Richard Haynes PTA/CPT - 1/1/2009

Question
I had ACL replacement surgery in spring '07 using a quadriceps tendon autograft.  All's ok except that, starting ~6 months after surgery, I developed a grinding/crunching sound in my operated knee; it occurs any time I extend my knee from 90 degrees or more of flexion.  Not much pain yet.  The patella is fairly tight too, I can move it with my hand less than on the other knee (it loosens up a little if I stretch it manually).  I've seen several doctors and they all told me not to worry about it, but that's hard to do.  I just had an MRI done a few days ago and the radiologist saw arthritis; the surgeon's report indicated no cartilage damage post-op.

What are the prospects of this crepitus going away?  Are there any exercises I can do to reduce/eliminate it?  Will it evolve soon into arthritis requiring some major measures?  Is it better to stop high-impact sports (I do karate) and just do swimming and biking?

Answer
G.M.

The crepitus sound may be with you for some time if not permanently.
That sound though it may not sound good if it does not hinder the operation of the knee or cause severe pain I would not be too concerned as the surgeon indicates.

In time we all will develop crepitus or joint noise that also is just part of wear and tear of the knees.

There are no exercises to my knowledge that are designed specifically to get rid of the noise.

Arthritis can develop in any knee that has been repaired  due to a traumatic injury or as we age in the thigh muscles begin to weaken they do not support the knee as well and the joint absorbs more impact and arthritis develops.

Check with the surgeon on the activities but I feel that once the ACL is healed completely you should be able to get back to all your activities.

Football players return to high impact activities after ACL surgeries for instance.

Use your judgement on this, consider your age whatever it is and it depends on your confidence level with the knee.

Good Luck
Richard Haynes
Punta Gorda, Florida.
www.rhaynes.blogspot.com
www.richardhaynes.com