| Presentation |
- Symptoms
- snapping sensations
- buckling
- knee pain on sitting
- pain with repetitive activity
- Physical exam
- tenderness in the medial parapatellar region
- painful, palpable medial parapatellar cord
- can be rolled and popped beneath the examiners finger
- provacative test
- hold the knee in full extension while examiner tries to flex against the patient’s resistance.
- the examiner again pushes the patella medially while palpating its medial border.
- pain produced with or without a click is considered a positive test.
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| Imaging |
- MRI
- can detect plica but has low sensitivity
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| Treatment |
- Nonoperative
- activity restriction, NSAIDS, and physical therapy
- indications
- most cases can be treated nonoperatively
- physical therapy
- moist heat applications
- hamstring stretching
- resistive strengthening exercises are avoided in early rehabilitation phases
- Operative
- arthroscopic resection of lesion
- indications
- only utilized in rare cases of plica band syndrome not responding to nonoperative treatment
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