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Knee Popping after Meniscus Surgery: What does it mean?

Many people experience knee popping or other cracking sounds as a result of their meniscus surgery. While this can be uncomfortable and irritating, knee popping is fairly common and normal. This article will serve to provide more information on how to minimize knee popping, discuss why it happens, and provide other helpful information regarding knee function, knee injury, knee surgery and recovery.

Anatomy and physiology of the kneeLateral view of knee tendons, ligaments and bones.

Bones

The 4 main bones involved in the knee joint include:

  • Femur
  • Patella
  • Tibia
  • Fibula

Ligaments

To provide stability, many ligaments are involved in the knee joint:

Ligaments are a type of tissue that connect bone to bone. They are strong, fibrous, and absolutely necessary in the stabilization of the knee joint. The knee joint bears much weight and is made to allow for shock absorption, stability and balance. Thus, you will note in the list below the many different ligaments involved in the joint that allow for its movements, rotations, ability to sustain jumping, squatting and lifting movements.

  • Collateral ligaments
    • Medial collateral ligament (MCL)
    • Lateral collateral ligament (LCL)
  • Cruciate ligaments
    • Anterior cruciate ligament (ACL) – Studies have revealed that the ACL actually produces 85% of the stability, flexion and rotation of the knee joint. Because of its important and frequent usage, this is also one of the most commonly injured ligaments in the knee joint.
    • Posterior cruciate ligament (PCL)
  • Other stabilizing ligaments
    • Transverse, arcuate popliteal, oblique popliteal, popliteofibular, capsular, anterolateral, arcuate, and posterior oblique

Fibrocartilaginous Menisci

These disc like structures made of fibrous material and cartilage act as shock absorbers and friction reducers between the femur and the tibia bones. They are located on the inner and outer condyles of the femur. Condyles are the round, protruding parts of bones–usually on the head of large bones.

  • Medial menisci: This menisci is more fixed (doesn’t move as much), and therefore more likely to acquire an injury.
  • Lateral menisci: This menisci is more mobile (moves around some), and therefore less likely to acquire an injury.

Bursa

Four bursae, or fluid filled sacs in the knee joint help tendons and skin to move easily over the joint.

Common knee injuries

In thinking about the function and anatomy of your knees; how often you use them; and what you use them for, it is not surprising to learn that knee injuries are fairly common!

Bursitis

Bursitis is an inflammation or infection in the bursa. Symptoms may include pain, redness and swelling.

Damaged ligament

Inflamed, damaged or torn ligaments can be common, especially among athletes. The most common ligament injured is the anterior cruciate ligament (ACL). While there are a variety of ligament related injuries, this article focuses mainly on meniscus related injuries.

Torn Meniscus

A torn meniscus or sometimes referred to as “Twisting your knee” is when the meniscus is injured, damaged or torn. Remember that there are two menisci: the lateral and medial. The most common injury is to the medial meniscus, or the one closer to the center of the body in the affected knee. This meniscus has less movement and therefore does not absorb shock, or tolerate jerking and twisting movements as well as the meniscus on the lateral side.

What is a meniscus tear?

A meniscus tear is when the meniscus, or c-shaped disc that provides a cushion between the condyles of the femur bone and the tibia bone, is damaged or torn.

Risk factors

People who are female and who are older in age have a higher risk of knee injury. Athletes, especially athletes in contact sports or sports that involve pivoting (like basketball or tennis) are at a higher risk of tearing a meniscus as well.

Causes

Most tears occur after an activity where the knee is forcefully twisted or rotated (sudden stops and turns, pivoting, landing wrong after a jump). Other activities that can cause tearing may include heavy lifting, deep squatting and kneeling.

Symptoms

  • Pain
  • Swelling
  • Stiffness and/or locking of the joint
  • Popping sounds
  • Difficulty straightening leg completely

Meniscus tear repair options

  • Rehabilitation therapy
  • Steroid shots
  • Pain management with Ibuprofen or Naproxen, ice and rest
  • Using a brace
  • Arthroscopic Repair
  • Arthroscopic Partial Meniscectomy
  • Arthroscopic Total Meniscectomy

Meniscus Surgery

Before surgery

Is surgery for me?— The need for surgery really depends on the degree or severity of the meniscal tear. Sometimes, depending on where it is damaged it can heal itself; if the tear is deep enough it cannot repair itself and will likely need surgical repair.

Surgery may not be indicated if the meniscus tear is too old. It is preferable to do surgery on a tear that is less than 12 weeks old.

Surgery may not be recommended when the tear is horizontal. Vertical tears are easier to repair.

If for some reason the doctor is unable to repair the meniscus, in some cases they are able to do a partial repair or partial extraction of part of the damaged tissue.

Procedure

The most common procedure type for meniscus surgery is called arthroscopy. Essentially this is a procedure where a scope is inserted through the skin with a light and a camera on the end. This allows the physician to view the joint without making a large skin incision. The doctor can then insert tools under the skin and perform the surgery in this way.

How long does it take?

The surgery lasts approximately 30 minutes. It can be done as an outpatient procedure.

What kind of scar will I have?

There are a few small incisions made around the knee for this operation. Because it is arthroscopic, meaning tools are inserted into the holes and the surgery is done with the skin more or less intact, scarring is less and often fades over time.

Recovery

How long is the recovery?

Recovery time will depend on the severity of the injury and type of repair that was done. Generally, for about one month after surgery patients need to use crutches to keep weight off of the affected side. Some doctors may also require the use of a stabilizing device such as wearing either a cast or brace for the first few weeks after surgery as well.

If the meniscus was only partially injured and partially repaired, recovery time will be shorter–perhaps about one month. If the whole meniscus was damaged and repaired, recovery time is expected to be longer–may be up to three months.

Postoperative medications

Ask your doctor what medications they recommend for you to take during your recovery. Likely they will prescribe a pain medication, an antibiotic (to prevent infection), an anti-inflammatory (to reduce swelling). They may also recommend the use of compression stockings or give you a medication to prevent blood clots.

Will I need to do physical or rehabilitation therapy?

Physical therapy is definitely recommended after meniscus surgery. It is of course highly recommended that you consult with your doctor, surgeon, or physical therapist before trying any exercises on your own. Some physicians will recommend non-weight bearing activities for a long time and others may want you to start trying weight-bearing activities sooner in your recovery. Always consult your physician first and follow their instructions.

Strength building exercises and other physical therapies can be a vital part of the recovery and can help to reduce popping sounds.

Complications

Although complications are rare and the surgery is considered low-risk, the following are possible complications of having meniscus surgery.

  • Damage to skin nerves
  • Infection
  • Knee pain and/or stiffness
  • Other complications of surgery: blood clots, blood loss, infection
  • Knee popping after surgery

Why knee popping after surgery?

Causes of knee popping after surgery may be due to fluid accumulation around the knee and tendons as a result of the surgery, or if an implant was placed.

Implants, usually made of plastic or metal are obviously harder than the soft menisci and can create a pop sound with different movements.

Popping sounds can also occur due to stiffness after surgery. It may take a while for the joint to move smoothly again as it gets used to using new hardware. Similarly, fluid is inserted into the joint through the arthroscope during the surgery–this also contributes to stiffness in the recovery period and can contribute to popping sounds.

How to reduce knee popping?

Knee snapping or popping is irritating and uncomfortable. For those who experience knee popping both without having had surgery or postoperatively, the following exercises may be helpful.

Studies have shown that leg strengthening exercises can help reduce knee popping. It should be noted that sometimes knee popping happens as a result of the surgery and strengthening leg muscles does not help to correct it. In these cases, popping may be the new norm and there is not much that can be done to help.

The following list are things to work on to try to reduce knee popping:

  1. Strengthen leg muscles
  2. Increase leg and hip flexibility
  3. Increase ankle range of motion and flexibility
  4. Avoid activities that cause pain to the affected joint
  5. Use a stabilization device, like a brace, if necessary

 

Comments

  1. Jr. Flores says

    I got acl and meniscus surgery back in sep 31 2015. I got hurt playing soccer in college in around june 2014. Didnt want to get surgery but i couldnt do much no more so i decided to do it. Its been over 3 years but i cant play sports no more because my knee pops and feela like it goes out of place and starts to get swollen and can hardly walk. I tried going back to sports about a year and a half after. Its been 3 years and now at work walking my knee gets “stuck” pops feels like its out of place and i have to sit and rub it off. I wonder why. Did the surgeon did something wrong? did i do wrong going back to sports? Is it something normal everyone feels? Need help.

  2. Does anyone ever respond to these questions? I had miniscus surgery for two torn miniscus’ and repair of a defect in my femur…exactly one week ago. My knee area (and now my ankle) is still tight and swollen. I also have some pain in the back of my my leg located directly behind my my knee joint. I need a cane when I walk to help with my balance. Is this all normal and how long is it going to take for my leg to return to its normal size?

  3. I had surgery over four years ago for a torn meniscus. I had some initial pain after the surgery and knee popping. Now my knee is constantly swollen, the pain is worse than ever. It locks up on me even after sitting for awhile and I end up falling on my face. Standing more than 45 minutes to an hour is getting harder to do. Matter of fact, I’ve had to get a handicapped parking placard just to be able to drive to a store and walk in to buy groceries. Arthritus runs in the family and I do have gout problems in the same leg. I am at the point where I cannot work standing up for 8 hours much less the 10 hours I normally have to stand. Is there any hope?

  4. I had an accident in 92 dislocation of the knee.
    Was given tibia tubicle transfer lateral release quadriceps bypass!
    Metal Plate and screw in tibia tubicle transfer.
    Told too much surgery by far for accident that had occurred.
    Never walked since. Previously a dancer.
    Leg locked hyperextended since 92 whenever stood, but able to weight bear.
    In 2017 confirmed osteoarthritis. Had mri showed damage possible tears of pcl, acl, and cartilage.
    Told to have arthroscopy which I had July 18.
    Since cannot weight bear, pain, femur head moves on every bend. Awful.
    Pain laterally and above and below patella laterally.
    Knee too loose following scope and tidy and removal if accumulated debris. Now cannot weight bear. Seven months of pain and life-changing disability. After 26 years of disability anyhow.
    Told removal of debris has caused weakness, leg no longer will lock out straight.
    Mri confirmed grades 3 and 4 arthritis.
    Meniscus tear, no cartilage, bone on bone, all ligaments lax not stabilizing knee. Since arthroscope cannot weight bear. A mess. Pain awful
    Swelling. Movement of femur head. Told full knee replacement required. HELP PLEASE ANY ADVICE. Very distressed.

  5. Margaret spangler says

    Knee pop after surgery sores from stitches love I like healing good just fill my engery down one day fill good next day tried just had cartilage knee surgery last Wednesday

  6. Derek Gregiry says

    I had chondromicia patella scrape and repositioning of knee cap and meniscus tear surgery 9 weeks ago. I felt great sonth ago. The last 3 weeks I am back to swelling of my knee and dharp pain if I on my feet lightly for an hour or so. Things were so great and suddenly they feel almost as bad as thevknee did 6 months b4 surgery. Im seeing my ortho in a week. He is a famous knee guy who has done pro athletes. I dont kniw what he will think. I feel like theres more torn cartilage again. Then again he ssid after MRI my ligaments were excellent. He has done hundreds of these day ORs. Its very common. Why is my knee regressing? As long as I lie in bed no pain or swelling. The odd day its not bad. Definitely though something is not right. Maybe another MRI?
    IM NOT HAVING ANOTHER OR. THIS WAS ENOUGH FOR ME. IM 49. ABUSED MY KNEES ALL MY LIFE. HARRASSED NOW WITH MY WORK DISABILITY. 🙁

  7. Susan M Franks says

    Had a torn meniscus and Acl had xray showed fluid on knee wore brace helped some but bad pain when twisted by doc then had MRI after a couple weeks then found out about torn meniscus and Acl . Orthopedic said could do surgry or cortisone injection he said he would try injection first . Now time to go back still have jabbing pain off and on stiffness swelling cracking sound and been exercise with a trainer and it shakes and feel like it going to give out. What should I do? Ortho said he has a gel he can try next.

  8. HAMZA Abimbola B says

    I haven’t had any surgery on my torn meniscus for the past 2 years when it got torn.I experienced mild pain on my right knee radiating to my hip.So advise me on what to do

  9. I had surgery in August 2017, I have not been able to walk any distance at all without a cane. I have had stiffness, swelling and lots of pain, I have had every test going from arthritis which they have come to that I don’t have a stitch of it, now my last option is there sending me to a nerve doctor figuring he has hit a nerve. Wishing now I had never got this done and not only did my doctor do one knee he did both at the same time. All my doctor can say is it didn’t work. Very frustrated.

  10. My husband had surgery on his knee in April of 18, for a torn ACL and meniscus. Since the surgery he has popping and his knee locks up constantly. A couple weeks ago he went in to have scar tissue removed as the doctor thought that was causing it. It’s been over two weeks from the surgery and it’s worse now, maybe swelling I don’t know, his doctor said everything looked good in there so what can be causing this. It’s all the time.

  11. Mandar Prabhu says

    I am 45 and have had a surgery for meniscus tear two years ago..I was completely well but suddenly a week back I HV again developed slight pain.. discomfort n slight swelling in that knee…I had started my morning walk which was prohibited post surgery…I thought after 2 years it would be fine to resume walking…why the pain now..unable to fold my leg too. Kindly advise

  12. I had partial ACL tear surgery and a repaired meniscus mid April 2018 on the job site I do concrete for a living. My question is as I am still having pain in my knee I just finished work conditioning but still having issues I was wondering how long do you think I’m going to have pain and discomfort in my knee? Sometimes I think the meniscus did not heal correctly but did not have a MRI to confirm this. I was told by my doctor that a lot was done to my knee. My doctor says my surgery was very unique and is using it as a case study.

  13. I have undergone BMAC surgery for medial femoral condyle repair 2 month ago. Now while doing straightening exercises a poping sound can be heard. Please kindly tell me the reason for that and how to avoid.

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