Many people complain of crepitus in the knee joint, but most often it is harmless. The “cracking” or “crunching” sound often occurs when standing up or performing some type of exercise. There is a theory that the popping sound occurs because air bubbles are caught in between the tissues and then burst, creating the sound.

Crepitus in the knee joint can occur in people of all ages but it tends to be more common with advancing age. The sound may be loud or soft but this is not indicative of the degree of pathology.

But does crepitus signal something ominous in the knee joint?

Most orthopedic surgeons, including Dr. Karkare, say that in most cases, crepitus is harmless if it occurs in normal people. But if crepitus is associated with an injury, or, if there is knee pain or swelling, then further investigations are required.

What are causes of crepitus?

There is a theory that popping sounds arise due to the air bubbles passing through the soft tissues and find their way around the knee joint. These air bubbles then mix with synovial fluid and when the knee is bent, the bubbles burst and a cracking sound is heard. While the popping sound may be loud, it is usually harmless.

However, crepitus is also known to occur when cartilage rubs on the joint surface when the knee joint is mobile. This usually occurs when the cartilage is thin and worn out. In this case, medical attention may be necessary.

If crepitus is associated with pain or the knee joint catches, this may be due to a meniscus tear, scar tissue or a tendon passing over a protuberant bony fragment. Swelling and pain of the knee joint with crepitus may be indicative of osteoarthritis, patellofemoral pain syndrome or torn cartilage. In these scenarios, the crepitus may occur while climbing a staircase, or sitting for a prolonged time with the knees crossed.

Crepitus following surgery: Crepitus is quite common after surgery on the knee joint. This type of crepitus is felt to be self-limited and benign, and no intervention is usually required. However, if the crepitus is associated with pain, it may be an indication for a minor debridement of the joint to remove any debris.

How do you protect the knees?

Orthopedic surgeons say that the best way to protect the knee is to warm up prior to exercise. By strengthening the quadriceps, one can decrease the load on the patellofemoral joint and also reduce the risk of eroding the cartilage. Other means of protecting the knee include stretching and wearing suitable shoes. It is also important to maintain a healthy weight to decrease stress on the knee joint.

If crepitus occurs during exercise, one should:

– Not stop but modify the exercise

– Avoid running on hills or inclines

– When cycling, maintain tension on the pedals

– If you are using quadriceps to lift weights, use lightweights and increase the frequency

Finally during an exercise listen to your body, if you develop pain, stop the activity.



Can Knee Replacement Help?

Dr. Nakul Karkare - NY Orthopedic Surgeon If there’s nothing else wrong with your knees besides Crepitus then you should probably not have knee replacement surgery.

Custom knee replacements can be a good option for many men and women, but they’re not for everyone.

Generally speaking, custom implants are not ideal for patients who have had prior knee surgery or who have injured ligaments.

Patients who are not eligible for CT scan are also not good candidates for custom knee replacements.

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