Knee Issues: Sounds, Pain, and Treatment Options

Knee problems

Hello, Doctor:
1.
I would like to ask if the popping sound in my knee when bending and straightening it indicates a dislocation of the knee.
2.
Whenever I bend my right leg, I feel tightness above my knee.
What could be the cause of this?
3.
During my physical therapy sessions, the therapist advised me not to bend my legs while sitting on a chair, as it puts significant pressure on the knee.
They suggested keeping my legs straight.
However, after a long day at work, I often find myself relaxing at home with my legs bent on the chair.
Does this really put pressure on my knee?
4.
Additionally, I have been experiencing long-term pain in my left knee without a clear diagnosis.
Some doctors say it is degenerative, while others disagree, but I cannot achieve full recovery.
I considered getting an MRI, but one doctor mentioned that it may not reveal anything, suggesting that the pain could be due to internal fibrosis.
If I undergo arthroscopy, what are the risks involved? Can arthroscopy accurately identify the cause of my knee pain? Will I need rehabilitation after the surgery? I apologize for the lengthy message, and I appreciate your detailed explanation.
Thank you.

Axiang, 40~49 year old female. Ask Date: 2023/07/14

Dr. You Dianqi reply Orthopedics

It is advisable to seek evaluation at an orthopedic outpatient clinic at a regional hospital or higher.
Thank you.

Reply Date: 2023/07/14

More Info

Hello! Thank you for your detailed questions regarding your knee issues. Let's break down your concerns one by one.

1. Knee Sounds: The "pop" or "click" sound you hear when bending or straightening your knee is not uncommon. This can occur due to various reasons, such as the movement of tendons or ligaments over the bones, or the presence of air bubbles in the joint fluid. However, if this sound is accompanied by pain or instability, it could indicate an underlying issue, such as a meniscus tear or cartilage damage. It's essential to monitor whether these sounds are associated with discomfort or functional limitations.

2. Tightness Above the Knee: The tightness you feel above your knee when bending your right leg could be due to several factors, including muscle tightness, tendonitis, or even issues related to the patellar tendon. If the quadriceps or hamstring muscles are tight, they can create a sensation of pulling or tightness in the knee area. Stretching and strengthening exercises, as guided by a physical therapist, can help alleviate this tightness.

3. Sitting Position and Knee Pressure: Your physical therapist's advice to avoid bending your knee while sitting is based on the principle of reducing stress on the knee joint. Sitting with your knee bent can increase pressure on the patellofemoral joint (the joint between the kneecap and the thigh bone), which may exacerbate pain or discomfort, especially if there is any underlying condition. However, it's also important to find a comfortable position, especially after a long day at work. If you find that keeping your knee straight is uncomfortable, try to alternate between positions to relieve pressure without causing strain.

4. Chronic Knee Pain and MRI Concerns: Chronic knee pain with no clear diagnosis can be frustrating. If a doctor suggests that an MRI may not provide useful information due to suspected fibrosis, it might be worth seeking a second opinion. An MRI is generally a valuable tool for visualizing soft tissue structures, including cartilage, ligaments, and menisci. If there is a concern about fibrous tissue causing pain, a diagnostic arthroscopy (a minimally invasive procedure using a camera to visualize the inside of the joint) could be beneficial. This procedure can help identify the exact cause of pain and allow for treatment at the same time.

Risks of Arthroscopy: Like any surgical procedure, arthroscopy carries risks, including infection, blood clots, and complications related to anesthesia. However, it is generally considered safe and can provide significant insights into the condition of your knee. The recovery period varies, but rehabilitation is typically necessary to restore strength and function post-surgery.

In summary, it is crucial to address your knee issues comprehensively. Consider consulting with an orthopedic specialist who can evaluate your symptoms, possibly recommend imaging studies like an MRI, and discuss the potential benefits and risks of arthroscopy if needed. A tailored rehabilitation program can also significantly improve your knee function and alleviate pain. Remember, early intervention can often lead to better outcomes, so don’t hesitate to seek further evaluation and treatment.

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