Medial Synovial Plica Irritation Follow-up

Updated: Mar 10, 2017
  • Author: Robert F LaPrade, MD, PhD; Chief Editor: Craig C Young, MD  more...
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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.

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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.

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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.

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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).

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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.

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