The LIBRARY => NOTES - Surgical Procedures => Topic started by: jmonroe81 on March 10, 2017, 02:05:37 AM

Title: S/P plica excision in a runner. Major quad atrophy & portal scar tissue
Post by: jmonroe81 on March 10, 2017, 02:05:37 AM
Hello! I am 6 weeks post op plica excision and chondroplasty of a chondral defect. I developed major quad atrophy despite PT. I cannot descend stairs. My knee feels like it's going to pop and I have no VMO control. I have full ROM. No pain really, except over my lateral portal incision and theres scar tissue there. That area is thick and feels like it is compressing against my patellar tendon. Laterally I feel like there is a pebble in the way, near the portal sight. Ive tried to work on the scar tissue. Massaging it, etc. But for some reason whenever I contract my quad, its the lateral portal area that hurts. My medial femoral condyle used to hurt from the plica, and now I have no pain. My main concern is my quad atrophy. I am not making any improvements in that area. PT does STIM and I ordered a home unit as well. The doc says my VMO will take a hit from the plica excision. i just feel like I'm not improving or improving VERY slowly. I cannot even begin to think about running. i cant even do a single leg hop. I have friends who've bounced back quicker than this and can run after plica excision. 5 wks post op my doc did a cortisone shot because of the swelling and it wasnt going away. Any suggestions???
Title: Re: S/P plica excision in a runner. Major quad atrophy & portal scar tissue
Post by: Clarkey on May 20, 2017, 12:36:39 PM
Sorry for such a late reply back, even if you no longer login to KG Bulletin Board my advice from my own personal experiences might prove useful for members in a similar situation with plica excision problems post-op. It does sound like you are dealing with scar tissue build up around the portals region that needs to be broken down in the early stages post operative within a six weeks time frame before the scar tissue hardens that's hard to break down again.

My ROM is also good and can walk ok at a slower pace just unable to run or walk quickly! As soon as I make an attempt to take a large stride feel anterior knee pain by the tibia the rest of the knee is not painful. Patella tendonitis looks like the culprit to the knee pain as well as fat pad issues past and present. The anterior knee pain could be fat pad inflammation as I have some joint effusion in the region on my latest MRI scan in January 2017. Fat pad debridement surgery would be the next option after all conservative treatments methods have failed to improve my ongoing right knee problems.

Soft tissues injuries seem to be made worse after surgery causing excessive amounts of scar tissue build up. Once it has had a chance to establish it is hard to get under control again! The closest none invasive way to break down the scar tissue is 'Graston Technique' rather than having surgery of Anterior Inteval Release (AIR)

The above links is not offered under the NHS if you live in the UK, have to pay privately for treatment which is a shame. Would be a good none invasive method of treatment for excessive scar tissue build on the NHS.

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