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Author Topic: plica syndrome???  (Read 9760 times)

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Offline cheergirl489

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plica syndrome???
« on: December 27, 2005, 06:41:36 AM »
Hey! I hope everyone had a nice Christmas. I was wondering if anyone knows anything about mediopatellar plica syndrome? I am a little unclear as to exactly what it is and what the treatments are. Also, does anyone know what kind of PT exercises can be done without irritating it?
~Megan~

Happy New Year all!!!  :)
patellar maltracking
mild chondromalacia
plica syndrome
Who knows? Thankfully it's doing just fine!... and I've been cheering!!!

Offline ChrisAngel

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Re: plica syndrome???
« Reply #1 on: December 27, 2005, 09:37:43 AM »
Hey! I hope everyone had a nice Christmas. I was wondering if anyone knows anything about mediopatellar plica syndrome? I am a little unclear as to exactly what it is and what the treatments are. Also, does anyone know what kind of PT exercises can be done without irritating it?
~Megan~

Happy New Year all!!!  :)

I have Plica Syndrome. I've had my Plicas removed once. To quote one of the links below:
"Plica (pronounced PLI-KAH) syndrome occurs when plicae (bands of remnant synovial tissue) are irritated by overuse or injury. Synovial plicae are remnants of tissue pouches found in the early stages of fetal development. As the fetus develops, these pouches normally combine to form one large synovial cavity. If this process is incomplete, plicae remain as four folds or bands of synovial tissue within the knee. Injury, chronic overuse, or inflammatory conditions are associated with development of this syndrome."

For me, the only treatment to take care of plicas, was to remove them with surgery. I'm now having my 3rd knee surgery, maybe because of a regrown plica (or another set of scar tissue). I recommend u discuss about this with your doctor to decide the best course of action.

There is a great sources of information about this in the net and I recommend u check the "Soft tissue healing problems"-section of the forum, where we have a lot of people suffering from plica syndrome just like you.

Here you've got some googled answers of what plica syndrome is.

http://www.kneeguru.co.uk/html/steps/step_05_patella/plica.html (this has good informative pictures)
http://www.athleticadvisor.com/Injuries/LE/Knee/plica_syndrome.htm
http://healthlink.mcw.edu/article/926049465.html
http://orthopedics.about.com/cs/otherinformation1/a/plica.htm

Sorry, I'm in a bit of a hurry at the moment, but please feel free to IM me if u want or have questions. Good luck!! :)

31 young :)
RemovePlica
-L 12/98+R 9/99
RemoveScartissue
-L&R 4/04
RemovePlica&scartissue
-L 8/06 ->R postponed for now (need to find a new surgeon..*sigh*)
*Fibromyalgia+CPS+Acid Reflux+Tietze's syndrome+CFS+depression*

Offline Heather M.

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Re: plica syndrome???
« Reply #2 on: December 27, 2005, 10:28:24 AM »
Here's a great, easy to undestand overview of PFS (patello-femoral syndrome), including an introduction to plica syndrome.  Read through all five or six tabs for information on PFS.  Many people are given a diagnosis of plica syndrome, but in a large number of cases this plica problem is actually the tip of the iceberg==in fact, plicae issues can be a sign of serious underlying tracking or mechanical disorder.  So that is why you might read stories about folks who had plica surgery/problems, but then went on to have a TTT or something like that.  I think Cat is a good example of this--she had problematic plica and looked at her options (plica removal, lateral release) and the low to fair odds of success...and I believe she just took the plunge and dove in straight to the deep end with respect to surgeries (not her mental state!  ;D  I thought it quite brilliant and brave to skip the whole "fooling around with it" done by overly confident surgeons trying to sell you something stage of knee treatments.  So she went straight for the big guns, which I believe had the highest chance for success.

Anyway, I hope it was Cat who did this route--it's late.  I'm tired.  But pretty sure it was.  If not, apologies all the way around, when I wake up in about 10 hours. *yawn*

Heather

PS here's the link:  http://www.steadman-hawkins.com/pate/overview.asp
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline stgiles16

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Re: plica syndrome???
« Reply #3 on: December 27, 2005, 11:35:39 AM »
Another great video of plica syndrome is www.hughston.com You click on education and then click on "what is a plica" I too have had my plica removed but it has now grown back. It really hurt when it was inflamed.

good luck
missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline cat

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Re: plica syndrome???
« Reply #4 on: December 27, 2005, 03:45:14 PM »
Hey all. Hey Heather. How ya doing?
Just to clarify things, I was diagnosed with plica- by one of the many docs I saw. (Each doc seemed to have a different take on things.) Two of the docs wanted to schedule me for a LR surgery. I did the only thing a sensible gal would do. I freaked out. So much for taking the "plunge". ;) I requested another round of therapy during which I did some homework and got yet another 'second' opinion. I went in armoured with my newly aquired internet research and mispronounced terminology determined to find out what was going on with my knee. This last and current OS did something quite novel- a standing exam.  :o Turns out that I have not only some of the things the other docs had seen but miserable malalignment as well and that it was actually my alignment that was causing the other problems. Now, I'm not saying that your problems are more than just your plica. Just wanted to encourage you to do your homework, do your therapy, and get more than one doctor's opinion before any blades are unsheathed. Some of those guys are soooo eager to get their hands on you.

 ;D cat  ;D
"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline cheergirl489

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Re: plica syndrome???
« Reply #5 on: December 29, 2005, 12:02:29 AM »
Thank you everyone! All of your info helped a lot. I have a better understanding of what plica syndrome is now. My doctor gave me some anti-inflammatory medication to take for 10 days and that seems to help some, but it still hurts when the medicine wears off. Since my pain is not only coming from the plica, it is difficult to address the other problems (chondromalacia and patellar maltracking) at PT without aggravating it. My doctor also gave me a brace to help the tracking and it seems to help, but I just went back to PT today and the medial knee pain is noticable once I take the brace off. I can also feel some popping on the medial side even with the brace on. Is this the plica? If so, are there certain exercises that can aggravate it? Maybe it is getting more irritated at PT. I don't know, I'm just trying to figure out how they can fix the maltracking and stuff if the plica keeps causing pain when I do the exercises. ::)
Megan
patellar maltracking
mild chondromalacia
plica syndrome
Who knows? Thankfully it's doing just fine!... and I've been cheering!!!

Offline Cindysphynx

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Re: plica syndrome???
« Reply #6 on: December 29, 2005, 02:54:39 AM »
I had plica removal, and I'm now having some new problems that I'm hoping are just tendonitis.

Anyway, can someone explain how plica can grow back?  My OS said it couldn't (or, at least, I think that's what he said), and if it is tissue formed in utero, how can it possibly grow back in adulthood?
partial meniscectomy and plica ressection -- Sept. 05
chondromalacia patella -- Jan. 05

Offline ChrisAngel

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Re: plica syndrome???
« Reply #7 on: December 29, 2005, 01:29:58 PM »
I had plica removal, and I'm now having some new problems that I'm hoping are just tendonitis.

Anyway, can someone explain how plica can grow back?  My OS said it couldn't (or, at least, I think that's what he said), and if it is tissue formed in utero, how can it possibly grow back in adulthood?

I wondered that same thing almost until few weeks ago. I didn't believe it could grow back. Until I also asked about it in the forum and got my answers. This forum has members, whose plicas HAD indeed grown back. So plica CAN come back. I didn't believe it either some time ago, but it is possible. I dunno the medical explanation of how it can grow back, but it just can. There are walking (or not, heh) examples in this forum.

I'm kinda in the same boat now, having symptoms maybe due to regrown plica, or recurring scar tissue.

Best of luck to you!  ;)

Chris
*~
31 young :)
RemovePlica
-L 12/98+R 9/99
RemoveScartissue
-L&R 4/04
RemovePlica&scartissue
-L 8/06 ->R postponed for now (need to find a new surgeon..*sigh*)
*Fibromyalgia+CPS+Acid Reflux+Tietze's syndrome+CFS+depression*

Offline stgiles16

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Re: plica syndrome???
« Reply #8 on: December 29, 2005, 02:45:13 PM »
My plica grew back and I have no idea why or how. It  is frustrating though.

hope you feel better soon.
missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline Cindysphynx

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Re: plica syndrome???
« Reply #9 on: December 29, 2005, 05:03:06 PM »
But how would you know that the tissue that had grown back was in fact plica tissue?  It could be something else, like scar tissue, no?

Has anyone had a repeat plica ressection to establish this for sure?
partial meniscectomy and plica ressection -- Sept. 05
chondromalacia patella -- Jan. 05

Offline ChrisAngel

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Re: plica syndrome???
« Reply #10 on: December 29, 2005, 06:06:08 PM »
But how would you know that the tissue that had grown back was in fact plica tissue?  It could be something else, like scar tissue, no?

Has anyone had a repeat plica ressection to establish this for sure?

Plica and scar tissue are different things and the doctors can tell the difference, once they see inside the knee (when doing a scope, for ex). I cannot tell why or how it happens, but it is happening to some people, like missy. It's not that imbossible when u think, plica is an alive tissue, that can sometimes grow back. Doesn't happen to everyone, so your current problems can as well be due to scar tissue. Scar tissue is a tough b**ch to beat, as you can see by reading some posts about it in the soft tissue healing problems area. But it's different for every individual.

I'm having a new scope next year. It can either be just some more scar tissue or a regrown plica. It can be both or either one. Very frustrating, as these problems seem to be very continuous. Ask about this from ur doctor or someone experienced in this forum. I'm sure someone can give u the information u need! Good luck! :)

Have a happy new year  :)

Chris
*~


« Last Edit: December 30, 2005, 11:02:57 AM by ChrisAngel »
31 young :)
RemovePlica
-L 12/98+R 9/99
RemoveScartissue
-L&R 4/04
RemovePlica&scartissue
-L 8/06 ->R postponed for now (need to find a new surgeon..*sigh*)
*Fibromyalgia+CPS+Acid Reflux+Tietze's syndrome+CFS+depression*

Offline cheergirl489

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Re: plica syndrome???
« Reply #11 on: December 30, 2005, 05:16:04 AM »
Just wanted to say Happy New Year and good luck to all of you!
~Megan~
patellar maltracking
mild chondromalacia
plica syndrome
Who knows? Thankfully it's doing just fine!... and I've been cheering!!!

Offline cheergirl489

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Re: plica syndrome???
« Reply #12 on: January 06, 2006, 12:38:45 AM »
Hello everyone. I hope you are all doing well and had a good holiday! Well... it's been about 4 days since I finished up the anti-inflammatory meds and as I thought... the pain is back.  >:( I think it is the plica, but I'm not sure. My knee hurts on the medial side and it feels like something pops/snaps just above the joint line. It is getting progressively worse. When I sit for like a minute it already hurts there and it feels like it has to pop or something and there is a feeling of pressure on the medial side until I straighten my leg. I guess the stupid plica has been aggravated again!  :-\ No matter what I do it seems to just get worse. This is the worst it's been yet. If anyone has any suggestions....
Megan 
patellar maltracking
mild chondromalacia
plica syndrome
Who knows? Thankfully it's doing just fine!... and I've been cheering!!!

Offline ChrisAngel

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Re: plica syndrome???
« Reply #13 on: January 06, 2006, 12:09:01 PM »
Hey cheergirl and Happy New Years as well!

I'm so sorry to hear u're in so much pain! :-\ If it's any help, I can tell I'm pretty much in the same boat with you. As I'm having a new knee scope sometime in January or February, I also know it's either a regrown plica or just some more scar tissue. My pain symptoms are very similar to you, although they are in both legs, as I've always had bad knees in both legs. But I somewhat know what the pain u describe, is like.

Have you scheduled another appointment to your doctor yet? I suggest u do that so you can discuss about further treatment for your knee. Ur doc might run some more tests, that would help to examine what's going on with ur knee. If the pain comes back after the meds have worn off, it sounds to me that there still is some inflammation inside that knee that requires treatment.

I wish I could give you more advice. I suggest u do the exercises that don't cause too much pain and avoid the ones that makes ur knee irritated, as it might cause further inflammation. That way u can keep the knee moving, without irritating it too much. You're lucky, I myself cannot do any exercises to strenghten my legs at the moment, as everything hurts. Ur situation is better and I think you have pretty good chances in recovering from it. Best of luck and let us know how you're doing!  :D

Hugs,
Chris
*~


31 young :)
RemovePlica
-L 12/98+R 9/99
RemoveScartissue
-L&R 4/04
RemovePlica&scartissue
-L 8/06 ->R postponed for now (need to find a new surgeon..*sigh*)
*Fibromyalgia+CPS+Acid Reflux+Tietze's syndrome+CFS+depression*

Offline cheergirl489

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Re: plica syndrome???
« Reply #14 on: January 06, 2006, 10:39:50 PM »
Thanks a lot Chris and best of luck to you as well! To answer your question, yes I have another appt. with my OS in about 2 weeks or so. I have had an MRI and multiple x-rays. He said that if the brace doesn't help he might have to do some surgery, but he doesn't want to do it on someone as young as me, so he will do everything possible to avoid it. With the way things feel now and what my PT tells me, surgery might be the only answer.  :'(
Megan
« Last Edit: January 07, 2006, 04:19:36 AM by cheergirl489 »
patellar maltracking
mild chondromalacia
plica syndrome
Who knows? Thankfully it's doing just fine!... and I've been cheering!!!