Author Topic: Surgery for a Plica? (Read 4123 times)

Surgeon2Be · « **on:** April 09, 2008, 10:25:53 PM »

I'm having surgery for the suprapatellar plica in my right knee and I'm 16. Can you please share your experiences with me on how the surgery went and post-op. I would also like to know how long it might put me out of soccer and how long I need to go to PT for. Thanks in advance!

Mandy · « **Reply #1 on:** April 10, 2008, 02:20:54 AM »

Hi there~

My first surgery on my knee was a plica excision. Definitely not too bad of a procedure. I had spinal anesthetic, as I hate general anesthesia & I wanted to watch the surgery as it happend on a video screen (I'm an Athletic Training major). Surgery was fairly quick, compared to my other procedures....maybe under and hour. Unfortunately I had to stay a bit longer in the surgery center than expected because my lower body just wouldn't wake up quickly from the anesthetic. All went well, and I was home within several hours of the procedure.

After surgery, I just had an ACE wrap and an ice pack on my knee. At the dressing change, I had two scope holes that were covered with steri-strips (my OS sutured with internal stitches). Started PT a couple of days post op and mainly worked on ROM and controlling swelling right away. Strengthening came a bit later.

Unfortunately there's no magic formula that tells you when you'll be back to playing soccer. I played very competitive hockey during my surgery. Now, I didn't get to skate until I was maybe 1.5 months post op. I never returned to hockey that year as I had some difficulties getting my strength back, and I actually needed more done to my knee than just the plica removed.

Please let me know if you have any other questions!!

Best of luck to you!
~Mandy

Surgeon2Be · « **Reply #2 on:** April 10, 2008, 08:18:03 PM »

Thanks Mandy

I have read a lot online about plica surgeries gone wrong and how the pain never goes away. Do you still have pain from time to time(at least after the plica excision and before everything else)? Also for the surgery, it's arthroscopic so is there going to be any huge incisions? Not that I mind a cool scar, but my brother has them everywhere from all of his 6 surgeries and I don't want that. How many weeks did you go to PT for, and do you still wear a knee brace during sports? And lastly, do they always do internal stitches?

Thanks again!

(How long were you on crutches? I cannot stand them!)

Mandy · « **Reply #3 on:** April 10, 2008, 11:20:25 PM »

Hi there!

Not sure if I'm actually a good example, but I'll let you know my experience. I'm always in pain with my knees, but that isn't because of the plica. One of my previous surgeons messed up a procedure he performed and now I'm left with osteoarthritis in my knee. I had some pain after surgery while I was still rehabbing, but again that wasn't from the plica itself....it was more due to the fact that my patellas were maltracking and messing with the undersurface of my patella.

As far as the incisions go, they are jus two little holes and not a big inscision. I don't mind my scars now, but there was a time I was bothered by them so I understand that you don't want them! Here's a picture of my knee after my plica excision: http://www.flickr.com/photos/10781788@N05/970967567/in/set-72157601136650311/. The actual scope holes are the ones with tape over them. The small purple dots are marker that my OS and his student drew, don't sure why! The internal stitching was just what my surgeon does. Surgeons vary on what they do. Most I would think use internal stitches and cover the outside in steri-strips. Other surgeons will just use stitches that need to be removed.

For PT, I've continuously been in PT on and off over the years. I think I was consistantly in formal PT for a few weeks if not months. I was allowed to start skating for hockey when I was around 6 weeks post op, I think. However, I wasn't able to get back full time to competing, so I just focused on rehab to build my quads up for my patella realignment surgery, which was almost 3 months after the plica excision.

I wear a brace right now anytime I'm up and around. However, this is an unloader brace for my arthritis, until I get my knee fixed in late May. After my plica surgery, I wore a brace called a Breg PTo when I was doing PT or working out. That was for my patella issues. Most people after a plica removal don't require bracing. Are you bracing right now?

Don't worry about crutches. Assuming you just have the plica removed, you'll be off of them in no time. I had surgery on a Friday, and was probably off crutches 100% by Wednesday of that next week. I started to stop using them over the weekend, but brought them back to school with me, just for protection in the halls.

Hope that answers your questions! Let me know if there are any others!
~Mandy

Surgeon2Be · « **Reply #4 on:** April 11, 2008, 12:23:37 AM »

Thanks sooo much! I have never had any surgery or anything, but have had terrible knee pain since I dislocated my knee when I was 7. I'm only 16, but the pain never goes away and I hope they figure out what's really wrong with it. I'm supposed to be wearing a brace for sports now, but it gets really annoying so I take it off(usually regret it after). Thanks for all the info and pic you showed me. I will have to get back to you after I have my surgery

Thanks again

Surgeon2Be · « **Reply #5 on:** April 13, 2008, 01:49:12 AM »

Mandy,
Did you experience any numbness before your surgery? I'm having a plica removed and my lateral meniscus stitched up, but my OS is concerned about the numbness that runs nearly all the way to my hip. I also pulled my hammie and thigh in the accident if that helps. It lasts anywhere from 10 minutes to a couple of hours and occurs at any time. Could this be just a pinched nerve or some serious lower back issues? I asked my doctor and he said he'll take a look during the arthroscopy.
Thanks in advance

Mandy · « **Reply #6 on:** April 13, 2008, 05:46:55 AM »

Hi!

I never had any numbness before my plica surgery. I do have numbness on the lateral sides of my inscisions from my realignments, but that's due to the nerves that were cut during surgery. I'm getting some feeling back into some regions, but others I can't feel. Sorry I don't have any input on this. It's definitely good that you've mentioned it to your OS. Do you know if he's concerned about the issue?

Surgeon2Be · « **Reply #7 on:** April 13, 2008, 05:34:41 PM »

The doctor's assistant was talking to me about my knee and I brought up the numbness that runs down my leg. He looked really concerned and tried several tests to see the strength in my foot which didn't turn out good. He then got the doctor and told him about it and the doctor immediately said that he wanted to do arthroscopy. I haven't really had any back problems being only 16, but got charley horsed extremely hard on my hip in gym a few months ago that made my whole leg go numb for 4 days. I could barely get off the floor it was so numb, but that probably doesn't have anything to do with the numbness now because that was in like dec. or jan.
So will it be alittle numb after surgery because of the incisions?

Pulse · « **Reply #8 on:** April 13, 2008, 08:41:11 PM »

I had my plica removed one week ago, it all went without pain at all. I spend 5 days in hospital. One day before operation. Operation day, the next day I was able to go wih crutches. On the 2nd day I was able to go with one crutche, same on 3rd day. On 4th day I was able to go without crutches. After a week I was able to safety drive a car. No pain after surgery! I will leave hospital on 2nd day when I will have my second knee operated. This is how my knee looked on day 5th - http://www.mwsoft.pl/marek/kolanko2.jpg
No numbness after and before operation.

Surgeon2Be · « **Reply #9 on:** April 13, 2008, 09:57:16 PM »

thanks for sharing Pulse

How long did your OS say it would be before you return to competitive sports (or normal day activities, which ever).

Pulse · « **Reply #10 on:** April 14, 2008, 07:40:14 PM »

He said that it will take 3 weeks!

Surgeon2Be · « **Reply #11 on:** April 14, 2008, 08:57:22 PM »

Pulse,
It looks like you have stitches on the outside of your thigh in the picture. Did you have something else done along with the plica excison?

Pulse · « **Reply #12 on:** April 16, 2008, 08:43:15 AM »

it's from drain, there was a small straw for about 20 hours to remove lotion from the knee it's normal procedure here. Every even small operation irritates kee and more lotion is produced and it should be removed. I have a picture of it and can attach if you want to

Surgeon2Be · « **Reply #13 on:** April 16, 2008, 04:03:56 PM »

thanks

can you post the picture?

Pulse · « **Reply #14 on:** April 17, 2008, 08:35:39 PM »

just after
http://www.pulse.neostrada.pl/knee0.jpg
after night
http://www.pulse.neostrada.pl/knee1.jpg
taking off the drain and bandage
http://www.pulse.neostrada.pl/knee2.jpg

Surgeon2Be · « **Reply #15 on:** April 18, 2008, 11:44:41 PM »

thanks for sharing the pictures Pulse

I'll have to update you after I have my surgery this coming friday!

CSUrider · « **Reply #16 on:** April 22, 2008, 11:29:57 PM »

Hi There!
I had a plica removal the first week of Feb. I had chronic pain in that knee for at least the past 10 years, and I feel so great now! I had the surgery on a Thursday afternoon and had to stay in bed through Sunday with this great ice machine around my leg. I used crutches to get around on Monday - Wednesday the week after. Then I just took it easy after that for another week or so. By about a month out I was feeling good enough to ride my bike and do most anything I wanted to. Now I guess it has been 3 months and I can go ride 50+ miles, no pain, no snapping

Good luck with the surgery!

Krystle

Surgeon2Be · « **Reply #17 on:** April 23, 2008, 07:37:28 PM »

Thanks CSUrider

I keep hearing all these awful stories about how people's plica surgery went wrong and all this terrible stuff happened. I'm glad you're feeling better! How long did you go to PT for? Do you ever experience any type of pain if you play sports(side stepping, etc)?

John1 · « **Reply #18 on:** April 27, 2008, 07:41:35 AM »

I hope the surgery went well, Surgeon2Be. You said you were getting your suprapatellar plica removed. Problems with the medial plica are more common. I am one of those people that had and is still having problems after having my medial plica removed. I still have a considerable amount of pain where the plica was.

After the first surgery, scar tissue formed (I think) because the surgeon did a terrible job. I have a video of the surgery and he didn't really remove the plica; he just kind of ran the shaver over it, but left a band of tissue there. By the time of the second surgery, this band had turned into a thick red band of scar tissue. It was more painful at that point, but the second surgery helped a lot. I think I still have some left over scar tissue that is causing the pain and I'm still trying to figure out how to get rid of that.

Well, I hope the surgeon did a good job of removing the plica completely. It's important to get back to using your knee so that scar tissue doesn't form where the plica was removed.

Good luck!

suhcmf · « **Reply #19 on:** April 29, 2008, 11:43:00 AM »

Jonh1: How long ago did you have your second surgery? I had my medial plica removed in February and am just now getting to where I could consider it a full recovery. I can do pretty much everything I want to do, but I still have the weird 'weak knee' feeling because it is not as strong as it once was. However, I remember my knee hurting a lot more than it does now. I'm 10 weeks out. Doc. said to wait until the 12-16 week mark before I judge the surgery as a whole.

Pulse · « **Reply #20 on:** April 29, 2008, 12:35:22 PM »

I had my plica removed on 4th of the April, plica from second knee will be removed on 15th of the July.
It's been 3 weeks now, leg is pretty strong, I do excercise a lot (isometric and stationary bike at high cadence).
The only thing which concerns me that it hurts when it's bent during prelonged sitting, less than it used to on the other hand ;-)

suhcmf · « **Reply #21 on:** April 29, 2008, 01:47:08 PM »

"The only thing which concerns me that it hurts when it's bent during prelonged sitting, less than it used to on the other hand "

Me too. I can't sit in the back seat of a car for more than ten minutes or it hurts real bad. But still, I am the same way, it's still not as bad as it used to be.

Surgeon2Be · « **Reply #22 on:** April 29, 2008, 04:13:02 PM »

Hey you guys, thanks for all of your responses

I'm now 1 day post-op(surgery got moved to monday)and in a lot of pain. I can barely put any weight on my leg because it is very weak. I still experience the catching feeling too. I got really sick from the anesthesia and am really dizzy and throwing up all the time now. So it didn't go as I had hoped, but I'm hoping it will get better. My calf and foot are also really sore right now. My foot is swollen and my calf feels like it's constantly cramping. I ice and elevate every hour for like 25 minutes like the doctor said and it doesn't help. Did anybody experience the pain and numbness in their foot and calf? It was like that before the surgery too.

*It also hurts to bend my toes. If I bend them, this really bad pain runs up the side of my calf into my knee*

John1 · « **Reply #23 on:** April 29, 2008, 11:46:15 PM »

suhcmp - my second surgery was November, 2005. I am not a typical case though. After my first surgery, I wasn't using my knee at all because I also had microfracture done for a cartilage defect, and I think that led to more scar tissue forming. My plica also wasn't just sore before the first surgery; it was actually torn lengthwise (I wonder if I can post a photo somehow), and I could feel it under my patella. The surgeon cut that part away, but left most of the part that was attached to the inner wall of my knee.

Sitting with my knee bent for a long time is also bad for me. Stretching your quads everyday can help with that a bit. I even try sitting on my legs, like my butt on my heels, to give the knee a good stretch. My legs are muscular so that stretches things, but it may not if you are skinnier.

Surgeon2be - I don't know about the numbness, could be just from the swelling putting pressure on the nerve. But you said you had it before the surgery, so I don't know. I wasn't sick after my first surgery, but I was after the second. After the second, when I first woke up a nurse stuffed a painkiller in my mouth (which I didn't need!), so I wonder if that made me sick.

For swelling, it might help to contract your leg muscles, like every second for a minute, every once in a while. The fluid in the knee and muscles drains through the lymphatic_system (http://en.wikipedia.org/wiki/Lymphatic_system) and is pumped up through your body by your muscles.

Let us know how you are doing.

Surgeon2Be · « **Reply #24 on:** April 30, 2008, 11:01:46 PM »

thanks John1. Unfortunately, the numbness seems to be getting worse

I tried doing those exercises, but those made my calf cramp up even more. My parents also will not call the OS because they say it's just swelling and it will go away. I told them it has been happening since before the surgery, but they still won't listen

Did anybody else's OS use steri strips instead of stitches? Mine did and there is like hole going into my leg and I can see down probably a centimeter. Can't this get infected easier?

John1 · « **Reply #25 on:** May 01, 2008, 12:05:19 AM »

Well that sucks that your parents won't listen to you. The surgeon gets paid a lot of money to do the surgery, so he/she should take the time to listen to your concerns. I would be concerned with the numbness also.

About the steri strips vs. stitches, I think I read some studies a few years ago that said the risk of infection wasn't any greater than with stitches. I asked my surgeon about it, and he just said he uses stitches.

Surgeon2Be · « **Reply #26 on:** May 02, 2008, 08:08:05 PM »

I tried posting this in the general section, but got no responses so I'm posting it here.
What are some causes for knee locking?
I just had arthroscopic surgery for a suprapatellar plica removal in my right knee and before that, my knee had been catching/locking on the outside of my knee. It was more than catching cause I could feel something get stuck, but if I smacked my knee it would come unlocked...so I'm not sure if it is considered locking or catching. It also feels sometimes like it gets stuck under my kneecap, but then sometimes it feels like it gets stuck on the very outer side of my knee.
Anyways, they thought I might have had a lateral meniscus tear too, but it turned out there wasnt't one even though that's where all my pain still is. I'm 4 days post-op and still experiencing that catching/locking feeling. My x-rays from the emergency room didn't show a loose body and my MRI just showed the possible tear and a massive plica, so what is causing all this? It doesn't really hurt, it's more uncomfortable when it happens.
My OS is also one of the best surgeons in NY and I trust that he wouldn't miss anything so...
Thanks in advance

John1 · « **Reply #27 on:** May 02, 2008, 11:55:17 PM »

Do you mean the locking is between your femur and tibia, or is your patella catching?

I know that once your muscles get weak that funny things can happen. My patella used to catch all the time when I would try to straighten my knee for many months after the surgeries. It was only after a got a lot of strength back that the patella started to move normally. The muscles kind of hold the bones in place the way they are supposed to. So maybe you have lost strength in your hamstrings and quads and when you get it back the locking will stop.

Surgeon2Be · « **Reply #28 on:** May 04, 2008, 07:33:33 PM »

Well I pulled my hamstring, thigh, and possibly my calf in the injury also

The calf pain is wierd though cause it's like in between the two leg bones and goes deep. It also only occurs when I walk for a long time or stretch a lot. I'm going to ask my OS about chronic compartment syndrome. I don't know how that happened cause all that happened was my leg got twisted outwards by the ball. Even my hip hurts.
The catching gets especially bad going down the stairs and I have to shake my knee out every 20 seconds when walking. I also fell down 5 stairs 3 days ago and twisted my knee trying to land, so the entire inside of my knee is killing me and whatever is below the patelllar tendon also really hurts. That makes me really nervous because right near the anterior horn of the medial meniscus is extremely painful, but I highly doubt the OS is going to do another MRI and my parents would never dish out another 1500 bucks for my knee

The catching happens right near the anterior horn of the lateral meniscus(just right at the bottom of the kneecap) and sometimes feels like it goes into the LCL(sprained it in the injury). I have pics from the arthroscopy and both the meniscus' look fine. The OS is going to think I'm just a crazy 16 year old girl if I tell him this...