Removal of a Plica (Plicectomy)
A plica is a fold in the membrane which lines the joint. Sometimes, for a variety of reasons, a plica can become swollen, thickened and inflamed; in this situation it may interfere with normal functioning of the knee causing symptoms such as clicking, locking, giving way and stiffness. There are two plicae which are most commonly affected – the supra-patellar plica situated just above the kneecap, and the medial plica which is usually felt just adjacent to the inner edge of the kneecap.
Often an inflamed plica will settle with rest, anti-inflammatory tablets and appropriate physiotherapy, but sometimes removal of the plica is necessary.
This is a simple procedure from which recovery is usually quick and problem free. If you have a sedentary occupation you may only require a few days off work. Physiotherapy is aimed at obtaining normal movement, strength and full activity as soon as possible after any swelling has settled down. This can be as little as 2-3 weeks, but is obviously variable from patient to patient.
The very nature of the “lateral release” procedure means that the knee may become quite swollen post-operatively although, with new instruments used in surgery, this is less common. Some swelling is expected and is not a problem, but does mean that you will need to curtail your activity to allow inflammation to settle. The physiotherapist will guide you on increasing exercise gradually. It may take up to four to six weeks to perform everyday activities, and three months to return to sport. Time needed off work will be dependant on your occupation – if unsure discuss this with the physiotherapist or doctor.
Exercises you may be given to strengthen the muscles which control movement of the patella:
Occasionally an “egg-like” swelling on the outside of the knee develops, this should not cause alarm – it will gradually settle. Bruising in the lower leg can also sometimes be quite severe, but this is usually a result of bleeding at the time of surgery, which “tracks” down the leg. Again, do not be alarmed, it is not usually sore and disappears after a few days.
If swelling becomes excessive and painful, DO contact the clinic for advice. If we feel it necessary you will be seen straight away.