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Plica Syndrome

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Plica Syndrome

Plica Syndrome

An overview  Plica is the part of the knee that consists of the mesenchymal tissue, which is formed in the knee during the embryological phase of development. This tissue is what forms the membranes that divide the knee into 3 compartments:  The medial tibiofemoral compartments,  The lateral tibiofemoral compartments, and,  The suprapatellar bursa.  The mesenchymal tissue usually […]

Symptoms

The main plica syndrome symptoms is knee pain. While this can be caused by several conditions, pain related to plica syndrome is usually achy and worsens when squatting, bending, or using stairs.

Additional plica syndrome symptoms may include:

  • A catching or locking sensation in the knee may occur when standing up (from a chair) after a long period of sitting.
  • Inability to sit for a long period of time without experiencing knee pain.
  • Clicking or cracking sound when the knee is bent or extended.
  • Feeling unstable on stairs and slopes
  • You may also be able to feel your swollen plica when you press the knee cap.
  • Visibly palpable tender plica.
  • In chronic cases quadriceps atrophy is common.

Causes

Plica syndrome occurs from a combination of several different factors, such as:

  • A decreased mobility of the kneecap.
  • A Quadriceps (front of the thigh) muscle or hip muscle tightness.
  • Muscular imbalances in the hamstring (back of the thigh), hip muscles, or quadriceps.
  • An improper technique with repetitive activities.
  • Plica syndrome is also caused or worsened by increased activities.
  • A change in the routine of an exercise or a sport activity.
  • An abnormal hip or knee structure.
  • An abnormal hip or knee mechanics.
  • Injuries.

More about Treatment

An overview 

Plica is the part of the knee that consists of the mesenchymal tissue, which is formed in the knee during the embryological phase of development. This tissue is what forms the membranes that divide the knee into 3 compartments: 

  • The medial tibiofemoral compartments, 
  • The lateral tibiofemoral compartments, and, 
  • The suprapatellar bursa. 

The mesenchymal tissue usually starts to involute (that is, folds inward) at 8 to 12 weeks of foetal growth, and it eventually becomes resorbed, leaving a single empty area between the distal femoral and the proximal tibial epiphysis. The movement of a foetus while in the uterus contributes to this resorption. However, in many individuals, the mesenchymal tissue is not fully resorbed, and as a result, the cavitation of the knee joint remains incomplete. The outcome in these individuals is that plica can be observed, which signifies inward folds of the synovial membrane in the knee joint. Several degrees of separation of these cavities are seen in the human knee. 

Plica syndrome is an irritation or an inflammation of a part of the synovial membrane in the knee. The synovial membrane is where the knee joint is enclosed, and also contains the fluid that keeps the joint lubricated. 

Plica syndrome occurs when there is an irritation of this synovial lining, usually as a result of repetitive friction to the tissue, or in some cases as a result of a direct hit on the knee that traumatizes the tissue. Due to this, this tissue becomes thick and painful. Repetitive friction occurs as a result of abnormal forces at the knee, most probable in the kneecap and surrounding musculature. It may also be caused by muscular weaknesses or structural abnormalities at the hip or foot, which in turn place increased tension on the knee. 

Diagnosis of Plica Syndrome

These are of three types – physical examination, radiological tests and diagnostic tests.

  • Physical examination

The first step in the diagnosis of plica syndrome is a physical examination of the plica syndrome knee. This is carried out to rule out any other possible causes of knee pain, like a torn meniscus, tendonitis and bone injury.

During a physical examination for a plica, syndrome knee makes sure to tell the doctor about the sports you play, your exercise routines, and/or any recent accidents or injuries.

  • Radiological Tests

If after the physical examination of a plica syndrome knee a conclusion could not be reached or there is any uncertainty in the diagnosis or other injuries are being suspected, a magnetic resonance imaging, MRI, the test may be suggested. The MRI using magnetic waves shows the soft tissues of the body. 

A CAT scan may also be carried out to check whether the plica has become thickened. However, in most cases of plica syndrome special tests such as the MRI or CAT scan is not usually required. 

  • Diagnostic Tests

If the physical examination carried out on a plica syndrome knee strongly suggests that a plica syndrome is present in the knee, an arthroscopy may be proposed. This is to confirm the diagnosis and also treat the problem at the same time. 

An arthroscopy is an operation in which a small fibre-optic TV camera is inserted into the knee joint. This allows the orthopaedic surgeon to assess the structures inside the knee to determine whether the plica is inflamed or not.

Plica Syndrome treatment

The plica syndrome treatment options are as follows

  • Conservative plica syndrome Treatment

Usually, most people with plica syndrome get better without undergoing surgery. The primary plica syndrome treatment goal is to reduce inflammation, and this may require limiting activities such as running, biking, or using the stair-climbing machine.

  • Surgery

If conservative plica syndrome treatments fail, arthroscopy surgery may be proposed. This technique sees an arthroscope inserted into the knee joint through a one-quarter inch incision. After locating the plica, another one quarter inch opening is made, through which small instruments are inserted to cut off the plica tissue and remove the structure. The area the plica has been removed heals back with scar tissue.

  • Rehabilitation

Aftermath surgery, you will be handed over to a physical therapist. Your first few rehabilitation sessions will be designed to ease the pain and swelling, and help you begin tender knee motion and thigh tightening exercises. Rarely are crutches needed after this kind of surgery.

The goal of the therapist is to help patients keep their pain under control, ensure they aren’t exerting too much weight on the injury, improve the strength of quadriceps muscle and knee range of motion. As soon as the patients get underway, their regular visits to the therapist’s office stop, and while the therapist will continue to be a resource, the patients take charge of their exercises as part of an ongoing home program.

FAQ

  • Are there exercises I can do for relief of plica syndrome?

Yes, and in fact, most cases of plica syndrome respond well to physical therapy or a home exercise program. This typically involves stretching your hamstrings and strengthening your quadriceps, and within 6 to 8 weeks of starting physical therapy or an exercise program, you start to feel relieved.

  • How long does it take to recovery from plica syndrome?

This depends on several factors including the overall health and the affected knee. For example, if surgery was carried out on your right knee, you may need to wait for about 2 weeks before driving. However, if it is the left knee that was affected, fully recovery make take place within 3 to 4 days.

You may, however, need to wait a number of weeks before returning to regular levels of exercise and physical activity.

  • How does it feel Living with plica syndrome?

Plica syndrome is usually very easy to manage with physical therapy and sufficient home exercises. And if surgery is required, the procedure is minimally invasive and the recovery period is usually less than many other types of knee surgery.

  • How to Prevent Plica Syndrome?

Plica syndrome usually occurs concurrently with other knee conditions. Therefore, it is necessary to be proactive in managing other knee injuries. This consist of maintaining adequate strength, normal knee joint alignment, and flexibility in the muscles around the knee joint plus the rest of the lower limb. It is also important to wear appropriate footwear that supports your foot biomechanics. 

Weight-management also plays a role in the pressure exerted on lower limb joints, and as a result, should be something considered as a long-term preventative measure in plica syndrome.

  • How does it feel to have plica syndrome?

Those with plica syndrome may experience:

  1. Pain and tenderness at the front of the knee and on the inside of the kneecap.
  2. A snapping or catching sensation while bending the knee.
  3. A dull knee pain at rest, that increases with activity.
  4. Some tightness in the knee.

Top Doctors For Plica Syndrome Treatment

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Dr. P. Suryanarayan Orthopedics | Gender: Male | Experience: 30 years | Hospital: SIMS Hospital, Chennai
Dr. V. J. Laheri Orthopedics | Gender: Male | Experience: 25 years | Hospital: Seven Hills Hospital, Mumbai
Dr. Sanyukta Phukan Banerjee Orthopedics | Gender: Female | Experience: 18 years | Hospital: Primus Super Speciality Hospital, Delhi
Dr. Vaibhav Jain Orthopedics | Gender: Male | Experience: 10 years | Hospital: Primus Super Speciality Hospital, Delhi
Dr. Shaloo Bhasin Gagneja Orthopedics | Gender: Female | Experience: 15 years | Hospital: Primus Super Speciality Hospital, Delhi
Dr. Nishant Gemini Orthopedics | Gender: Male | Experience: 20 years | Hospital: Primus Super Speciality Hospital, Delhi
Dr. Dattatreya Mohapatra Orthopedics | Gender: Male | Experience: 10 years | Hospital: Primus Super Speciality Hospital, Delhi
Dr. Deepak Thakur Orthopedics | Gender: Male | Experience: 15 years | Hospital: Primus Super Speciality Hospital, Delhi
Dr. Surya Bhan Orthopedics | Gender: Male | Experience: 35 years | Hospital: Primus Super Speciality Hospital, Delhi
Dr. Dinshaw Pardiwala Orthopedics | Gender: Male | Experience: 22 years | Hospital: Kokilaben Dhirubhai Ambani Hospital
Dr. Avinash Date Orthopedics | Gender: Male | Experience: 25 years | Hospital: Kokilaben Dhirubhai Ambani Hospital
Mr. Christopher Pedra Orthopedics | Gender: Male | Experience: 15 years | Hospital: Kokilaben Dhirubhai Ambani Hospital
Dr. Mani Venugopal Orthopedics | Gender: Male | Experience: 36 years | Hospital: Fortis Hospital, Bengaluru
Dr. Jayateerth Kulkarni Orthopedics | Gender: Male | Experience: 30 years | Hospital: Fortis Hospital, Bengaluru
Dr. Chander Shekhar Orthopedics | Gender: Male | Experience: 32 years | Hospital: Apollo Indraprastha
Prof. Dr. Semih Takka Orthopedics | Gender: Male | Experience: 10 years | Hospital: Hisar Intercontinental
Dr. Murat Cobanoglu Orthopedics | Gender: Male | Experience: 29 years | Hospital: Hisar Intercontinental
Dr. Prasan Deep Rath Orthopedics | Gender: Male | Experience: 10 years | Hospital: Max Super Speciality Hospital, Saket
Dr. H.N. Bajaj Orthopedics | Gender: Male | Experience: 25 years | Hospital: Max Super Speciality Hospital, Saket
Dr. Vikas Gupta Orthopedics | Gender: Male | Experience: 10 years | Hospital: Max Super Speciality Hospital, Saket
Dr. Ramneek Mahajan Orthopedics | Gender: Male | Experience: 15 years | Hospital: Max Super Speciality Hospital, Saket
Dr. J. Maheshwari Orthopedics | Gender: Male | Experience: 35 years | Hospital: Max Super Speciality Hospital, Saket
Dr. S.K.S. Marya Orthopedics | Gender: Male | Experience: 30 years | Hospital: Max Super Speciality Hospital, Saket
Dr. Mujeeb Mahammad Shaik Orthopedics | Gender: Male | Experience: 18 years | Hospital: Thumbay Hospital, Ajman
Dr. Mohammad Kamel Orthopedics | Gender: Male | Experience: 16 years | Hospital: Thumbay Hospital, Ajman
Dr. Manoj Kumar Poovakkattillathu Orthopedics | Gender: Male | Experience: 15 years | Hospital: Thumbay Hospital, Ajman
Dr. Mohamed Hanafy Mohamed Ahmed Salama Orthopedics | Gender: Male | Experience: 25 years | Hospital: Thumbay Hospital, Dubai
Dr. Rajesh Garg Orthopedics | Gender: Male | Experience: 5 years | Hospital: Thumbay Hospital, Dubai
Dr. Avinash Murlidhar Pulate Orthopedics | Gender: Male | Experience: 21 years | Hospital: Thumbay Hospital, Dubai
Ms. Rashi Sehgal Orthopedics | Gender: Female | Experience: 10 years | Hospital: RAK Hospital
Ms. Ajina V. Nazrudeen Orthopedics | Gender: Female | Experience: 6 years | Hospital: RAK Hospital
Dr. Shreerang Madhusudan Joshi Orthopedics | Gender: Male | Experience: 32 years | Hospital: RAK Hospital
Dr. John Ranjan Bera Orthopedics | Gender: Male | Experience: 20 years | Hospital: RAK Hospital
Dr. Adel Saad El Hawary Orthopedics | Gender: Male | Experience: 32 years | Hospital: Saudi German Hospital
Dr. Sharmila Tulpule Orthopedics | Gender: Female | Experience: 25 years | Hospital: Saudi German Hospital
Dr. Omar Elofi Orthopedics | Gender: Male | Experience: 18 years | Hospital: Saudi German Hospital
Dr. Mohammad Mansour Gaballa Orthopedics | Gender: Male | Experience: 37 years | Hospital: Saudi German Hospital
Dr. M. Tarek Adnan Orthopedics | Gender: Male | Experience: 10 years | Hospital: Saudi German Hospital
Dr. Lothar Fromund Reinhold Orthopedics | Gender: Male | Experience: 25 years | Hospital: Saudi German Hospital
Dr. Ashok Kumar Orthopedics | Gender: Male | Experience: 15 years | Hospital: Saudi German Hospital
Dr. Madian Al Terkawi Orthopedics | Gender: Male | Experience: 10 years | Hospital: Saudi German Hospital
Dr. Haroon Iqbal Khan Orthopedics | Gender: Male | Experience: 15 years | Hospital: Saudi German Hospital
Prof. Dr. Rady Warda Orthopedics | Gender: Male | Experience: 28 years | Hospital: Saudi German Hospital
Prof. Bruno Marelli Orthopedics | Gender: Male | Experience: 30 years | Hospital: Saudi German Hospital
Dr. Issam Mardini Orthopedics | Gender: Male | Experience: 20 years | Hospital: Saudi German Hospital
Dr. Mohamed Elhoussainy Orthopedics | Gender: Male | Experience: 10 years | Hospital: Saudi German Hospital
Dr. Nuket Demirok Orthopedics | Gender: Female | Experience: 15 years | Hospital: Saudi German Hospital
Dr. Ahmed Abogamal Orthopedics | Gender: Male | Experience: 20 years | Hospital: Saudi German Hospital
Dr. Eisa Omer Orthopedics | Gender: Male | Experience: 15 years | Hospital: Saudi German Hospital
Dr. Manjit Mohan Orthopedics | Gender: Male | Experience: 7 years | Hospital: NMC Royal AbuDhabi
Dr. Ashish R. Ashtekar Orthopedics | Gender: Male | Experience: 8 years | Hospital: NMC Royal AbuDhabi
Ms. Vijaya Sambamurthy Orthopedics | Gender: Female | Experience: 5 years | Hospital: NMC Royal AbuDhabi
Dr. Ahmed Kaabneh Orthopedics | Gender: Male | Experience: 14 years | Hospital: NMC Royal AbuDhabi
Dr. Ahmad Baashir Yagan Orthopedics | Gender: Male | Experience: 11 years | Hospital: NMC Royal AbuDhabi
Dr. Faiza Farsi Orthopedics | Gender: Female | Experience: 9 years | Hospital: NMC Royal AbuDhabi
Dr. Mohamed Mahmoud Ali Mahmoud Orthopedics | Gender: Male | Experience: 16 years | Hospital: NMC Royal AbuDhabi
Dr. Swaminath P.V. Orthopedics | Gender: Male | Experience: 14 years | Hospital: NMC Royal AbuDhabi
Dr. Sumitra Reddy Orthopedics | Gender: Female | Experience: 10 years | Hospital: NMC Royal AbuDhabi
Dr. Divyashree Pulak Puneet Orthopedics | Gender: Female | Experience: 13 years | Hospital: NMC Royal AbuDhabi
Dr. Omar Ibrahim Orthopedics | Gender: Male | Experience: 6 years | Hospital: Al Zahra Dubai
Dr. Uwe Nellessen Johannes Orthopedics | Gender: Male | Experience: 20 years | Hospital: Al Zahra Dubai
Dr. Deepak Bhatia Orthopedics | Gender: Male | Experience: 15 years | Hospital: Al Zahra Dubai
Dr. Amr Osman Orthopedics | Gender: Male | Experience: 14 years | Hospital: Al Zahra Dubai
Dr. Andreas Appelt Orthopedics | Gender: Male | Experience: 30 years | Hospital: Al Zahra Dubai
Dr. Mohamed Ragab Elsheshtawy Orthopedics | Gender: Male | Experience: 8 years | Hospital: Al Zahra Dubai
Dr. Sabyasachi Banerjee Orthopedics | Gender: Male | Experience: 20 years | Hospital: Al Zahra Dubai
Dr. Mohamed Elkabbani Orthopedics | Gender: Male | Experience: 17 years | Hospital: Al Zahra Dubai
Dr. Samih Tarabichi Orthopedics | Gender: Male | Experience: 35 years | Hospital: Al Zahra Dubai
Dr. Beena Hameed Orthopedics | Gender: Female | Experience: 30 years | Hospital: Al Zahra Dubai
Dr. William Andrew Hodge Orthopedics | Gender: Male | Experience: 30 years | Hospital: RAK Hospital
Dr. Amit Chaturvedi Orthopedics | Gender: Male | Experience: 20 years | Hospital: Thumbay Hospital, Ajman
Dr. Brijesh Valsalan Orthopedics | Gender: Male | Experience: 10 years | Hospital: Thumbay Hospital, Ajman
Dr. Alaa Eldin Orthopedics | Gender: Male | Experience: 27 years | Hospital: Al Zahra Dubai
Dr. Anshu Rajnish Sharma Orthopedics | Gender: Male | Experience: 25 years | Hospital: Kokilaben Dhirubhai Ambani Hospital
Dr. Anand T. Galagali Orthopedics | Gender: Male | Experience: 26 years | Hospital: Fortis Hospital, Bengaluru
Dr. Anoop Bandil Orthopedics | Gender: Male | Experience: 11 years | Hospital: Apollo Indraprastha
Dr. Murat Dökdök Orthopedics | Gender: Male | Experience: 10 years | Hospital: Anadolu Hospital
Dr. Nidhi Goyal Orthopedics | Gender: Female | Experience: 5 years | Hospital: Apollo Indraprastha

Top Hospitals For Plica Syndrome Treatment

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Thumbay Hospital, Dubai With our Hospitals and Medical Centre in Ajman, Fujairah, Sharjah, Dubai and Hyderabad (India), Thum
Maharaja Agrasen Hospital, Bengaluru The Maharaja Agrasen Hospital is located in the heart of Bangalore and is known of its excellence in
Columbia Asia Hospital, Bengaluru Columbia Asia is an international healthcare group operating a chain of modern hospitals across Indi
Gleaneagles Global Hospital, Mumbai Gleneagles Global Hospital, Mumbai offers end-to-end clinical, surgical and diagnostic services. The
Kerala Institute of Medical Sciences (KIMS), Trivandrum KIMS HEALTHCARE GROUP is one of Asia’s leading multi-specialty hospital networks focussed on provi
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