Artificial knee joint: Possible reasons for kneecap pain
A distinction is made between two types of kneecap noise. One is a crunch, which is a grinding noise. The other is a cracking sound, which is a jumping sound. The grinding sound occurs when the cartilage behind the knee joint is worn down. The cracking sound is caused by the kneecap cracking or scarring.
Normally, the back surface of the kneecap, which is also covered with protective cartilage, is not replaced when the artificial knee joint is inserted. Replacement is only carried out if advanced osteoarthritis with a corresponding bone lump on the back surface of the kneecap is detected during the original operation. This involves removing the worn cartilage from the back surface of the kneecap and replacing it with a plastic moulded back surface.
Arthrosis damage to the back surface of the kneecap
If the back surface of the kneecap has not been replaced in an artificial knee joint, osteoarthritis can progress behind the kneecap. If the artificial femoral component is in an unfavourable position (twisted too tightly) or the kneecap (too low) and the kneecap is in an unfavourable position (pulls outwards), the cartilage behind the kneecap wears down more. This can then lead to the typical arthrosis pain such as swelling, knee joint effusion, pain and noises. On the one hand, the noises are caused by the rough cartilage surface of the back of the kneecap. On the other hand, scarring or a non-optimal outward movement of the kneecap can also be responsible.
First conservative, then surgical treatment
Noises in themselves are not yet a cause for concern, but if pain is added or increases, the problem should be examined more closely by an experienced knee specialist. Depending on the cause of the kneecap pain, it can be treated with the help of targeted physiotherapy, knee supports, anti-inflammatory or cartilage-supporting medication. If this is not enough, various surgical procedures can be considered, depending on the initial situation, such as arthroscopy, reconstruction of the inner patellar ligament (MPFL), replacement of the posterior surface of the patella, displacement of the bony attachment point of the knee ligament on the lower leg or correction of the overly twisted artificial femoral component by replacing it. An experienced knee specialist can advise you on the most suitable treatment for you.
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Dr Andreas L. Oberholzer is a recognised expert in knee problems and has extensive experience in the field of artificial knee joints and alternative treatment methods.
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PD Dr Andreas L. Oberholzer
FMH specialist in orthopaedics and trauma surgery. Areas of specialisation: Knee, hip and foot surgery.
