[RESEARCH] Is Knee Noise a Problem?

Noises Around the Knee

INTRO:
Noise in the knee joint is a common symptom that often leads to outpatient clinic visits. However, there have been no previous review articles regarding noise around the knee despite its high prevalence. Song et al. (2018) reviewed the noise characteristics according to sound nature and onset as well as factors for differentiation between physiological and pathological noises. They also described causes of the physiological and pathological noises and management of noise in the knee.

RESULTS:
The sounds around the knee have been described using various terms, including:
Popping, Snapping, Catching, Clicking, Crunching, Cracking, Creaking, Grinding, Grating, & Clunking.

Differentiate between physiological noise and pathological noise by checking for pain and swelling/effusion in the knee joint, as this is often associated with pathological noise. A loud “pop” with pain at the time of injury usually indicates damage to the ligaments or the meniscus. Crepitus, in the absence of any history of injury, may indicate cartilage lesions in OA or inflammatory arthritis.

Physiological noise varies and include:

• Buildup or bursting of tiny bubbles in the synovial fluid.
• Snapping of ligaments.
• Catching of the synovium or physiological plica.
• Hypermobile meniscus or discoid meniscus.
• Perception of previous noise after knee surgery due to emotional concerns.

If there is no pathological condition, there is no need to be concerned about the noise. Management of pathological noise will depend on the underlying cause.

CONCLUSIONS:

• Noise around the knee is a common phenomenon.
• In most cases, the sound is physiological, and there is generally no reason for concern.
• Pathological noise is accompanied by pain, effusion, swelling, and a history of injury.
• Healthy patients experiencing physiological noise should be given appropriate information and reassurance.
• Careful evaluation of the characteristics of noise and differentiation can provide guidance for patients

SOURCE:
Song et al. 2018. Noise Around the Knee. Clinics in Orthopedic Surgery 2018;10:1-8

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Dalton Urrutia, MSc PT

Dalton is a Physical Therapist from Oregon, currently living and running the performance physiotherapy clinic he founded in London for Grapplers and Strength & Conditioning athletes. Dalton runs the popular instagram account @physicaltherapyresearch, where he posts easy summaries of current and relevant research on health, fitness, and rehab topics. 

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