Why Is My Knee Popping After Meniscus Surgery?

What is a knee meniscus?

The knee meniscus is two C-shaped pieces of cartilage that sit between the thigh bone (femur) and the shin bone (tibia) in each knee. There are two menisci in each knee: the medial meniscus on the inside and the lateral meniscus on the outside.

The meniscus ensures that weight is evenly distributed in the knee joint. The primary role of the meniscus is to act as a 'cushion' or shock absorber during high-impact activities, protecting the lower part of the leg. The meniscus also facilitates stability and smooth knee movement.

Injuries to the meniscus, such as meniscus tears, are common, especially during activities that involve twisting or sudden changes in direction while the foot is planted.

What is torn meniscus surgery?

Surgery for a torn meniscus is typically performed arthroscopically and falls into two main categories:

• Partial meniscectomy:

  • For a partial meniscectomy, the surgeon will trim and remove the torn portion of the meniscus.

  • The procedure is usually performed if the meniscal tear damage is extensive.

  • Meniscus tears in the inner part of the meniscus, which lacks blood flow, are less likely to heal with repair and more often require partial meniscectomy.

• Meniscus repair:

  • For a meniscus repair, the torn meniscus is stitched back together.

  • This is usually only possible if the tear is in the outer portion where there is sufficient blood supply to support healing.

The choice of procedure depends on the location and type of meniscal tear. Other factors, such as the extent of the meniscus tear and patient factors, like age or activity level, are also considered.

What can I expect after arthroscopic knee surgery for a torn meniscus?

Most patients go home the same day after meniscus surgery. Recovery protocols vary depending on whether a repair or meniscectomy was performed:

• Partial meniscectomy:

  • Patients can often put weight on the knee within a day or two and return to sports within 4 to 8 weeks while following their tailored physiotherapy plan.

• Meniscus repair:

  • Recovery will take longer, with return to sporting activities typically taking 6 to 9 months while following their tailored physiotherapy plan.

Initial aftercare will include wearing a knee brace (if necessary) and following the 'RICE' method – rest, ice, compression, and elevation.

You are advised to keep the bandage on and avoid submerging the knee until the follow-up appointment.

Antibiotics may be prescribed to reduce infection risk, and compression stockings may be recommended to prevent blood clots.

Why is my knee popping after meniscus surgery?

Hearing popping or clicking noises in the knee after meniscus surgery is a common concern. Several factors can contribute to these sensations:

• Fluid accumulation

  • After surgery, fluid may accumulate in the knee joint due to the body's inflammatory response and the fluid used during arthroscopy.

  • This retained joint fluid from surgery can cause the knee to pop as it moves and adjusts post-surgery.

• Scar tissue

  • The healing process after knee surgery can cause tissue injury and lead to scar tissue formation.

  • As this tissue develops and remodels, it can create friction or catch within the joint, resulting in popping or cracking sensations.

• Swelling and stretching of knee tendons and ligaments

  • Surgical trauma can cause swelling and temporarily stretch the knee tendons.

  • This can alter their track across the bony surfaces, leading to audible pops or snaps during motion.

• Weakened leg muscles

  • Muscle weakness is common after meniscus surgery and can persist for months.

  • Weak muscles may not stabilise the knee effectively, increasing the likelihood of abnormal joint movement and are associated with popping sounds.

• Changes in patellar tracking

  • The kneecap (patella) moves up and down a bony groove.

  • Due to swelling or muscle weakness after surgery, the patella may be compromised and track differently, producing popping or clicking noises.

When should I worry about my knee popping after my meniscus surgery?

When the knee popping sounds are accompanied by swelling and pain or your range of motion is affected and the knee gives way. It is possible that you may have a knee injury. It is best if your doctor examines the knee to help make a clear diagnosis.

However, it is important to know that hearing popping sounds after your meniscus surgery is normal as long as it does not cause any pain or discomfort.

If you recently had meniscus surgery and are experiencing any knee popping accompanied by pain and swelling, please consult with a specialist. Request an appointment with Thomson Medical today.

Treatment options for knee popping

Most knee popping after meniscus surgery is harmless and resolves as healing progresses. However, if popping is accompanied by pain, swelling, or instability, further evaluation is needed. Treatment options may include:

• Physical therapy to strengthen muscles around the knee, improve range of motion and address any muscle imbalance contributing to knee popping

• Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to alleviate pain and inflammation associated with knee popping. In some cases corticosteroid injections may be recommended to provide additional relief.

• In rare cases, arthroscopic intervention may be needed when scar tissue or a meniscal tear is causing persistent knee popping. This minimally invasive procedure involves using a small camera and specialised instruments to remove excess scar tissue or repair the meniscus.

Prevention and rehabilitation

A structured rehabilitation programme is crucial for optimal recovery and to minimise knee popping:

• Physical therapy:

  • Focuses on restoring strength, flexibility, and range of motion, especially in the quadriceps and surrounding muscles.

• Gradual progression:

  • Activities and exercises should be increased gradually to avoid overloading the healing knee.

• Adherence to protocols:

  • Following your surgeon’s and physiotherapist’s guidance is key to preventing complications and ensuring a smooth recovery.

FAQ

What are the symptoms of a failed meniscus repair?

Symptoms of a failed meniscus repair may include persistent or recurrent knee pain, swelling, locking, catching, or a feeling of instability. If these symptoms occur, especially after a period of improvement, consult your surgeon, as further imaging or intervention may be required.

Is it normal for your knee to crack after knee surgery?

Yes, it is common to experience cracking or popping noises during the rehabilitation process after meniscus surgery. Unless they coincide with pain, swelling, or instability, these sounds typically don't warrant concern.

Why is my knee so tight after meniscus surgery?

Knee tightness after surgery is typically due to swelling, inflammation, and the formation of scar tissue. This is a normal part of the healing process but should gradually improve with rehabilitation. Persistent tightness may require further assessment.

What is the age limit for meniscus surgery?

There is no strict age limit for meniscus surgery, but the decision depends on factors such as overall health, activity level, and the extent of knee degeneration. Older adults may be less likely to benefit from repair due to poorer blood supply in the meniscus and may have a higher risk of developing osteoarthritis after meniscectomy.

How do I know if my meniscus is healing?

Signs of healing include gradual reduction in pain and swelling, improved knee function, and increasing ability to perform daily activities and exercises without discomfort. Regular follow-up with your surgeon and physiotherapist, along with imaging if needed, can help assess healing progress.

How can I speed up my meniscus recovery?

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.