eMedicine Specialties > Sports Medicine > Knee

Medial Synovial Plica Irritation: Follow-up

Author: Robert F LaPrade, MD, PhD, Professor, Department of Orthopaedic Surgery, Divisions of Sports Medicine and Shoulder Services, University of Minnesota
Contributor Information and Disclosures

Updated: Oct 15, 2007

Follow-up

Return to Play

Patients/athletes may return to participation in sports based upon their symptoms. Athletes are recommended to start out slowly and observe how their knee reacts overnight, before advancing their workout/exercise regimen. This gradual progression is important to follow because plical irritation appears to involve some tissue inflammation, which may take hours to develop after activities. Usually, it is safe to say that if a patient does not have pain or swelling with an activity, that it is safe to continue or attempt to advance in that activity.

Complications

Nonoperative complications include continued medial synovial plical irritation, which over time could potentially lead to a fibrotic plica. The most common complication, which is a poorer result than a complication, is increased pain after surgical debridement due to increased scar-tissue formation after surgery. The best way to avoid these complications is to make sure that the patient is enrolled in an appropriate physical therapy or home exercise program.

Prevention

The best way to prevent continued medial synovial plical irritation is to avoid those activities that cause irritation and to address the problem that caused the plical irritation in the first place. Such prevention strategies would include surgery to address meniscal tears or cartilage flaps or enrollment in a proper physical therapy program for those with patellofemoral dysfunction.

Prognosis

The overall prognosis for most patients with medial synovial plical irritation is good. Most patients will respond to a physical therapy program within the first 6-8 weeks, with most of the other patients responding over the next few months. Surgical intervention for a medial synovial plica should be reserved for those patients in whom all other modalities previously described in this article have failed (see Treatment, Acute Phase, Rehabilitation Program and Other Treatment).

Education

Most patients need to be instructed in a home exercise program to address their underlying quadriceps weakness and hamstring tightness. In addition, many of these patients may have a recurrence of some symptoms over time. Patients need to be informed of this possibility and be instructed to work on a home exercise program first, before consulting their physician's office, because they can frequently have an alleviation of symptoms with their home exercise program.

 


More on Medial Synovial Plica Irritation

Overview: Medial Synovial Plica Irritation
Differential Diagnoses & Workup: Medial Synovial Plica Irritation
Treatment & Medication: Medial Synovial Plica Irritation
Follow-up: Medial Synovial Plica Irritation
Multimedia: Medial Synovial Plica Irritation
References
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References

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Further Reading

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Keywords

suprapatellar plica, medial retinaculum

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Contributor Information and Disclosures

Author

Robert F LaPrade, MD, PhD, Professor, Department of Orthopaedic Surgery, Divisions of Sports Medicine and Shoulder Services, University of Minnesota
Robert F LaPrade, MD, PhD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Medical Editor

Anthony J Saglimbeni, MD, Staff Physician, Family Practice Residency, Medical Director, Center for Sports Medicine, O'Connor Hospital; Private Practice
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD, Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Sports Medicine Fellowship Director, Medical College of Wisconsin
Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa, and Wilderness Medical Society
Disclosure: Nothing to disclose.

 
 
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