What is the most common symptomatic plica and how to treat it?

Updated: Jul 05, 2018
  • Author: Tracy Lee Bigelow, DO; Chief Editor: Thomas M DeBerardino, MD  more...
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Answer

The most common symptomatic plica is medial parapatellar plica. Surgical intervention for plica syndrome should be considered when symptoms have persisted and efforts at nonoperative management have failed for a period typically approaching 6 months. Permanent modification of athletic activity is usually another option, but patients rarely find it acceptable. Moreover, surgical treatment offers such predictable results that withholding treatment could arguably be considered ethically questionable. Longer periods between symptom onset and surgical treatment appear to be associated with cartilage damage. [37]

Patients with absolute contraindications for surgical treatment include those who are considered unfit for surgery from a medical standpoint. Active soft-tissue infection around the knee that precludes the use of standard arthroscopic portals is another contraindication. Relative contraindications include hypercoagulability syndromes that predispose the patient to thrombotic complications, as well as excessive risk for reflex sympathetic dystrophy (RSD).


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