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Loose Bodies in the Knee

What are loose bodies in the knee?

“Loose bodies” in the knee refer to small fragments of bone or cartilage that are free-floating within the knee joint. Loose bodies are generally secondary to another disease that can cause persistent symptoms including the risk of new loose body formation. The first order of business is for Dr. Masi to determine the underlying cause of loose bodies. The correct diagnosis and comprehensive management including removal of loose bodies can provide relief of symptoms and prevent the formation of new loose bodies.

  • Trauma: Direct injury to the knee, such as from a fall, accident, or sports injury, can lead to fragments of bone or cartilage breaking off. For instance, a meniscus tear or a fracture might produce loose fragments.
  • Osteochondritis Dissecans: This condition arises when a small segment of bone, along with its attached cartilage, loses its blood supply and begins to crack or separate. This fragment can eventually become a loose body within the joint.
  • Degenerative Joint Diseases: Osteoarthritis is the most common form of arthritis and results from wear and tear on the joint. Over time, the cartilage that covers the ends of bones in the joint deteriorates. Fragments of this worn cartilage can break off, creating loose bodies.
  • Synovial Chondromatosis: A rare, benign condition where the synovial tissue that lines the knee joint forms benign cartilage nodules, which can sometimes detach and become loose bodies.
  • Surgery: Sometimes, fragments of bone and cartilage can be inadvertently left behind or created during a medical procedure.

Common symptoms associated with loose bodies include:

  • Intermittent symptoms: One characteristic of loose bodies is that the symptoms can come and go. For instance, a person might experience joint locking or pain on one day and then have several days or weeks without any issues.
  • Pain: The loose body can cause discomfort, especially when moving the joint. The pain can be sharp or dull and might increase with activity.
  • Swelling: The presence of loose bodies can lead to inflammation and result in joint swelling.
  • Stiffness: The joint might feel stiff, especially after prolonged periods of inactivity.
  • Locking: One of the hallmark symptoms of loose bodies is the sudden inability to move the joint, known as “locking.” This happens when a loose body becomes lodged between joint surfaces, preventing the joint from moving smoothly.
  • Clicking or catching sensation: Some people might feel or hear a clicking or catching sensation when moving the joint.
  • Reduced range of motion: Loose bodies can impede the joint’s full range of movement.
  • Instability: Some people might feel that the joint gives way or is less stable than before.
  • Decreased function: Depending on the joint involved and the severity of symptoms, there might be a noticeable decrease in the joint’s overall function, making activities like walking, running, or grasping objects more challenging.

Loose bodies in a joint, such as the knee, are diagnosed using a combination of clinical evaluation and imaging studies.

Dr. Reynolds will review your medical history. He will ask about the onset, duration, and nature of your symptoms (like episodes of locking, clicking, pain, or swelling), and inquire about any previous injuries, surgeries, or other conditions that might predispose to developing loose bodies. He will test the affected knee’s range of motion, stability, and tenderness and swelling. He may try to elicit the symptoms by moving the joint in specific ways.

Dr. Reynolds will order X-rays to detect bony loose bodies. X-rays can also help identify other potential problems like osteoarthritis or fractures. He may order an MRI to detect cartilage loose bodies and help assess any underlying conditions that might lead to the formation of loose bodies, such as osteochondritis dissecans.

Arthroscopy uses a small camera that is inserted into the joint, providing a direct view of the joint’s interior. It can visualize loose bodies and assess their size, number, and location. If necessary, Dr. Masi can also remove the loose bodies during the same procedure.

Treatment options vary based on the size, number, and location of the loose bodies as well as the patient’s symptoms. Options can range from conservative management with physical therapy and pain management to surgical interventions like arthroscopy to remove the loose bodies.

If you suspect you have loose bodies in your knee or any other joint or pain and swelling in the joint, it’s essential to consult Dr. Masi Reynolds at Masi Orthopedics. Failure to diagnose and treat loose bodies can cause further damage to the surrounding tissues.

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