PLICA SYNDROME.
DEFINITION
– Plica syndrome is a fold of synovium present in suprapapatellar, infrapatellar and mediopatellar aspects of knee joint.
– It can get injured during trauma to the knee joint, Anterior crucial ligament tear and hemarthrosis leading to knee pain.
– When it is injured, there will be inflammation and pain is felt over an area medial to patella.
– Pain increases after long sitting or knee flexion movements as the Plica is compressed in between patella and the femoral condyle.
– At later stage : Plica becomes tough inelastic fibrotic band.
– Presence of the Plica syndrome can be confirmed by the pain on medially displaced patella with knee flexion to 30° .
– Patella skips or seems to jump while performing active knee extension b/w the range 60 – 45° , as it passes over Plica.
– A false positive McMurray’s sign may be present.
• Treatment
– Conservative management : routine knee rehabilitation programme.
– Transverse friction massage over Plica
– Hamstring stretching.
– If conservative treatment fails, Arthroscopy or arthroscopic surgery can be done to excise Plica .
•Physiotherapy management
– Arthroscopic surgery is minimally invasive technique.
– Exercises are initiated early.
– Hence, return to function is much more rapid.
– Strength and adaptibility of repaired tissue to functional activities is important.
– Full weight bearing can be initiated safely by 2 weeks following cast removal.
