Synovial Plica Syndrome of the Knee: A Commonly Overlooked Cause of Anterior Knee Pain

AbstractSynovial plica syndrome (SPS) occurs in the knee, when an otherwise normal structure becomes a source of pain due to injury or overuse. Patients may present to general practitioners, physiotherapists, or surgeons with anterior knee pain with or without mechanical symptoms, and the diagnosis can sometimes be difficult. Several studies have examined the epidemiology, diagnosis, and treatment of SPS. We review these resources to provide an evidence-based guide to the diagnosis and treatment of SPS of the knee.

Download Full-text

Bilateral Patella Cartilage Debridement and Exercise Rehabilitation for Chondromalacia and Plica Syndrome: A Case Report

Applied Sciences ◽

10.3390/app11094078 ◽

2021 ◽

Vol 11 (9) ◽

pp. 4078

Author(s):

Jihong Park ◽

Jingoo Kim ◽

Bongseong Ko

Keyword(s):

Knee Joint ◽

Functional Outcome ◽

Outcome Measures ◽

Knee Pain ◽

Anterior Knee Pain ◽

Water Immersion ◽

Sensory Level ◽

Plica Syndrome ◽

Functional Outcome Measures ◽

Anterior Knee

A 41-year-old active (exercising >600 min per week) male without a surgical history complained of nine years of intermittent bilateral anterior knee pain after physical activity. He was diagnosed with bilateral chondromalacia (grade IV chondrosis) with plica syndrome, for which he underwent bilateral patella cartilage debridement with medial plica excision (additional removal of lateral retinaculum in the right knee). The patient then performed 12 weeks of an aggressive postoperative rehabilitation program. Each rehabilitation session consisted of disinhibitory modalities (sensory level of transcutaneous electrical stimulation and cryotherapy: focal knee joint cooling and cold-water immersion) and voluntary exercises (aerobic, resistance, and flexibility). During rehabilitation, pain perception, knee joint skin temperature and circumference, and functional outcome measures (Kujala anterior knee pain scale, International Knee Documentation Committee Score, and lower-extremity functional scale) were also recorded. While the patient’s pathology and surgical intervention were not extreme, progressions in the rehabilitation components and functional outcome measures in this clinical case could be used as a future reference for postoperative interventions. Additionally, surgery-induced inflammation seemed to last for four weeks.

Download Full-text

Anterior Knee Pain: Diagnosis and Treatment

Principles of Orthopedic Practice for Primary Care Providers ◽

10.1007/978-3-319-68661-5_19 ◽

2017 ◽

pp. 313-327 ◽

Cited By ~ 1

Author(s):

Kaitlyn Whitlock ◽

Brian Mosier ◽

Elizabeth Matzkin

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Diagnosis And Treatment ◽

Pain Diagnosis ◽

Anterior Knee

Download Full-text

The development of an evidence-based clinical checklist for the diagnosis of anterior knee pain

South African Journal of Physiotherapy ◽

10.4102/sajp.v73i1.353 ◽

2017 ◽

Vol 73 (1) ◽

Cited By ~ 1

Author(s):

Dominique C. Leibbrandt ◽

Quinette Louw

Keyword(s):

Knee Pain ◽

Systematic Reviews ◽

Anterior Knee Pain ◽

Pain Syndrome ◽

Stair Climbing ◽

Tilt Test ◽

Evidence Based ◽

Duration Of Symptoms ◽

Prolonged Sitting ◽

Anterior Knee

Background: Anterior knee pain (AKP) or patellofemoral pain syndrome is common and may limit an individual’s ability to perform common activities of daily living such as stair climbing and prolonged sitting. The diagnosis is difficult as there are multiple definitions for this disorder and there are no accepted criteria for diagnosis. It is therefore most commonly a diagnosis that is made once other pathologies have been excluded. Objectives: The aim of this study was to create an evidence-based checklist for researchers and clinicians to use for the diagnosis of AKP. Methods: A systematic review was conducted in July 2016, and an evidence-based checklist was created based on the subjective and objective findings most commonly used to diagnose AKP. For the subjective factors, two or more of the systematic reviews needed to identify the factor as being important in the diagnosis of AKP. Results: Two systematic reviews, consisting of nine different diagnostic studies, were identified by our search methods. Diagnosis of AKP is based on the area of pain, age, duration of symptoms, common aggravating factors, manual palpation and exclusion of other pathologies. Of the functional tests, squatting demonstrated the highest sensitivity. Other useful tests include pain during stair climbing and prolonged sitting. The cluster of two out of three positive tests for squatting, isometric quadriceps contraction and palpation of the patella borders and the patella tilt test were also recommended as useful tests to include in the clinical assessment. Conclusion: A diagnostic checklist is useful as it provides a structured method for diagnosing AKP in a clinical setting. Research is needed to establish the causes of AKP as it is difficult to diagnose a condition with unknown aetiology.

Download Full-text