Should I Undergo Knee Arthroscopy Again for Persistent Clicking Sounds?

Knee arthroscopy surgery

Hello Dr.
Chen: During high school, I injured my knee while playing basketball, and since then, I've been experiencing a "clicking" sound in my knee.
I underwent arthroscopic knee surgery in July of last year, but I haven't noticed much difference before and after the surgery; I still hear the "clicking" sound when I walk.
Should I consider having the arthroscopic knee surgery done again?

Xiao Yan, 20~29 year old female. Ask Date: 2014/03/25

Dr. Chen Yongxue reply Orthopedics

Dear Dr.
Chen,
I apologize for the garbled text in your previous message.
Here is the content:
During high school, I injured my knee while playing basketball, and since then, I have been experiencing a "clicking" sound in my knee.
I underwent arthroscopic knee surgery in July of last year, but I haven't noticed much difference before and after the surgery; I still hear the "clicking" sound when I walk.
Should I consider having another arthroscopic knee surgery? Please come to our orthopedic outpatient clinic for a detailed examination.
Thank you.

Reply Date: 2014/03/25

More Info

When considering whether to undergo knee arthroscopy again due to persistent clicking sounds, it is essential to evaluate several factors. First, it is important to understand that clicking or popping sounds in the knee can be relatively common and may not always indicate a serious underlying issue. These sounds can arise from various sources, including the movement of tendons, ligaments, or cartilage over the bony structures of the knee. In many cases, these sounds do not correlate with pain or functional impairment.

In your situation, you mentioned that you underwent knee arthroscopy last July, but you have not noticed significant improvement in your symptoms, particularly the clicking sounds. This raises a few considerations:
1. Nature of the Clicking Sound: The clicking sound you experience could be due to several benign causes, such as the movement of the patellar tendon or the meniscus. If the sound is not accompanied by pain, swelling, or instability, it may not warrant further surgical intervention.

2. Previous Surgery Outcomes: It is crucial to assess the outcomes of your previous arthroscopy. If the surgery was intended to address a specific issue (like a meniscal tear or loose bodies) and those issues were resolved, but the clicking persists, it may indicate that the sound is not related to a surgical problem. On the other hand, if the surgery did not address the underlying cause of your symptoms, further evaluation may be necessary.

3. Consultation with a Specialist: Before deciding on another arthroscopy, it is advisable to consult with an orthopedic specialist. They can perform a thorough clinical examination and may recommend imaging studies, such as an MRI, to evaluate the knee's internal structures. This can help determine if there are any new or unresolved issues that could be contributing to your symptoms.

4. Non-Surgical Options: In many cases, conservative management can be effective. Physical therapy focusing on strengthening the muscles around the knee, improving flexibility, and enhancing overall joint function can often alleviate symptoms. Additionally, activity modification and the use of supportive devices may help manage any discomfort.

5. Risks of Repeat Surgery: Every surgical procedure carries inherent risks, including infection, bleeding, and complications related to anesthesia. Additionally, repeat arthroscopy may not guarantee a resolution of symptoms and could potentially lead to further complications or prolonged recovery.

6. Long-Term Management: If the clicking sound is not associated with pain or functional limitations, it may be beneficial to adopt a long-term management strategy that includes regular monitoring, physical therapy, and lifestyle modifications rather than pursuing another surgical intervention.

In summary, while the persistent clicking sounds in your knee may be concerning, they do not automatically necessitate a repeat arthroscopy. A comprehensive evaluation by an orthopedic specialist is essential to determine the best course of action based on your specific circumstances. Non-surgical management strategies may provide relief and improve your knee function without the need for additional surgery.

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