Knee - Plica
Description
A synovial plica is a shelf-like membrane between the synovium of the patella and the tibiofemoral joint. Plicae essentially consist of mesenchymal tissue which is formed in the knee during the embryological phase of development.
In the knee, 4 types of plicae can be distinguished, depending on the anatomical location within the knee joint cavities: suprapatellar, mediopatellar, infrapatellar and lateral plicae.
What are the causes?
Plica can be irritated from an injury or if you overuse your knee.
What are the symptoms?
Patients often report that symptoms are absent in the early phases of sporting activities, but can come up suddenly and worsen progressively. They are often accompanied by a pain which can be described as intermittent, dull and aching and which will aggravate when performing patello-femoral loading activities such as walking up or down stairs, squatting, kneeling or after holding the knee in flexed position for some time.
How is it diagnosed?
Dr. Liu will perform a thorough history and physical exam with X-rays. On exam, pain, swelling and strength may be present. It can be hard to diagnose knee plica syndrome. The signs are like those of other knee problems. An MRI may be ordered to further evaluate soft tissue in the knee.
Non- Operative
Symptoms are often relieved with conservative treatment, such as changes in activity levels or a therapeutic exercise program. Stop doing the activities that make your knee hurt until your pain is resolved. This may mean changing your training routine or switching to low-impact activities that will place less stress on your knee joint. RICE stands for rest, ice, compression, and elevation. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help reduce swelling and relieve pain.
Operative
Operative treatment for plica may be considered if a patient fails to respond to conservative care. Dr. Liu can perform a minimally invasive arthroscopic procedure to remove the plica. Recovery after a knee arthroscopy and removal of plica usually requires a short course of physical therapy and a rapid return to sports is to be expected.
Coming Soon!
Can I shower after surgery?
If you have a bulky dry dressing you can remove it on postop day #3; you may then shower allowing water to run over steri-strips or sutures; towel pat dry and keep clean; NO soaking or submerging operative body part. If you have a waterproof dressing, please leave it on until you follow up in the office. You can shower over the dressing, no soaking or submerging the shoulder
How long do I need to wear the compression stockings?
Dr. Liu wants you to keep the compression stockings on for 3 weeks. Compression stockings are the best way to help the swelling to go down after surgery.
Should I use ice or heat?
Ice can provide analgesic effects and control swelling for the first 3-5 days; after that we recommend ice after exercises or PT.
How do I use an ice machine or CPM?
if either device is part of your recovery, treat this as an assistance to your recovery. Use either as directed, allowing only the machine to move or do the work. Remember, you should not be doing the work or moving the operative body part on your own.
How do I decrease my pain after surgery?
You may take your pain medication as prescribed; if pain continues, you may add ibuprofen or naproxen in between pain medication doses: (8am pain med, 10am ibuprofen 600-800mg or naproxen 500mg, 12p pain med).
Who schedules my first post operative appointment?
You are responsible for scheduling this appointment. This can be done prior to your surgery or within 1-3 days following. Please call the office, at 702-740-5327, provide your date of surgery, and you will be provided your appointment time and date.
When can I drive?
This depends on your surgery. Please wait until your first post op visit to discuss with your provider.
When can I go swimming?
Please wait at least 4 weeks until you submerge your incision into baths or pools. When your incision is submerged, it can open up and increase risk of infection. We ask that you wait 4 weeks when the incision is healed to soak in tubs or pools.
When do I start Physical Therapy?
Physical Therapy will be discussed at your first postoperative visit 10-14 days after surgery.
I have questions that have not been answered.
Please re-read your postoperative instructions handout. If questions remain, please contact the surgery line that has been provided to you on your post surgical handout.