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Author Topic: plica removal, post-op pain  (Read 2777 times)

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Offline brittan

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plica removal, post-op pain
« on: March 22, 2006, 10:41:59 AM »

   Dear Knee  Geeks,

    How are you? It's Ian Brittan here. I had a synovial plica excision on march 1st. Something significant has happened and I'm a little in the dark as to what might be happening.
 
   Firstly, I'll tell you how it happened: Everything was going beautifully. Crutches the first week, R.I.C.E, pills, all good. Swelling went down and daily improvement was noticed. Second week, I tried to use the crutches a little less and begin to walk.
 
   At first I was unable to bend my knee for the walking action. I kept my injured leg straight. Using stretching, light physio and a little electro muscular stimulation, I loosened up the quadriceps that had been quite tight. Immediately, I found I could now bend the knee to lift the lower leg while walking. It felt wonderful, if a little loose.
 
   Unfortunately, I think I got a little carried away. On day 13, when I thought I could begin to stop using the crutches, I spent the day walking unaided. And without the bandage strapping and white tights. I tried to walk as normal, with no limp. Perhaps the heat of the day and my weight, without support was a bad idea. I wanted to start exercising my quadriceps a little and flex the knee.
 
   I also experimented with walking up one flight of stairs and down, three times in total during the day. In hindsight, gong up is double your body weight and going down is seven times your body weight, right? I was also told, "good leg goes to heaven, bad leg goes to hell", for stairs. I had been doing this up until day 13. But my leg felt so good at the beginning of day 13, that I decided to be more liberal and experimental. So I tried to walk as normal up and down those stairs. I think going down did the damage. The pain didn't hit until the evening, too.
 
   I think those two things combined to trigger the pain I'm in now. It's getting better now, day 15 (I've gone back to R.I.C.E), but it really scared me. That night (of day 13) I felt a new kind of pain in the same region as before, but a slightly different location. Medial side (inner), along the side of the patella, a little under it and quite deep inside my knee.
 
   The doc told me I would have pain from the scarring (from the excision of the plica) for three weeks and I'm putting this pain down to that, but I am not 100% sure. What I realise that I don't know is where the scarring from the excision is, how it causes me pain and how I have aggrevated it. It may be something else but I don't think so.
 
   A simple solution might be to direct me toward a website with all the information on synovial plica excision and immediate recuperation. Not physio, I know about that, more the surgical aftermath. I'd love to see a diagram of where the scarring is located in my knee to see if it correlates with the pain. I'm not sure what alternatives there might be to the cause of the pain, maybe tweaked an unsupported ligament (the knee did feel a little loose), maybe irritation from the side of the patella where I had erosion? I'm not sure, and this is why I'm writing. Also would Ibuprofen be a good pill to be taking right now?
 
   I had planned on walking for week three, stitches out at the end. Swimming for week 4. Light weights in the gym for week 5 and 6, and building from there. This sudden pain really rocked me and I'm desperate to find out it's cause.
 
   To that end I realised I knew nothing about the scarring (Where the plica was formerly attached to the knee (and to which part of the knee, which tissue?)). I had just prepared myself for a third week of pain to be wary of, but that, if I did everything right, the pain would go for week four. With this sudden flair up in pain, my confidence has taken a bit of a kick and I'm extremely wary of trying any physio at all until the pain has completely gone. And I'm paranoid that perhaps that pain is going to stick around longer and continue to bother me over the coming months. A horrific thought.
 
   I've been hunting on the internet for information but have found it quite frustrating as there doesn't seem to be much in this field (or I'm looking in the wrong places). Post operative information on the excision of the synovial plica. Plenty of stuff pre-operation but not much post-operation. So, I decided to write.
 
   I'm sorry it's a lengthy letter. I'm guessing there's a website with all the answers to my questions except what I seem to have done on day 13. That's my personal question to you guys. What do you think? The rest I can look up when I know where to look. My second question to you. And that's it, really.
 
   I hope someone has some blessed good advice for me, which is why I signed up. Yours sincerely, Ian Brittan 

Offline cccanmend

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Re: plica removal, post-op pain
« Reply #1 on: March 23, 2006, 03:59:07 AM »
Hi Ian,  My name is Cathy and on March 10th I had the same prodedure you had.  I did not know the doc was going to remove plica but after the surgery i found out.  I myself was great for 5 days. I was actually walking with crutches on Monday, and like you felt so good on tuesday i decided i would do what you did. I said i may as well do some wash.  Well  up and down up and down the stairs I went.  Low and behold on Tuesday afternoon i was crippled with pain.  This was in my calf. Thought  I was going to die.  Went to see the doc the following day, and they litteraly rushed my to Brigham and Womens. They thought i threw a clot. Thank god that was not the case.  So i like you went back to R.I.C.E. but with a tight large ace wrap around the knee.  I am one week follow up today and feel great. As a matter of fact went out and bought a bike and rode without any problems today.  Had full ROM with leg and knee.  Came in and iced it to be sure I would be ok.  I have heard of a lot of folks haveing severe pain after plica removal. I know am facing a partial knee replacement on May 1st. do you know much about this subject. Thanks hope you feel better.
Cathy

Offline tblansit

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Re: plica removal, post-op pain
« Reply #2 on: May 25, 2006, 08:14:54 PM »
I had plica excision on 4/31/06.  Almost 2 months later I still struggle with ROM (flexion).  I have pain free flexion up to 90 degree.  Any further and I have a lot of pain.  PT has begun manually stretching and flexing my knee.  It really hurts along the interior and above the knee cap. PT is able to get me to about 115 degree before the pain becomes intolerable. I am starting to think that this is finally startng to help.

Has anyone else had similair issues in regaining ROM?

Offline lesleyjh

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Re: plica removal, post-op pain
« Reply #3 on: May 26, 2006, 09:50:56 AM »
Hi, I had a plica excision just over 4 weeks ago,and I have been in agony! It has been very hard. Like you I am having alot of difficulty with ROM. Its very painful,but my last couple of physio sessions have got better. I think you just have to work really hard on the quads to support your knee. I cant lock my knee straight it hurts so bad, and like you get alot of pain above the knee cap. I have been told it will get better, but it doesnt feel like it at the moment! I still have swelling so that doesnt help either. Good luck and let me know how you get on.
Arthroscopy-excision of synovial plica  24th April 06 (left knee)

Offline oceanluver

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Re: plica removal, post-op pain
« Reply #4 on: July 07, 2006, 04:37:16 PM »
Gee I am so glad to have found this site and these posts. I am so lost and confused anger, upset, etc I had arthroscopic knee surgery on June 22nd 2006 MRI showed torn meniscus and some other things. When they did the surgery the OS could not see a tear, but did find a synovial plica tearand removed the tissue. Said it was getting caught between my knee cap & femur. My first post op visit was 1 week later to remove stitches. I was still using crutches but much of the swelling was down and it looked good and seemed to be doing good to me. The doc said I need to get off the crutches and use the knee and continue with PT, it started on Wed June 28th. They at that time had me bend as much as I could and straighten as much as I could and measured it. I could get to 83 degree bend on my own and straightening was ? So went back to PT Fri 06/30 it was swollen up more, and was killing me. I have been icing, elevating, resting but trying to do the exercises at home that they told me. So in PT they tried to push me and I told them it just hurt too bad, they said I should be using my crutches and not walking on it completely just yet. So over the weekend I took good care of it and by Sunday night 07/02 was feeling much better started doing some exercises, felt pretty good did not push it but was impressed that it was moving so good and had more ROM. Went to PT Mon 07/03 and told her it was doing better and was showing a great improvement from Fri. So she had me do my stuff then took measurements. I could get to 87 degree bend without forcing with pain but not severe. With really pushing it I could get 90 degree and lots of pain. So PT said great and keep doing what I was that 90 degree was all I needed at this point and everything was looking good, and it felt good as could be I guess. So I go in to PT Wed 07/05 and I am real happy with it feeling good as can be moving good even a little improvement. So I do my stuff, and PT decides to add 2 exercises. One is no problem the other a little hard and uncomfortable but I can take it. Then the measurement, I can bend to 90 degree without forcing it hurts but I'll live, THEN she says try for more adn I try and it moves a bit, she says okay is that it and I said yea that is where pain tells me no more, and she puts her hand on my ankle and says okay relax, so I do thinking she is going to ease it back down and ice it and she shoves it back and holds it I come up off the table shouting she says just a minute and measures thats 97 degrees that is great okay you can relax it down now. I'll get the ice. That was it, I knew right then something was wrong. I cold not get it down hardly any I sat there holding my leg she came with the ice and I told her I think she pushed it too much. She said no pain no gain. Put on the ice and I could not straighten it. I left went home and later it started to swell, and hurt. I tried to do my exercises and nothing. I iced it and nothing. Got up yesterday and it was swollen up more iced it rest, elevated, iced and nothing. I can barely get anything out of it at all. Up all night last night called PT at 2am left message to let them know how mad I was. Suppose to go to PT today,called my nurse and told her and she said she would talk to them. If I want to go today I can but if not then she will tell them I will be back Mon. So I am going to call her and tell her I'll return Mon 07/10 it is still hurting swollen, movement is minimal and painful. The way the doctor talked on June 29th this would be a quick recovery, and implied I would be back to normal in no time at all. So I was thinking it sure doesn't seem to be doing as well as the doc talked about, but PT says I am doing good, then they push it and now I am worse than I was, and now I am wondering how long it is going to take, and why the doc and PT seem to contradict each other, why if on 07/03 was 90 degrees great and where the doc wants me did she push it by hand to 97 degrees. Any advise would be helpful since I am being told a different thing constantly.















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