartilage associated with trauma.