Knee Plica Surgery?
POSTED ON 11/25/2012 IN Knee BY Christopher Centeno
A Google search under Knee Plica Surgery yields many other searches such as Knee Plica Recovery and Knee Plica Surgery Recovery Time. First, what the heck is a plica and why are so many patients concerned about recovery and recovery time? The general concept is that the normal synovial covering of the knee joint is getting pinched and irritated by the knee cap, which is causing pain. Think of this covering as something that normally moves in and out of the space between the knee cap and it's groove. When the knee cap spends too much time with pressure on one side of the groove or places too much pressure there, you can bet that this tissue will become irritated. Add in the fact that the normal stem cell population in this tissue declines as we age, and tissue that may have been very capable of keeping up with this extra pressure when you were 20 has a hard time keeping up when you're 40. The surgery involves cutting this piece of irritated tissue out. One issue with removing this piece of synovial membrane is that this tissue is very rich in stem cells that normally help to maintain the overall health of the knee.
All of this talk of surgically removing the irritated tissue begs the question, how did the plica get there in the first place? It got there because the knee cap isn't tracking well in it's groove, so cutting it out surgically makes about as much common sense as cutting off the callouses on your hands because you work in the garden! If a surgeon is telling you need a plica cut out, spend some time trying to figure out the cause of why your knee cap tracking might be off and/or looking at treatments for bad patellofemoral tracking. Another potential solution is ramping up repair in the knee by adding growth factors or stem cells. The upshot? IMHO plicas are the end result of another problem, so cutting them out rather than addressing the issue that caused them makes no sense. Think about it this way. Let's say the tires on your car are wearing unevenly and your car is pulling to one side. You decide to solve the problem by cutting off the thick parts of your tires to create a balanced ride rather than investigating why the tries are wearing unevenly in the first place! True Plica recovery isn't usually surgical, it's bio mechanical or biologic.
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