Date of Award

7-2020

Document Type

Thesis

First Advisor

Mohamed Elhamadany

Keywords

Synovial plica, Athlete, arthroscopic knee surgery for a plica resection.

Abstract

Background and Purpose. Synovial plica is a common abnormality found primarily in the knee joint. Plicae can become irritated and inflamed with repeated motions causing pain and limited range of motion. Conservative management of symptoms is often the first method of treatment. However, surgical excision is considered if symptoms still persist.

Case Description. The patient is a 16-year-old female referred to physical therapy (PT) for post-arthroscopic management of a left plica resection and partial synovectomy. The patient presented with limited strength, range of motion and increased pain, congruent with her post-operative condition. The patient was seen by PT 2 times per week for 7 weeks.

Intervention. Physical therapy management focused on implementing blood flow restriction training (BFR) along with neuromuscular reeducation (NMR), stretching, and gait training to improve her overall functional status and return to prior level of function.

Outcomes. The patient’s Focus on Therapeutic Outcome Measure (FOTO) score improved from a 62/100 to a 84/100, visual analog scale (VAS) from a 3/10 to a 0/10, and improved strength from a 3/5 to 5/5 in the left lower extremity. The patients left knee range of motion was also normalized to >120 degrees of flexion and 0 degrees of extension.

Discussion. This case report outlines how a combination of BFR training, NMR, stretching, and gait training can improve the functional status of a patient post- arthroscopic plica resection. Limited literature is available on post-operative management for patient who had undergone arthroscopic knee surgery for a plica resection. More research is needed to define the appropriate PT treatment methods for those with a similar post-operative condition.

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