Treatment of Pathological Synovial Plicae of the Knee

Abstract

OBJECTIVE:To analyze the incidence, clinical significance, and clinical manifestations of pathological synovial plicae of the knee.MATERIAL AND METHODS:Between 2002 and 2006, 63 patients with pathological synovial plicae of the knee were studied. Of those 63 patients, 21 had the diagnosis confirmed by previously performed magnetic resonance imaging. All of the patients initially underwent conservative treatment for 90 days that involved strengthening and improving the flexibility of the muscles surrounding the knee as well as modification of their sports activities.RESULTS:A total of 55 patients improved after conservative treatment. Six of these patients eventually experienced a recurrence of symptoms, but the symptoms were not incapacitating in any of these patients. The other eight patients underwent arthroscopic removal of the synovial plica. Of these eight patients, six returned to their pretreatment physical activities, and two had persistent symptoms during physical activity.CONCLUSION:The presence of a synovial plica of the knee should be considered as a potential diagnosis in patients with knee pain, especially those who practice sports inappropriately. Conservative treatment is effective in most cases, and surgical treatment should be reserved for exceptional cases that do not improve with conservative treatment.

Medial Plica Syndrome of the Knee: Arthroscopic Plica Resection versus Structured Physiotherapy—A Randomized Controlled Trial

“…Very few studies have examined the outcome of conservative treatment of patients with plica syndrome, one of the most relevant being treatment of pathological synovial plicae of the knee. 9 13 The conclusion that surgical treatment should be reserved for exceptional cases is hereby drawn from the fact that 78% of patients were free of symptoms after undergoing conservative treatment involving strengthening and improving the flexibility of muscles surrounding the knee. However, the report by Camanho 9 does not rigorously differentiate between medial and suprapatellar plicae.…”

“…No randomized controlled trial has ever elucidated the effect of physiotherapy in the treatment of medial plica syndrome. The presumed positive effect of physiotherapy is mostly derived from reports like by Camanho titled “Treatment of pathological synovial plicae of the knee.” 9 The conclusion that surgical treatment should be reserved for exceptional cases is drawn from the fact that 78% of patients were free of symptoms after undergoing conservative treatment involving strengthening and improved flexibility of muscles surrounding the knee. Arthroscopic plica excision commonly shows good clinical results as reported by Schindler in the meta-analysis of the Sneaky Plica, which identifies 23 studies assessing the clinical outcome of 969 patients following open or arthroscopic plica excision.…”

[ARTIGO RETRATADO] Revisão dos artigos sobre ortopedia recentemente publicados na imprensa científica brasileira

“…They maintain that detected alterations in the foot rollover process during gait may be used to develop clinical interventions using insoles, taping and therapeutic exercise to rehabilitate this dysfunction. Camanho 7 analyzed the incidence, clinical significance, and clinical manifestations of pathological synovial plicae of the knee and claim that the presence of a synovial plica of the knee should be considered as a potential diagnosis in patients with knee pain, especially those who practice sports inappropriately. Angelini et al 8 compared the accuracy of tunnel placement and graft isometry for anterior cruciate ligament reconstruction performed using a computer-assisted navigation system (Orthopilot), and traditional instruments instruments.The anterior cruciate ligament was removed intact from 36 pairs of human cadaver knees.…”

The locomotor system as seen in Brazilian scientific journals: a mini review

“…As might be predicted the knee is the most frequently examined anatomical subject, with 12 selected papers: knee stability and mechanics is the object of four papers; 2 , 3 , 16 , 36 ­ anesthetic procedures for knee surgery is discussed in 2 articles; 27 , 34 various forms of knee injury are discussed in four articles; 5 , 10 , 13 , 70 one articles examines the properties of synovial plicae 30 while one deals with osteoarthritis. 32 …”