The synovial plica essentially represents a remnant of the synovial membrane within the knee joint, which originates during embryonic development of the knee. These embryological remnants are usually resorbed before birth; however, in some individuals, they may persist and gradually disappear later in life.In the majority of cases, synovial plicae are asymptomatic and do not cause pain or discomfort. There are, however, instances in which these remnants fail to resorb and remain in the knee joint, leading to painful symptoms. When this occurs, the condition is referred to as Plica Syndrome.Plica Syndrome develops when repetitive friction of the medial femoral condyle results in hypertrophy or loss of elasticity of the synovial fold. The condition is most commonly observed in children, adolescents, and young adults, primarily due to overuse of the knee joint.
Causes of Synovial Plica Syndrome
Synovial Plica Syndrome may develop as a result of:
- Overuse of the knee joint
- Exercises involving repetitive knee movements, such as running, cycling, and similar activities
- Increased physical activity
- Knee trauma
- Accidental falls
- Hematoma formation
- Muscular weakness
- Rotational injuries
Symptoms of Synovial Plica Syndrome
The hallmark of Synovial Plica Syndrome is pain localized to the knee joint. However, pain is not the only clinical manifestation. Additional symptoms may include:
- Knee swelling
- Audible clicking sounds during knee flexion or extension
- Sensation of knee locking, particularly during squatting
- Difficulty performing deep squats
- Difficulty ascending or descending stairs
- Sense of instability
- Reduced range of motion
- Accumulation of fluid within the joint (effusion)
Diagnosis of Synovial Plica Syndrome
Synovial Plica Syndrome can be diagnosed through a combination of assessments, including Medical history review,Physical examination and Magnetic Resonance Imaging (MRI) and/or X-ray imaging.
Treatment of Synovial Plica Syndrome
The management of Synovial Plica Syndrome is primarily surgical. However, conservative therapy may provide temporary relief from symptoms. Conservative measures include:
- Rest and avoidance of activities that aggravate the symptoms
- Limiting knee flexion to no more than 90 degrees_
- Physical therapy programs
- Cryotherapy
- Anti-inflammatory medications (NSAIDs)
The most effective treatment remains surgical intervention, performed via arthroscopy. This minimally invasive approach allows for Small incisions,Reduced pain,Excellent clinical outcomes and Accelerated postoperative recovery.Patients typically do not require hospitalization and can be discharged approximately 2 hours post-procedure without the need for crutches. Many are able to resume driving and return to work the following day.Full recovery varies among patients and depends on multiple factors, including overall health, the postoperative course, and individual knee response.
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