Knee Replacement “Clicking”

Following knee replacement surgery, patients sometimes report hearing clicks or a clicking sound during certain activities or at a certain point or points during their gait cycle.  In most cases, this sound is believed to be benign and is not associated with pain or other adverse consequences.

So what causes this clicking?

To answer this question, it is helpful to understand a little bit about the nature of total knee replacement.  In knee replacement, the ends of the bones that make up the knee joint are “resurfaced” with metal and plastic components.  The surgeon uses specialized instrumentation and surgical technique to properly align the implants to the bones and the bones to one another.

This alignment is not straightforward because in the replaced knee joint, as in the normal knee, the bones are not “mechanically interconnected”; rather the joint is constrained by the remaining soft tissue (ligaments, muscles/tendons) and the conformity of the implant components.  During the knee replacement operation, the surgeon works to optimize range of motion and joint stability through proper alignment and sizing of the implant.

The resulting tension in the replaced joint can, therefore, vary slightly from patient to patient and can be different within the range of motion of a single patient.  That is, some patients may have “tighter” knees or “looser” knees or a single knee can be “tight” in flexion, but “loose” in extension and vice versa, but in general, some degree of laxity is desirable to allow for adequate motion.

Because there is almost always some laxity in a replaced knee, clicking can sometimes be heard as a result of contact between the metal and plastic components during activity.  Often it is heard during a transition from low or non-weight bearing to weight bearing.  For example, a patient may hear the click while walking as the leg comes out of swing phase and makes contact at heal strike.  For the most part, the clicking is usually not associated with any adverse conditions.

Comments

48 Responses to “Knee Replacement “Clicking””

  1. Matt Hopkinson on January 29th, 2009 8:27 pm

    In my extensive physiotherapy experience, quadriceps control also plays a role with this. If there is a decrease in optimum strength the movement becomes sloppy and uncontrolled causing the knee to jar. Good basic tone will also give the knee a tighter feel. Finally patients with both hip and knee replacements will initally be understandably focussed on their new joint. Instead of feeling the softer arthritis feel, a new harder feel is evident. As they get used to having a new joint and enjoying its capabilities (without the pain) they no longer notice the clicking.

  2. L Serpe on January 30th, 2009 2:44 am

    Matt,
    The idea that initial laxity and subsequent “clicking” would be mitigated or perhaps eliminated by post-op rehab and strengthening of surrounding musculature is plausible. Thanks for your input and perspective on this topic!

  3. Clicking Noise After Total Knee Replacement » TravelBlog Archive » Total Knee Web on March 20th, 2010 2:49 pm

    [...] the rest of this story on clicking noise after total knee replacement Tags: after knee replacement, clicking noise after total knee replacement, knee clicking after [...]

  4. robert johnson on August 12th, 2010 7:45 pm

    The above article sounds like the kind of information we hear BEFORE the operation. On the surface ,it makes sense and seems reasonable. But there are two problems with this information.

    1. There is clicking, and then there is CLUNKING. Ask someone on the Topix.com thread: “Popping and clunking sounds coming from new knee” what they think of this article, and I think alot of them will tell you this is what they were told, but that’s not the issue. Clunking is a much more serious variety of clicking, and apparently it is not all that uncommon.

    2. Because of this propaganda that clicking is to be expected, when you find yourself in the situation post-op where you are experiencing clunking instead of clicking, it is extremely difficult to break through to the Doctor and his assistants that your understand about the clicking expectations, but that’s not what you are experiencing. It is very hard to convince them that something is wrong, because they have this built in excuse of clicking as normal.

  5. admin on August 13th, 2010 1:05 am

    Hello Robert,

    Thank you for your comment. You are correct, there is a distinction between the typically “benign” clicking described above and more serious “clunking” which can sometimes occur (and unfortunately, what you seem to be experiencing). A clunking involving the patella (patellar clunk syndrome) is described in the following post:

    http://www.totalkneeweb.com/patellar-clunk-syndrome-complication-following-knee-replacement-surgery

    There are also related posts listed at the end as well.

    Hopefully you find this additional information useful.

  6. Judy Morissette on January 9th, 2011 1:46 am

    I had double knee replacements on 9/07/10 and I have much stiffness. The worst problem is that my knees feel like they are on fire alot of the time. I walk almost 1.5 miles/6 days a week. I also have alot of clicking while walking. While walking I do not have the fire feeling and in general I feel better while walking. My doc just says that the xrays look good. Any comments? How do I get past the “good xrays” and the doc just saying it will take time when I feel that something is wrong?

  7. courtney Benson on January 29th, 2011 3:39 pm

    tkr both knees one in 07, one in 08. left one has grinding noise underneath kneecap also clunk sound no pain but its driving me nuts. I hate the thought of having to go underneath the knife again. I wonder whats going on in there(knee)

  8. Albert Caron on February 5th, 2011 2:16 pm

    I had a total knee replacement in November 2010. It feels good during the day but aches like crazy when I go to bed. Any ideas as to why this happens. I still have some pain pills left but I do not want to take them. I am not a pill person.

  9. darshana behl on March 13th, 2011 1:04 pm

    surgery of both knees tkr rpf has been done on nov. 18 in forits hosp mohali by drMANUJ WADHWA. the problen is both knees click when legs lift up get down .i am worried but doctor said nothing to worry. plz tell me what to do.thanks

  10. rich foshey on May 20th, 2011 11:53 am

    about 7 years ago I jhad a knee replacement and although there is not the intence pain anymore i have a click that with each step i hear and feel i went to the dr who did the operation and he said the xrays look normal .now the knee joint is making 2 clicks .
    I had talked to my nephew who is a surgical tech and he said something is not rght I have also talked to some people who had total knee replacement and they said they have no cliking at all
    what concens me is this did this from day one and now the clickig is louder and now has another click happening what kind of wear or misalignment is being done when I go hunting my friends say the clicking gives a me away to my location and that is a human ear and deer or other animals can hear me much further away

  11. Babs on August 22nd, 2011 7:33 pm

    I hate to say this, but it feels so good not to be alone with all this!!!

  12. Rich on October 15th, 2011 1:17 pm

    Clicking, in this article, is said to come from the metal and plastic “clicking” against each other. If this is true, the implants should fail earlier than anticipated. Simply, the plastic will wear out more quickly due to high contact/impact stress. .

  13. Graham Sayer on November 11th, 2011 7:50 am

    I am a 78 yo healthy (albeit a cancer survivor) male who has always followed a strong fitness regime involving martial arts, weightlifting, running, cycling, indoor rowing and boot camp outdoor sessions, so when I wrecked my knee joints from 40 yrs of hard surface running, at least I had an advantage in managing the recovery & rehab stages. Here is my 5 weeks recovery timetable:
    Week one/day 2 walking with 2 wheel walker. Physio started
    Day 3 walker & aluminium crutches alternating
    Day 4 discharged to home. Continued my own physio at home. Mod to severe pain – controlled with opioid drugs & senna pod derivatives for the severe constipation caused by opioids.
    Day 5 Using alum. crutches only to get around home.

    Week Two/Day 9 Using one crutch only & had modified weights session followed by sunbaking.
    Day10 Still fair degree pain, swollen knee & ankle. Drove manual SUV vehicle up and down driveway.. Scared the animals.
    Week Three/Day15 able to move around without crutches
    Day 16 Steel incision closure clips removed Day 17 Drove vehicle out on road & didn’t kill anyone. Also walked 1km
    Week Four/Day22 AB exercises & weights workout. Mowed acre of lawn on rider mower
    Day 26 Resumed outdoor high intensity boot camp training with group. No running & gentle on cliff stairs..OMG…
    Week Five/Day 29 Climbed ladder to inspect roof – all OK but stiff
    Day 35 Indoor rowing session on Concept2 machine & road cycling. Difficulty in releasing foot from clip racing pedals due to twisting motion required. Leave a few weeks more.
    After working on steep hillsides on acreage property, some knee pain develops and slight clicking.
    Second knee joint due for TKR in Jan 2012.
    Happy to answer any questions as patients outcomes vary enormously.. Love from Australia

  14. GrahamSayer on November 16th, 2011 5:47 am

    Just a small correction to my previous posting. The walker used in hospital for two days, was a 4 wheel version which moves more smoothly than the 2 wheel version.

  15. Cliff on February 9th, 2012 12:03 pm

    had a TKR on my right knee 11/10/11 and so far everything is going OK except for one thing…the knee clicked like a castanet right from the first step in the hospital and still does, only it seems to be getting worse. The Dr just shines it off with “oh the knee has to settle” but after three months it does not seem to be settleing. The question is am I going to be stuck with this clicking knee for the rest of my life. Will it, in fact, stop clicking in the future. If not, is there a procedure to correct this problem. I hope so ’cause it is driving me nuts.
    I am asking because Dr’s don’t like to admit mistakes.
    Any comments would be appreciated.

  16. Dick Norton on February 22nd, 2012 6:52 pm

    I have the same grinding as mentioned by Courtney Benson. My TKR was 12/10. Any update information available about grinding vs clicking? I do not want to go under the knife again, but…

  17. linda herb on March 7th, 2012 8:25 pm

    I had a tkr on 11/22/11. I also have the clicking sound when i walk and at noght when i stretch my leg out in bed. It drives me crazy. Sometimes wish i would have never had the surgery.

  18. Cliff on March 18th, 2012 5:44 pm

    Linda, we must have gone to the same “Dr Click”, lol.. I had my right knee done 11/10/11. I too, have constant clicking and my knee ‘aches” when I lay down. So far, you are the only one I have found that has ‘clicking”, including a number of friends who have had TKR, so it can’t be “that normal”. My Dr Click first said the knee “had to settle” then said had to give it time to develop “scar tissue”. Frankly, I think he is full of sh.. ! When I push him he says “what do you want me to do, operate again” which of course shuts me right up, lol I see him again in a couple of months. The pain is going away slowly, even at night but I am going to push him on the clicking and when he says operate again I am going to say no, I wanted you to do it right the first time you bast…., lol. Good luck.

  19. Raunee on March 21st, 2012 5:49 pm

    Linda, Cliff, and all
    I had my right TKR on Feb. 9, 2012. Six weeks ago. I too have the clicking sound. People discuss a clunking sound, but I think mine is a clicking noise. I talked to my Dr. yesterday and he said this is “normal”, but I think all OS say the same thing about any question we have. The click I have has been there since my surgery. If I lay on my bed and bend my leg, it can click up to three times, I even had my OS feel the clicking yesterday. Maybe it will get better, but I doubt it. it is not a painful click, just annoying. He was not concerned.

  20. DB on April 2nd, 2012 11:32 am

    I had bilateral total knee replacements about 3 1/2 months ago. One knee clicks in the “front” at times. My physical therapist believes that this is related to the kneecap finding its track when I take a step. She said that, especially in women, the alignment of the gait is different than in men, because of the wider hips. She told me to try exercising to strengthen the medial (inside) muscle of of that leg in order to increase the support of the kneecap, pulling it more to the center rather than it’s path toward the outside of that leg. To do this, whenever you’re sitting in a chair, raise and straighten both legs out at the same time repeately. Hold for a 15 count and then lower. Do this repeatedly whenever sitting. By lifting both legs at the same time, it exercises that medial muscle to hold the kneecap in a better position. I have started this excercise and can feel the muscle in question moving. I hope it helps others.

  21. Raunee on April 3rd, 2012 3:44 pm

    It will be two months on Thursday since my surgery. “DB” I will try the exercise you mentioned. I need some new ideas to streghten my leg and muscles. My knee still swells quite a bit and is warm to the touch. Does anyone know if this means I may have an infection???

  22. Cliff on April 4th, 2012 2:42 am

    Raunee, keep using ice for the swelling..eventually it will go away. Everyone is different but it usually takes 3 to 4 months. I will be 5 months on the 10th and have no swelling at all. Minor pain but the clicking is still driving me nuts
    As far as infection is concerned, you will know if it is infected. You knee will blow up like a balloon and the pain will be unbareable, at least that is what my Dr told me when I thought my knee was infected. Also he told me it could stay warm for up to a year, it varies.
    Did you go to therapy? I went 12 times and it worked so well, I joined their fitness center.
    Good luck…it seems like it is getting worse but it really gets better.

  23. lee ann on May 3rd, 2012 8:28 pm

    I had tkr on both legs 6 and 7 years ago. my left leg done first and no complaints. the right leg has bothered me since getting done and in the past several years has gotten progressively worse, meaning it is swollen, feels very tight when I bend -no pain when I bend it, just skin feels real tight. hurts so much when i lift leg to get into car; and feels wobbly when I go up steps – now i can barely walk one block and must be very careful to walk with a cane or holding on to a grocery cart and it aches every night.

  24. Mim on May 18th, 2012 4:03 am

    Had my TKR in 2009 on my left knee. Since then facing problem of similar worrying clicking sound like you all plus numbness, soreness,some swelling and pain when too long on my knee. Have discussed with the surgeon and given 3 steroid jabs. Only gave short term relief only. Other relief resorted often by applying diclofenac gel and analgesic & anti-inflammatory plaster as prescribed by hospital, and at times took pain killer when unbearable. Now make it a point to use knee support when moving about. Does help a bit. Just do not know what long term effect. Now I am at a loss what more can be done short of undergoing another surgery which I had already suffered and dread most. Welcome some experts/surgeons/doctors reading this or those who have overcome this sort of problem can help. Thanks

  25. jean robertson on May 27th, 2012 5:03 am

    i had a total knee replacement 12 weeks ago, i have a long history with my knee had a car accident in 1967 knee cap was ruinded and removed had a lot of ops and my ligaments and tendons were so damaged they are usesless, and i have had to wear o locking knee brace for over 40 years.yrs the total knee replacement was done as i had the bone on bone was to painful/The problem now is my leg is crooked and my foot is at a right angle about 6 inches
    how can this be fixed. pleas can someone help me

  26. WandaN on June 11th, 2012 4:11 pm

    I am so glad I found this forum. I have found that what I am experiencing is normal. I, too, having the clicking. I failed to mention it to my doctor, but plan to on my next visit in August. My TKR was performed on April 20, 2012. I am in my 8th week and feel very impatient. The feeling I hate is the feeling of contraction around the incision site. I find myself, wherever I am, bending my leg trying to stretch my knee. It feels better after the stretch, but soon starts contracting again. I did mention this and the extreme stinging to my doctor who said it was normal and should stop but it will take time. I am still doing my therapy on my own. I long for the day that I can honestly say I am totally pain free. I know that day will come.

    Another problem is the incision site is so sensitive, anything irritates it. Doctor suggested massaging with Vitamin E which I do several times daily. Sometimes I just cover it when I go to bed, so I can sleep better.

  27. Cliff on June 14th, 2012 2:27 pm

    Wanda
    I am in my 7th month and I still have some pain but it is getting better. Also still have the “contracting” but that too is not happening as often. I had to have anscopic(sp) surgery because of scar tissue building up..took away pain in some parts of knee/leg but put some pain in other parts. Clicking is driving me crazy but nothing Dr can do about it except do TKR over again. I told him “not even at gun point” would I let him do that.
    Hope you have better luck with your knee then I have had with mine.

  28. Kenneth Stanfield on June 19th, 2012 7:00 pm

    Although, a clicking sound is not always associated with a problem it should be reported to your surgeon and investigated. Don’t just assume it is nothing.

  29. RONALD WRIGHT on July 5th, 2012 8:20 pm

    Hello all, CLICKING & CLUNKING TKR’s patients. I have a little different problem approx. one year after TKR I stood up after sitting in a chair with an asleep right leg. So I put all the weight on the Left leg that had the surgery. Well, I did not realize that the left leg was asleep also and I hyper-rotated the tkr aprox 120 deegrees inward, landing on my right shoulder as not to land on my face so I rotated on the way to the garage floor. I was able to pull myself up using my arms after a 12/13 pain level which felt like my right knee ACL all over again. Only this time its the left TKR. Now my kneecap clunks when I tap on it with the leg hanging relaxed. It did not make this noise prior the hyper-rotation. Does anyone know if there is something I could of fractured, broken, torn.? Swelling since March/12 .CT scan shows nothing wrong?!! The CT Tech said I would be on the table fifteen minutes, actual time just under 5, so now I am attempting to schedule an appt. for damage assessment. I wonder if I”ll be told the same, ( noise is normal ) although I had no noise untill after the rotation going on four swollen and painful months. currently on disability medicare & Hummana hmo. Should I run the other direction or risk being told a redo is required. Worse scenario possible on the other hand is there something keeping the knee cap in place that I could of broken = simple fix …LOL yeah right keep dreamin

    any thoughts ??? not complaining, just explaining…..

    RON W

  30. chrisj on September 17th, 2012 9:40 pm

    Hi,
    Glad I found this also. I will be getting a TKR within a year. I just started a new job (for which I travel) and need the one year anniversary of employment for the Family Leave. Although, it hurts so much, so often I am close to getting it done now!

    I am creating a questionnaire for maybe 10 people to help me with things they’d do different, questions they wished they asked.
    This clicking sound is something I’ve not heard about and that goes on the list.
    One question is how much exercise (for what muscles) should I be doing to get the leg ready. I work out frequently now, but may need to work on specific areas.

    Also, I am heart attack survivor, so that comes into play during the surgery… blah….

    I am 57 YO, about 170 lbs.

  31. george on October 23rd, 2012 7:46 am

    about 15 weeks ago i had a full kneereplacement , all was going well after about ten weeks , i notice my limp was not geting better, and what drives me mad is it clunks when i walk , my limp is worse then befour i had it don , but apart from the discomfort, i have very little pain , exray looks good had a ultrasound ther was fluid on the knee>> i see my specillist, in a few weeks , they say he is the best last time i went after 8 weeks he never looked at my knee just looked at the exrays , and said all looks well, my limp is bad and it clunks. iam fed up

  32. Kitt on November 5th, 2012 3:09 pm

    Had a RTKR on 4/18/12. Had some clicking but it didn’t bother me. Going on 7 months and the clicks and pops are getting louder. I talked to the OS and he said better loose then tight. I questioned him as to whether I had over exercised the leg because shortly after surgery I couldn’t bend it. So went crazy with PT. Flexion is at 135 degree and norm is supposed to be 120. He said more for flexion is better.

    So, knowing I have to have the left knee replaced, I’m exercising and dieting to lose weight. Riding a recumbent bike 45-60 minutes daily. I can hear the knee actually clicking and grinding. There’s more grinding going on than the bad knee.

    Someone above stated that if it’s plastic against metal, that would mean it will wear out sooner. Not a bit happy about that. Gave up power walking and walking on treadmill to prevent it from wearing out too soon.

    Has anyone had grinding? When I put my hand on my knee, you can feel it hitting all around. Not just in one spot.

    Thanks

  33. K Ramakotaiah on November 28th, 2012 3:03 pm

    I had TKR (Lt) on 22nd Sept. 2012. When I went for a review by the doctor after 6 weeks, the doctor was telling that I had very good flexion. I told him that I was having light exercise on a stationary bike. The doctor was annoyed at that, and told me to only walk daily 2 KM & climb 50 steps, which I cannot do, becausr my right leg is paining with OA, and needs surgery. The doctor goes on telling not to do any exrrcise, and I am not convinced, at all. I started exercising on the bike by slow movements, with gradual reduction of seat height, & with no associated pain. He, further, says that if the inserts become loose, he will remove them. I do not know if they become loose just like that. I also do not undetstand if cycling with light movements & no resistance is so harmful to the joint. Reg. joint sound, I don’t hear any noise during a walk. But, I am now hearing some light cliks while bending and stretching.

  34. Mim on December 3rd, 2012 9:59 am

    Hi Rama. Surprised your doctor discouraged you from light indoor cycling. Maybe your TKR was fairly recent . Mine the other way round. Can’t do distant walk exercise and my doctor have no objection to indoor cycling-must exercise he say to strengthen the muscle. As indicated in my earlier posting am facing numbness and pain. Nothing more the doctor can do after steroid injection -have to live with it but continue to apply ointment and decloren gel for short term relief . Clicking is a common problem for most TKR and I don’t think there is any solution. Hope anyone out there can suggest any remedy for my ailments

  35. TinkerJohn on January 3rd, 2013 9:09 pm

    TKR 7/11/2012; Regained 130 degrees ROM within 4 weeks
    Then the grinding, clunking, crunching noises began. Subsequent x-rays look fine to surgeon.
    Yet, when I tie a string to my ankle and stretch it to my hip socket, the knee is not inline with the string . . . which indicates misalignment. The surgeon refuses to acknowledge this . . . and want me to suffer another 6 months before he addresses it.
    Is this due to limits of liability . . . or ego . . . or insurance regs . . . or what?

  36. Cliff on January 4th, 2013 3:43 am

    Don’t know what state you live in but in California you can only sue Doctor within one year of surgery. This is why they tell you nothing is wrong when you know there is. If you really think you got a barber for a surgeon, go see a lawyer right away and sue the bastard if you can. Signed “a disgruntled patient”

  37. Dave on February 24th, 2013 6:40 pm

    I had a TKR 1 year ago at the age of 50. I didn’t really notice the clicking until about 6 months. I have a clicking when i walk and my knee has what i would call a 3 hour time limit. The xrays looked perfect , after about 9 months I was somewhat pain free but after a few hours on the knee it starts to ache a little ( I dont consider it pain since I had arthritis for 30 years ) I am pretty sure that the clicking is completely caused by the knee cap which my doctor claims was replaced ( I have no reason to doubt him ) I think he did a great job but surgeons are pretty much very talented and knowledgeable plumbers. They are not like Dr House that is TV fiction. Anyway, I think maybe there is just not a perfectly smooth or rounded pathway for the knee to bend , maybe scar tissue or a fluid pocket forms Who Knows. My ONLY fear is that whatever it is makes the knee wear faster. I believe controlled exercise is CRITICAL and I am guilty as most of not doing that. I still consider the operation both barbaric and a miracle at the same time. But I try to be reasonable. This is NOT a real knee and is limited an problematic at best. Every time I walk without pain ( and that is most of the time ) I thank god that this was possible and just enjoy something so simple as being able to walk. I am going to try to work it out as I did the nerve pain I had from scar tissue at 6 months. It took like 3 months to work that out and I guess this is not over yet. My mother has been exercising her first knee replacement for 15 years and she is happy with her knees and they are in good shape. I hope that everyone has good luck with their knees and has a good surgeon that did a good job and is as pain free as possible. Its not perfect but its the best we have I guess.

  38. Christine Chapman on June 10th, 2013 9:12 pm

    I had a TNR 18mo ago. I think everything went fine and for the most part I am happy with the knee. I am able to go down on my hands and knees to exercise and garden. I do have some pain that the i have seen the Dr. for and he repeated my PT for a few weeks. I can now really isolate where the pain is coming from. If I stand with my full weight on my surgery knee and lock my knee for a short time when I try and walk I am having a lot of pain on the inside of the knee. After moving around and trying to walk the pain will go away and I seem to be fine. Anyone else had this?
    My sister thinks it is my petella, but she isn’t a MD.

  39. Lenore Kelly on July 23rd, 2013 2:43 am

    I had bilateral knee surgery in Australia early January 2013. I severely damaged my right knee as a 16 year old in 1959 was hospitalised two weeks total bedrest during which time I was given medication supposedly to prevent arthritis. The knee was very painful and eventually caused enormous pain and angle of leg was somewhat deformed. I wore elastic strapping on a off for 50 years.Over the years I developed arthritis in both knees. Six months post surgery I certainly walk better and am free of knee pain although I do have stiffness. I attend weekly sessions doing pilates with a Physiotherapist. Still have some swelling in both knee areas and knees click as I walk. Surgeon was very pleased with the bend in my knees particularly in the severely damaged one but recently advised that perhaps I will have the clicking for ever as in his words “that is a problem with the replacement/artificial knees at this point in time” and that basically I will learn to live with it. My knees are quite tight but I assume with time that will improve.There is light at the end of the tunnel but it is a long journey but I am pleased I no longer use a walking stick or crutches as was the case pre surgery. I have no regrets I had it done but wish I had earlier in fact many years ago..

  40. Frank Pietromonaco on November 19th, 2013 1:40 am

    My Right TKR was done in July of 2010. It was a very difficult surgery and recovery but the net result was terrific. My problem was that soon after the 6 month mark, I experienced a sharp “crack” at different times I would straighten or bend my knee. I went back to the surgeon 1 year post-TKR and had arthroscopic surgery to remove a foreign body. The surgeon did not think this was the cause of the cracking. As time progressed, the cracking became so profound that I was sure the Patella was getting stuck or lodged in the joint. In some cases I would have to force the knee to break through the resistance to bending. It made driving difficult because my reaction time was slowed to move from accelerator to braking. Three weeks ago the knee was stuck to the point I could not bend my leg. When I finally forced it through, it sounded as though I broke a brittle tree limb. The sensation nearly caused me to faint.
    This has continued to get worse. Since my surgeon passed away next year, I returned to a reputable surgeon I had seen years before. He ordered Tc-99m bone scan that revealed a high level of evidence of bone repair activity that should NOT be happening 3.5 years post-op. The activity would be normal within 12 to 18 months post implant placement. The surgeon’s assessment is the fixture has loosened and I will need a full revision. I am devastated. The surgery is scheduled for 12/30/2013.
    This is how drastic the clicking can become. I hope you can ask about the bone scan. Has anyone had a similar experience? We will not know what is going on until the open the knee but it has been a useful tool for my diagnosis. There is inflammation, infection or both going on. I don’t know if recent trauma can be a cause of the results from the bone scan. I have sent an extensive list of questions to my surgeon. I wish you all luck and good health.

  41. Lora on December 8th, 2013 8:17 am

    HI, I had TKR in June of this year. I am already scheduled for arthroscopy for crepitus ( grinding of scar tissue)… Im confused and scared. Why so much scar tissue so fast? It is very painful to go from sitting to standing and often just to change positions while sitting. Anyone else dealing with this?

  42. Kitt on December 13th, 2013 3:46 am

    I still go through with the clicking and have become used to it. I experience little or no pain.

    Regarding the crepitus. Okay, as explained to me by my chiropractor. It’s like cracking your knuckles on your fingers. Only it’s at your knee and will do not damage or harm. Now or in the future. I’ve accepted his interpretation for the grinding and learned to relax the knee a little more when standing up or sitting down and not placing so much weight on it. I’ve also lost 75 lbs, so it’s helped.

    Sadly, most surgeons only focus on “their” work and neglect to look at the physiological impact of this surgery on the overall knee/leg. They’ll x-ray it a dozen times and tell you all is well. Which is true. Their work is perfect, but something happened as a result of their surgery and they need to be more observant of the patients’ concerns and worries and investigate it further and help find a remedy for the issue.

    Back to the Chiro. I am doing stretching exercises which stretches the IT bands. Also using a muscle roller or travel stick. I discontinued doing the exercises recommended by PT as they were causing additional pain. Whatever you do, do not use a TENS unit. It will only anger the surrounding muscles. I was using one everyday for months. When I began his suggestions, things got better. I quit the TENS. Never perfect, but better. I hope I am able to maintain the knee for a long time. They claim it will only last 20 years with limited use, but I walk 1-2 miles/day, so I’m beating it up. But then I can’t just sit around for the rest of my life.

  43. Graham on December 15th, 2013 8:02 pm

    Variance between results can be put down to individual surgeons skills, template accuracy, prosthetic brand/type, patients physical fitness and mindset. A lot of variables….I had both TKA’s a few months apart a year ago and was walking the next day, driving after 7 days, back into Boot Camp training at 4 weeks…I now do cycling, indoor rowing (Aust record holder age group) boot camp and weights..I run up hills and stairs and did a skydive with freefall from 12,000ft on my 80th birthday…So you can see how patients vary..It is mandatory to keep your weight at normal levels and a BMI in the mid twenties…this means healthy plant-based diet and no sugar drinks or garbage snack foods.

  44. Kitt on December 17th, 2013 3:51 am

    Graham… I totally agree. Wish I knew back then what I know now. Especially the weight. Have lost it and a very clean eater. Hoping it will allow me to hit “80″ and be healthy. Will forego the skydive. Not a fan of heights. However, kudos for continuing to “live”.

  45. hazrat sultan on April 20th, 2014 8:30 am

    My TKR is now 6 months old. I m afraid to walk more than 1 km a day and play golf : as the TKR may not last more than 10 years. I am engineer nd know over use may not last long as in case of all machines. I need advice from, who has the correct answer. How much walk minimum in yards , km per day is desired for 75 yrs age.

  46. Graham on April 25th, 2014 6:48 am

    For hazrat sultan….This depends on many variables, particularly whether a state-of-the-art prosthetic joint was used, correct alignment using templates (this is crucial) and adjacent tissue management (Were all the supporting structures/tendons,ligaments etc) repositioned correctly?
    I had both knee TKA,s at 79 yrs of age, healed quickly and now still indulge in boot camp sessions, cycling, indoor rowing and weightlifting…(I hold 2 x Australian records for rowing – age group).I completed a skydive & freefall from 12,000 ft for my 80th birthday landing on the beach on soft sand. For my 81st birthday shortly, I will abseil down a 90m/300ft cliff face….OMG
    You must protect your joints by always having one foot on the ground at all times and avoiding any high impact on the foot which would send a shockwave up the leg to the kneejoint
    Therefore, you should easily be able to walk 5 km a day but you need to add at least one other activity..cycling is ideal indoor on a machine or outdoors if safe, it does not stress the joint..
    Don’t think about all this..Do it now…Graham (retired medical scientist)

  47. Dave T on May 17th, 2014 4:59 pm

    Thanks for all the input. I developed clicking about 3 months after knee replacement. I have been quite worried about wearing out the knee prematurely. The comments made here make me feel a little more at ease about the problem. I will continue to work out, especially the legs and question the doctor on six month visit in June, 2014. I had planned on other knee replacement but am in doubt about another lengthy painful period in my life. Will report back after visit with doctor and more exercise.

  48. d morris on May 17th, 2014 6:26 pm

    Hello

    I had a tkr in 2012 I had clicking after the first week. I went back for my 2 month check up and to get refilled on my morphine and diladid and explained that the clicking in my knee was painful. He explained that itnwas normal and itnwould go away. Well it is know 2014 the pain is getting worse oh and I do have a knee cap they took that from me 7 years ago and they may need to put one in. Its crazy but I think there is something wrong with the mechanism that was put in my knee. I had 11 surgeries over 18 years they have even moved bones and still put a normal replacement mechanism not cool. Just wanted to share my thoughts.

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