Orthopod's Training Aid

[Jack Moroney (RIP)]

I need some insight on knees. Last September I had my left knee quad tendons reattached because of busted tendons and as of a couple of weeks ago I needed a cane for stability. At the same time my quad tendons in my right knee were strained and so could not use that leg for a couple of months , but that one is doing okay but feels a little unstable and we are watching it for a couple of more months before to see it it will sabilize or if we might need to go jerk around inside with the cartilidge. Anyway, they have allowed me to drive for the first time last week and I have been doing nothing more and nothing less than they have prescribed. Actually been feeling pretty good and have gotten my upper body strength back to where I was before this adventure began and actually beyond that point. Legs, of course, are a little different. They have a mild excercise routine: walking, stretching, leg presses with light weight, leg lifts and knee extensions-all of which I do religiously. Now, here is the kicker. Friday the knee that they cut on to repair the tendons has started to make a single "click" with every step. There is no pain associated with it, but the sound is audible. I will be making an appointment with the VA folks on Monday, but I am getting a little anxious about what might be going on and some of the things I might bring up with the medicos when, and if, I get to see them. Anyone have any ideas of what might be going on?

Jack Moroney-currently inacapable of sneaking up on border crossers from Canada without sounding like a lone chirping cricket.

[TitratetoEffect]

Sir,

I'm glad to see that you are doing better. I responded to your post when you first had the surgery and mentioned that I had treated two patients in my time as a therapist that had the same diagnosis as yourself. Their outcome was not very good. However, it sounds like you got into a decent PT program and are progressing slowly but steadily. Now, it is hard to say what is going on with your knee without actually being able to do a proper physical exam, but my first impression of that clicking that you hear and feel may be scar tissue associated with the healing of the patellar tendon/ligament. Scar tissue is laid down by the body to repair the injury and this scar tissue is tough and not as elastic as the original tissue. In addition, the body may 'overheal' in some cases so that a lot of scar tissue is formed. The clicking may be a result of this healing and is not necessarily a bad thing. Also, it takes a while for the scar tissue to mature and remodel. With burns it may take up to a year or more for scar tissue to mature. I forgot if surgical scar tissue is different, I don't think it is since it is made of the same tissue. I kinda forgot a lot of therapy stuff since ... my, uh.... career change.

If that clicking is associated with locking or pain with bending and especially going up and even worse decending stairs then you may have some meniscus involvement . I hope they are able to determine what is going on when they see you on the next visit.

Phil

How about knees clicking after sitting down for a while?

Sir Jack,

Glad to hear you are doing better, clickin' and all!

You could mutate the old Timex watch slogan from the 40's or whenever that they brought back in the 90's.

FrontSight

[Eagle5US]

Hi Jack...I am right in there with ya buddy...

Along the lines of what titrate was talking about...it isn't uncommon for folks going through decent amounts pf physical therapy to develop "plicas" . These little buggers are a result of the body's inflammatory response to the tendon rubbing over a biney surface-kinda like a callous. The thing then gets a bit firm and as your muscles strengthen and the tendons tighten-you have this band running over a boney prominence and "clicking" as it goes over.

Again an echo...clicking associated with locking can be badness...good on ya for scheduling another appointment with the bone mechanic.

Martin-
Could be any number of things-unless it limits your activities I wouldn't worry about it just yet.

PA