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Author Topic: "Catches" in the knee--what are the possibilities?  (Read 42760 times)

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Offline Nancy T

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"Catches" in the knee--what are the possibilities?
« on: November 22, 2006, 08:14:49 PM »
(I posted this yesterday on the meniscus forum, but then thought I should post it here since I don't know what is wrong with my knee.)

I get "catches" in my right knee that are often painful, occasionally not. From reading a bit, I wonder if it's a meniscal tear? (Haven't seen a doctor yet but thinking seriously of it!)

I injured this knee 16 years ago when I went to hang curtains and stood on the arm of an armchair (real smart) that tipped over with me. I landed on the floor with excruciating knee pain for a couple of minutes, then got up and found I could move the knee forward and backward, so decided it wasn't "broken" and didn't see a doctor, to avoid paying my deductible!

The  next day and for a month afterward it was very stiff and moderately painful, as I remember. For many months afterward, the knee would "catch" when walking, going up or down stairs, etc.

In the last few years (I'm now 49) it began "catching" painfully again--momentary catches, especially when turning during ordinary moving around (I don't do sports but do regular moderate walking for exercise, am about 50 lbs overweight). The pain would be momentary or last no more than 30 seconds probably, and sometimes there would be no pain but still a very distinct catching feeling, usually below the kneecap on the inside (medial side?). It never locks up completely.

Months could go by without any "catches" and then they'd start up again for no apparent reason, numerous times a day.

So on Oct. 17 I slipped on the stairs--right foot slipped forward and down a few stairs; I landed on my rear as I broke my fall with my right arm holding the railing. I don't remember the knee specifically hurting at that moment, but some slight discomfort later in the evening but nothing to make me think I'd injured it.

In the following week I began having more of the "catches" again, and ten days after the fall I was having aching pain on the sides of the knee when I'd sleep on my side at night, and a lot of sudden sharp pains and catches when walking or taking stairs. The very sharp pains would subside after a few slow, careful steps, but I had some stiffness in the knee and overall soreness and would just get sudden sharp pains from slight knee movement sometimes even when sitting.

The sharp pains and soreness--and sometimes tenderness to touch, though no visible swelling--are mostly in the "four corners"--above and below the kneecap, right and left of it. A few times I had sharp pains behind the knee too. It just feels as if various muscles or tendons or bones or SOMETHING around the whole knee are variably sore, out of place, suddenly hurting and then subsiding, etc.

Another thing that happens is that I'll be walking along fine when suddenly I feel a weird movement on the inside (medial?) part of the knee as if it's about to "slip out of place" that is not quite a "catch," but I definitely have to stop and slowly extend and flex the knee a few times to get it feeling completely "back in place" and continue walking without fear of it "catching" painfully.

And I swear that the right kneecap gets out of whack when I'm lying on my side at night. I will wake up and when I try to turn over or straighten the knee (when sleeping on my side I bend my knees up a little and put a pillow between them), it's painful and slow, as if something has to get back into place there. As if gravity had pulled my kneecap downward to the left or right, depending on which side I'm sleeping on.

I'm not double-jointed or anything, although a neurologist wrote in his report that I have "some laxity in the interpharengeal joints" (I'm sure I spelled that wrong, but he'd wiggled the joints of my ring finger). I have lumbar scoliosis too, but it hasn't caused me any problems and my hips are even. A bit bow-legged like my grandmother.

The left (uninjured) knee has also had "catches" in the past, but not nearly as much as the right knee. Oddly, my left elbow has had episodes of the same kind of painful catches, and my right wrist too (such as when turning a key in the ignition).

I have always thought this would clear up on its own, was due to being overweight, wasn't worth seeing a doctor about, etc. because "everything always turns out to be nothing." The knee is considerably better than it was three weeks ago (when I began wearing an elastic brace with open kneecap, at least until the itching drives me crazy), but it still has some pain and I'm always fearful of more "catches."

After that long-winded history, can any knowledgeable folks here tell me what the differential diagnosis of "catches" in the knee is? Is it necessary to see a doctor if I can still walk normally, if a bit tentatively? I do have good insurance, but in the past 7 years I've had a lot of strange unexplained symptoms including dizziness and hearing loss (may be a mild autoimmune or neurological disease), and I'm afraid of being thought a middle-aged female hypochondriac if I show up with variable knee pain in multiple locations that isn't really impairing my ability to walk. With no swelling, I'm guessing the doctor would not find anything physically wrong and be inclined to think I'm "overreacting" (it's a prejudice we middle-aged women are highly subject to). However, this past month's episode has been much worse than any previous ones, and I've never before had the "nighttime kneecap slipping."

If wearing the brace (as much as I can stand it), being careful not to twist the knee suddenly, and taking Advil are keeping the problem under control, and the whole thing is improving partially, do I really need to see a doctor (that is, would they likely advise me to do anything different than I'm doing now), or should I simply wait longer, keep trying to lose weight, and see if it goes away?

Thanks much for any info or advice,

Nancy T.

Offline plantgeek58

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Re: "Catches" in the knee--what are the possibilities?
« Reply #1 on: November 22, 2006, 09:30:10 PM »
Nancy,
From what you've described, I'd say it's definitely time to see a specialist. They're not going to think you're overreacting. Just because your pain isn't constant doesn't mean everything's OK. You have some serious symptoms going on and you need to find out what's wrong. It does sound like one problem could be a meniscus tear, because that would explain the catching and the pain on twisting and on stairs. You don't usually see swelling from a tear in the front of the knee, but sometimes the back of the knee swells and it feels like something is pressing on it. I don't know much about the symptoms of other injuries, but it sounds like your kneecap is subluxing (not tracking right in its groove) and that can cause serious wear and tear on the cartilage in your joint. So please do see someone about this and maybe ask for an MRI. It's never a good idea to just ignore an injury and hope it goes away. I did that and I can't tell you how many times I've kicked myself for it, because my right knee is a mess now.
Terre
RK 7/04 part. m. menisc., plica resect., MF
    3/05 part. m. menisc., open OATS
    1/07 part l. menisc., MF, patellar chondroplasty
    9/08 MF
LK 11/04 & 8/06 part m. menisc.
     7/07 LR, patellar tendon debrid., part m. menisc.

Offline Nancy T

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Re: "Catches" in the knee--what are the possibilities?
« Reply #2 on: November 24, 2006, 06:49:00 PM »
Terre,

Thank you very much for the information and the very good advice. I'm sorry you ended up having bad trouble with your knee.

I certainly wondered if "subluxation" is what's happening with the kneecap. It sure feels like it.

What I don't understand is why the knee gets much better and I have few or no problems with it for a long time, and then all of a sudden it's catching and slipping and hurting again.

I agree I should see a doctor about it. It's hard to go when the pain and "catching" have gotten SO MUCH better--walking and turning all around the kitchen yesterday, cooking for 14, I only had one catch/slip--but it was a doozy that made me yell!

Thanks again,
Nancy

Offline ex-gymnast

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Re: "Catches" in the knee--what are the possibilities?
« Reply #3 on: November 26, 2006, 01:54:26 AM »
I also have a sublexing kneecap. According to my OS the pain is worse when the tissue behind the knee becomes inflamed.  (This may not be noticed when looking at the knee.)  When the inflamation goes down your knee should feel better.

Another option is scar tissue.  With a pervious injury it is possible that scar tissue has built up and that is causing the catch.  When I had this problem I was having occasional pain.  The doc said it was caused when the scar tissue shifted in the knee.
If I knew I'd be like this now, I'd do it all again.
1998- Lf ACL replace (failed)
1998- Lf ACL replace (worked)
1998- Rt LR
1999- Rt Scope
2000- Rt ACL replace
2001- Rt hardware replace
2002- Rt Scar Tissue Removal
2005- Rt Pattella Scraped
2009- Rt clean-out the mess
To Come: 2 Replace

Offline Nancy T

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Re: "Catches" in the knee--what are the possibilities?
« Reply #4 on: November 26, 2006, 02:41:18 AM »
Ah, that's a thought--I didn't think of scar tissue from the previous injury. I guess I will not know the truth until I see a doctor.

What treatment do you get for the subluxing kneecap? Do you have to wear a brace, do exercises, what?

Nancy

Offline plantgeek58

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Re: "Catches" in the knee--what are the possibilities?
« Reply #5 on: November 27, 2006, 03:12:38 AM »
Nancy,
I think the treatment for the subluxing kneecap depends on how bad it is and how aggressive you want to get. The most conservative treatment that I know of is PT to strengthen the VMO. There are also J-shaped and U-shaped braces that you can get to keep the kneecap aligned properly. Then there are two surgical procedures that I know of to treat the problem. Lateral release is the less aggressive one, and involves partially cutting the lateral retinaculum, in order to reduce its pull on the kneecap. This is done arthroscopically. The other procedure is known as osteotomy, and there are various versions of it. Basically, though, they all involve cutting and moving the tibial tubercle, the piece of bone to which the patellar tendon is attached. Screws have to be inserted to hold the tubercle in its new position.This is the most aggressive procedure and is not done arthroscopically, but it has an excellent success rate. I will be having it done this summer on my right knee and lots of other people here have had it.
At any rate, you have lots of options. Keep researching and talk to your doctor about which one(s) will be best for you.
Terre 
RK 7/04 part. m. menisc., plica resect., MF
    3/05 part. m. menisc., open OATS
    1/07 part l. menisc., MF, patellar chondroplasty
    9/08 MF
LK 11/04 & 8/06 part m. menisc.
     7/07 LR, patellar tendon debrid., part m. menisc.

Offline Nancy T

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Re: "Catches" in the knee--what are the possibilities?
« Reply #6 on: November 27, 2006, 06:08:49 AM »
Thanks for the info, Terre--obviously this is all new to me, although the symptoms aren't! I will make an appointment with my PCP and see what, or who, she recommends.

What kind of symptoms do you folks have with a subluxing kneecap? Mine never gets completely stuck, so I don't think it can be too bad.

Good luck with your surgery! I hope it solves your problems. Why are you waiting til summer (if you don't mind my asking)?

Nancy

Offline plantgeek58

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Re: "Catches" in the knee--what are the possibilities?
« Reply #7 on: November 28, 2006, 12:14:46 AM »
Hi Nancy,
No, I don't mind the questions. My kneecap doesn't "jump the tracks" unless I bend my knee all the way back to my butt, then it pops right back in when I straighten. It isn't painful and that isn't my real problem. The real issue is that the maltracking is causing a lot of wear and tear to my articular cartilage. It's also causing pain in my patellar tendon, which conservative treatment hasn't helped. That's why I'm having the surgery.
I have to wait til summer because of both work and school. I work in the "green industry" (retail garden center), but I'm taking classes for a career change to Biotechnology. The heavy lifting at my current job is simply causing too much damage to my knees. I know that I'm going to be on crutches for at least 2 months with this surgery, and rehab is going to be long and painful. Summer is the best time to do it because I won't have class and things will be slowing down enough at work that I can leave my assistant manager in charge.
Good luck with your doctor's appointment and let me know if I can be of any more help.
Terre

RK 7/04 part. m. menisc., plica resect., MF
    3/05 part. m. menisc., open OATS
    1/07 part l. menisc., MF, patellar chondroplasty
    9/08 MF
LK 11/04 & 8/06 part m. menisc.
     7/07 LR, patellar tendon debrid., part m. menisc.

Offline Nancy T

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Re: "Catches" in the knee--what are the possibilities?
« Reply #8 on: November 28, 2006, 07:30:08 AM »
Thanks, Terre!!

Wow--two months on crutches. I wouldn't survive that. Sounds awful.

Good luck with your career change and the surgery!

I'm sure I will indeed be back with questions at some point!

Nancy

Offline Natalie.D

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Re: "Catches" in the knee--what are the possibilities?
« Reply #9 on: November 28, 2006, 12:34:17 PM »
Hi,

I just wanted to mention that you could have a loose body in your knee which could well be causing the catching, especially if its not constant, when you fell the first time you could have knocked a bit of cartilage off which has floated around in the joint, I've had this a few times and it can be exceptionally painful.  Usually if you have a loose body floating around they tend to give you the option of an arthroscopy (keyhole) to clean out the joint, they also have a look around whilst they're in there and see what other damage has occurred.  Good luck with your appointment but please bear in mind that PCPs are not always the best to diagnose orthopaedic problems so you should be referred to an orthopaedic surgeon who is qualified in knees.

Natalie.
Dislocations since age 12
Trochlear Dysplasia
Maltracking
Hypermobile
LR/MR-failed
TTT, LR, MR L knee 95-Success
TTT, LR, MR R 02-Success
Screws out
Partial tear ACL
Severe end stage OA
4 Debridements
Partial Meniscectomy
Failed Microfracture
11mm Defect LFC
Bone Spurs, Kissing Lesions

Offline Nancy T

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Re: "Catches" in the knee--what are the possibilities?
« Reply #10 on: November 29, 2006, 08:16:35 AM »
Thanks very much for the info, Natalie. It sounds like there are quite a few possibilities.

I know my PCP won't be able to sort it out, but I'm hoping she can refer me to the proper specialist. I saw an orthopedist specializing in the spine last summer (for my scoliosis), but I think he only does backs, so I need a recommendation from her for someone knowledgeable about knees.

Nancy

Offline Kimmykick

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Re: "Catches" in the knee--what are the possibilities?
« Reply #11 on: March 23, 2016, 08:23:33 PM »
Hi Nancy I'm just writing to see how you made out on your knee issue I know this is an old post but I'm hoping you'll be able to respond.

I am pretty much having the same issue right now I had an MRI I just went to the doctor and had it read he indicated that there was an ACL tear and a meniscus tear now both of these tears I believe are seven years old but I keep getting that catching in my knee as well on the inside I know it's not right it just feels weird and like it has to adjust and go back to the way it was. Im Still as confused as I went in there I don't understand or he didn't mention as to what that feeling is on the inside of my knee is it a tear getting caught on something I just don't know of course they want to start out with traditional physical therapy and shots but my question is I know it's been at least 7 years but what's the physical therapy going to do now. So if you get to see this post I'd be grateful if you can reply and let me know how you made out thank you much.  Or anyone else that is having  or had this.  Thank you,   Kim


(I posted this yesterday on the meniscus forum, but then thought I should post it here since I don't know what is wrong with my knee.)

I get "catches" in my right knee that are often painful, occasionally not. From reading a bit, I wonder if it's a meniscal tear? (Haven't seen a doctor yet but thinking seriously of it!)

I injured this knee 16 years ago when I went to hang curtains and stood on the arm of an armchair (real smart) that tipped over with me. I landed on the floor with excruciating knee pain for a couple of minutes, then got up and found I could move the knee forward and backward, so decided it wasn't "broken" and didn't see a doctor, to avoid paying my deductible!

The  next day and for a month afterward it was very stiff and moderately painful, as I remember. For many months afterward, the knee would "catch" when walking, going up or down stairs, etc.

In the last few years (I'm now 49) it began "catching" painfully again--momentary catches, especially when turning during ordinary moving around (I don't do sports but do regular moderate walking for exercise, am about 50 lbs overweight). The pain would be momentary or last no more than 30 seconds probably, and sometimes there would be no pain but still a very distinct catching feeling, usually below the kneecap on the inside (medial side?). It never locks up completely.

Months could go by without any "catches" and then they'd start up again for no apparent reason, numerous times a day.

So on Oct. 17 I slipped on the stairs--right foot slipped forward and down a few stairs; I landed on my rear as I broke my fall with my right arm holding the railing. I don't remember the knee specifically hurting at that moment, but some slight discomfort later in the evening but nothing to make me think I'd injured it.

In the following week I began having more of the "catches" again, and ten days after the fall I was having aching pain on the sides of the knee when I'd sleep on my side at night, and a lot of sudden sharp pains and catches when walking or taking stairs. The very sharp pains would subside after a few slow, careful steps, but I had some stiffness in the knee and overall soreness and would just get sudden sharp pains from slight knee movement sometimes even when sitting.

The sharp pains and soreness--and sometimes tenderness to touch, though no visible swelling--are mostly in the "four corners"--above and below the kneecap, right and left of it. A few times I had sharp pains behind the knee too. It just feels as if various muscles or tendons or bones or SOMETHING around the whole knee are variably sore, out of place, suddenly hurting and then subsiding, etc.

Another thing that happens is that I'll be walking along fine when suddenly I feel a weird movement on the inside (medial?) part of the knee as if it's about to "slip out of place" that is not quite a "catch," but I definitely have to stop and slowly extend and flex the knee a few times to get it feeling completely "back in place" and continue walking without fear of it "catching" painfully.

And I swear that the right kneecap gets out of whack when I'm lying on my side at night. I will wake up and when I try to turn over or straighten the knee (when sleeping on my side I bend my knees up a little and put a pillow between them), it's painful and slow, as if something has to get back into place there. As if gravity had pulled my kneecap downward to the left or right, depending on which side I'm sleeping on.

I'm not double-jointed or anything, although a neurologist wrote in his report that I have "some laxity in the interpharengeal joints" (I'm sure I spelled that wrong, but he'd wiggled the joints of my ring finger). I have lumbar scoliosis too, but it hasn't caused me any problems and my hips are even. A bit bow-legged like my grandmother.

The left (uninjured) knee has also had "catches" in the past, but not nearly as much as the right knee. Oddly, my left elbow has had episodes of the same kind of painful catches, and my right wrist too (such as when turning a key in the ignition).

I have always thought this would clear up on its own, was due to being overweight, wasn't worth seeing a doctor about, etc. because "everything always turns out to be nothing." The knee is considerably better than it was three weeks ago (when I began wearing an elastic brace with open kneecap, at least until the itching drives me crazy), but it still has some pain and I'm always fearful of more "catches."

After that long-winded history, can any knowledgeable folks here tell me what the differential diagnosis of "catches" in the knee is? Is it necessary to see a doctor if I can still walk normally, if a bit tentatively? I do have good insurance, but in the past 7 years I've had a lot of strange unexplained symptoms including dizziness and hearing loss (may be a mild autoimmune or neurological disease), and I'm afraid of being thought a middle-aged female hypochondriac if I show up with variable knee pain in multiple locations that isn't really impairing my ability to walk. With no swelling, I'm guessing the doctor would not find anything physically wrong and be inclined to think I'm "overreacting" (it's a prejudice we middle-aged women are highly subject to). However, this past month's episode has been much worse than any previous ones, and I've never before had the "nighttime kneecap slipping."

If wearing the brace (as much as I can stand it), being careful not to twist the knee suddenly, and taking Advil are keeping the problem under control, and the whole thing is improving partially, do I really need to see a doctor (that is, would they likely advise me to do anything different than I'm doing now), or should I simply wait longer, keep trying to lose weight, and see if it goes away?

Thanks much for any info or advice,

Nancy T.

Offline iwillwalkagain

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Re: "Catches" in the knee--what are the possibilities?
« Reply #12 on: April 11, 2016, 08:31:22 PM »
My knee "catches" more when I do rehab exercises like quad sets and SLRs.  I think these exercises inflame my knee further.  Wall sits and step ups are ok however.