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Author Topic: Why iis plica removal so difficult to recover from?  (Read 6950 times)

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Offline kscope09

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Why iis plica removal so difficult to recover from?
« on: January 21, 2010, 09:34:37 PM »
As I've mentioned on other threads I'm having a rotten recovery.  As well as having the chrondoplasty and acl debridement I had plicas taken out.  They were suprapatella and lateral, not the usual medial that most people seem to get.  When I came out of hospital I had no crutches and apart from a couple of hiccups early on I did well, though slowly.  My op was in August and by mid December I knew I should be better by then but it seemed like I was still going to make a full recovery.  Now I'm still hopeful but not as sure.  I wonder if the plica exism could be one of  my problems.  When the plicas came out I thought that they'd never trouble me again.  On the net though I find that plica recovery can be very problematic.

Why is plica recovery so difficult?
Does it often take such a long time to recover?  Do they go in time?
Is there anyone else on the forum who had suprapatella and lateral plicas?

I've asked my pt about plicas but he just say's that some OS's think their better left in and that there's a big debate about them and not enough is really known about plicas yet.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline tez27

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Re: Why iis plica removal so difficult to recover from?
« Reply #1 on: January 21, 2010, 09:52:16 PM »
What excactly is a plica I have read about them alot on this board but never found out what they were
Is it some kind of scar tissue
Sorry but I'm new to all this knee jargon
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline kscope09

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Re: Why iis plica removal so difficult to recover from?
« Reply #2 on: January 21, 2010, 10:01:45 PM »
Well!  I'm not that clear myself since most descriptions seem either too vague or too technical, but it seems to be a fold of synovial membrane that becomes thickenned and inflamed when the knee sustains an injury.  The plica is something that is left over from phetal development and usually just sits there in the knee and doesn't bother you.  Tnhey can get stuck on your kneecap and cause all kinds of trouble.  They can be treated without surgery but if an OS finds one during the scope he'll remove it.  The scope is the only decent way of seeing them sine they don't show up well on mri.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline tez27

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Re: Why iis plica removal so difficult to recover from?
« Reply #3 on: January 21, 2010, 10:08:35 PM »
Thanks alot for the answer thats something else I've learned today I'll be an expert yet lol
I hope you get some answers to all you knee problems and you get some relief soon I know it can really get you down when you feel things are not improving as they should
take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline will1129

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Re: Why iis plica removal so difficult to recover from?
« Reply #4 on: January 21, 2010, 11:55:29 PM »
I don't know but mine's been a pain in the ass to recover from as well. I had surgery last May, and although mine has been very slowly improving, the knee still feels nowhere near as good as it did before the surgery.

So basically I had surgery to improve the knee, and it's felt like **** for the last eight months.
Deeply regret having knee surgery...hoping it can be fixed.

Offline Lottiefox

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Re: Why iis plica removal so difficult to recover from?
« Reply #5 on: January 22, 2010, 09:37:02 AM »
What is the rationale for removing a plica? Do they start to interfere with normal function once inflamed? The first OS I saw (who wanted to do MFX MFC and chondro of patella) threw into conversation "sometimes I find a plica and might whip that out". It seemed very routine for them, but I too have read conflicting opinions about whether to leave them or not. I felt like saying to him how he knew for sure to take it out! I can understand why you need to MFX etc but plica removal seems very down to the individual OS.  :-\    kscope I have heard that sometimes that suprapatellar one acts like a kind of band over the patella so I can kind of see why it might be better off out.

Another confusing element of knee surgery..... ::) ??? :'(
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline kscope09

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Re: Why iis plica removal so difficult to recover from?
« Reply #6 on: January 22, 2010, 10:55:14 AM »
The plica was definately causing problems that have gone now, but I'm very sore in that area.  it might not even be the plica healing that's causing it.  It might be because when I had the chrondoplasty done I tended to distribute my weight so that too much didn't go on the medial side.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: Why iis plica removal so difficult to recover from?
« Reply #7 on: January 22, 2010, 04:16:24 PM »
I have to agree that plica removal is hard to recover from and seems to take time to recover from fully. I do not want to sound negative all the time but feel my knee no better of then before surgery. I get told by members on my thread things will improve and should recover from the surgery but there no guarantee that the surgery will be a success. As long as the pain and swelling is there, the knee not improving but can take up to 6 months to recover so it may be too early to say if its worked or not. I am walking a lot better then I was 4 weeks ago with less of a limp but thats the only big improvment so far. Reading members plica removals they are all having problems and not easy to recover from.

Nick  :) {2010} :)

RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Pin2Ride

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Re: Why iis plica removal so difficult to recover from?
« Reply #8 on: January 24, 2010, 08:25:48 AM »
Hi all ,

I'm one of plica syndrome  and had post-op for 3 months on my left knee. I've search for the FYI about  plica is so complication , really it is.

The medicine are research to find out the successful factor is depend on how to rehab by yourself and the age.   My cause is too much sport  also natural factor , OS said.

Most of the patient who youngster are fully recovery  from plica removal .  it's including me coz  I'm just 24 and athlete.   

I'm going to get the OR again on my right knee have medial plica. I can't let it grown up anymore  because it's bother me discomfort so much and hard to running or play sports.

I went to see the OS , I met 3  different OS this month before to decide to accept the arthroscopic  to plica removal again. They are all to agree with this  surgery is the best option for me.   I know my left knee is not back to normal yet.  Sometime I feel spasm on the knee cap and better  less pain then before surgery. I'm very glad with the post-op result.

The OS said it will be normal in 6 months post-op.

He look very confidence  on me  to offer the  surgery  on  right knee again.   He didn't guarantee on this time and said it can help you back to running again and less pain then the moment.   

at the first question is did you go to see the anatomy of the knee ?  where is the plica location at ?   


you will see the fold is sticking too much , yes it's  too sticker !   well , sound like you hitting the knee.. i get that..

I think that why too slowly recovery to adopting inside the knee after plica removal  because the knee structure are change.

But hey , I'm still worry it will be grow back on 10 years later.  my sixth sense told me that..  >:(


Offline fire535

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Re: Why iis plica removal so difficult to recover from?
« Reply #9 on: August 02, 2010, 05:58:56 PM »
To the post below, your English is ok, but some of it is poorly constructed,  I would loved to go to Thailand someday, hope you have a full recovery.

Offline kris_83

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Re: Why iis plica removal so difficult to recover from?
« Reply #10 on: August 03, 2010, 11:58:13 AM »
kscope- I know we have passed in these plica discussions before, but what kinds of symptoms were you having presurgery and what problems are you having now? I have read about the plica possibly growing back and wonder how long that takes. I'm not sure if my surgeon took the whole thing out or just some of it.

Before surgery I had awful catching sensations and inflammation that was far-reaching: my patellar tendon was inflamed, I had sharp, shooting pains going all the way up to my groin, basically I was a mess. Not sure how much of that was related to the plica, but after my surgery the inflammation outside of the direct patellar area is now completely gone.

I read the article you posted a while back and it seems that plica excision isn't really a quick fix. I'm almost 2 months post-op now, and still having some soreness, aching, stiffness and weird twinges and blasts of pain. From what I understand, that's pretty normal. I'm also not sure how much of my pain is left over from the chrondro... can you tell the difference in the location of your soreness?

Before the surgery there were days I couldn't walk. Just someone touching my knee was excruciating and no one could tell me why. I hope to not have aches and pains forever, but I am definitely way better off than I was before.
12/09 dx- patellar subluxation (not!)
1/10 mri- neg; PT rx failed
4/10 more PT
5/10 dx patellar hypertension
6/7/10 chrondroplasty, patellar decompression, synovectomy and plica excision
5/6/11 dx RA, sjogren's

Offline kscope09

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Re: Why iis plica removal so difficult to recover from?
« Reply #11 on: August 03, 2010, 04:47:48 PM »
Presurgery there was lots of catching and pain.  The patella felt like it was jumping about and I couldn't bring my leg straightforward and back without it feeling weird.  Pains were mostly  blasts, twinges and stabs but they seemed mostly to be the esult of part of my acl being stuck down the side so I've always put that down to most of my symptoms.  With the fragmnt taken out my knee moves backwards and forwads a million times better but there is a lot of pain and soreness just above the lateral arthroscopy portal which ranges from 1-about 11 (out of 10( and seems to be totally random.

Friction massages and ultrasound seem to help andsquatting seems to aggrivate t but not alays.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: Why iis plica removal so difficult to recover from?
« Reply #12 on: August 03, 2010, 05:14:28 PM »
I found out last week Wednesday that I have scar tissue around the lower half of my kneecap by portal area after having an ultra sound scan. I so far had one steroid injection and its not helped and my physio did friction massage  last week Saturday and so far thats not hepled so the next option is another scope to remove the scar tissue.

I had a chat with a KG member yesterday and she told me she had her medial plica removed and had to have another scope to remove scar tissue. Its fairly common to have alot of scar tissue after having had your medial plica removed. I been told by my physio that the reason I unable to run could be due to scar tissue. And now know why I cannot kneel or squat without feeling pain at the bottom of my kneecap due to scar tissue.

I keep you guys informed on what happens next time I see my OS, I am fine about having a 2nd scope as I really would like to run again if it happens! There a risk that it could make my knee even worse but willing to risk it as the main reason last time for having a scope was to start running again.

Nick  :) {2010} :)

RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kris_83

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Re: Why iis plica removal so difficult to recover from?
« Reply #13 on: August 04, 2010, 10:52:04 AM »
Thanks for the update Nick! I am definitely interested to see what happens with your OS appointment. Because I had some issues with patellar mobility post-surgery, my OS was a little concerned about scar tissue developing. It also seems pretty common. I'm still having the issues with kneeling also... for now, honestly, I've stopped trying.

Why would scar tissue removal make your knee worse? I understand that it probably just comes back again, but wouldn't you be better for a bit while it's all cleared out?
12/09 dx- patellar subluxation (not!)
1/10 mri- neg; PT rx failed
4/10 more PT
5/10 dx patellar hypertension
6/7/10 chrondroplasty, patellar decompression, synovectomy and plica excision
5/6/11 dx RA, sjogren's

Offline kscope09

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Re: Why iis plica removal so difficult to recover from?
« Reply #14 on: August 04, 2010, 10:59:36 AM »
Charkey - The friction massage does sometimes take a few days to take effect.  Wen I first had it done, it took about four or five days of really bad soreness before it felt OK again.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o