Question - Knee Cliicking, Popping and Feeling Like it Gives Way

by AJ
(Alma, MI)

My daughter is 13 and a distance runner. She has been sidelined since track season. In April after an amazing pre-season 5K she started having the feeling of her knee locking or coming out of place in practice or during a race.

Wouldn't happen every day and was only painful for a moment then she would be fine and continue on. May 8th this same giving way happened during a 1600 relay leg and this time she couldn't walk on it with out pain. Said it felt like it ripped.

Had x-rays done and the bones looked fine. Very swollen so they gave her a knee brace and crutches and she stayed off it for nearly a week. They gave her an MRI and said she had a lot of synovial fluid on her knee. 5-6 weeks of PT and then back to the orthopedic surgeon. She was cleared after 5 weeks to start some light running. Once she got up to around 7 minutes of continuous running the knee started behaving like last spring. She is now scheduled for orthopedic surgery next week.

Today we had her in an aqua jogger and also biking per PT. It is giving away or clicking at almost every move. Wondering if she should just stay off it...is she doing more damage?

What do you think is wrong with her knee?

Her doctor is guessing a plica problem that didn't show up on MRI. We are very anxious to know whether surgery is going to fix this and if she will ever be able to run again.

Any insight would be greatly appreciated,

AJ

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Jul 25, 2008
Waiting for surgery
by: Bart - SII

If the PT that your daughter is going through is causing undue pain and swelling, then I would probably consider backing off a bit until after the surgery...she probably isn't causing any more damage with what she is doing, but since she is set for surgery soon, there isn't a need to continue to irritate the knee.

As for my opinion on what could be wrong - my first thought when reading your post was an ACL tear and or meniscus tear - the giving way, locking up, clicking, popping - all are classic symptoms for an ACL tear. But, since she had an MRI that only showed synovial fluid and no mention of pathology with the mensicus or ACL, and no apparent mechanism of injury, it could very likely be a plica that is causing the problem.

Plica (which is a thickening of the synovial lining of the knee) can cause the same types of symptoms that your daughter is having - clicking, popping, locking up, and a feeling like the knee is giving out. As the irritation continues, the plica will scar and become larger, thus increasing the symptoms. Many times it will actually be getting stuck between the femur and the tibia when the knee bends and extends - causing a popping or shifting feeling with every move.

A plica excision will often help significantly with symptoms - And that is often all that is needed with surgery. Some physicians will perform a lateral release along with the plica excision, however, I do not agree with this course of action unless the patella continues to track laterally and exhibits lateral tilt after the plica is removed.

Recovery from a plica excision is usually fairly fast, somewhere along the lines of 4-6 weeks after surgery. Rehab is a very good idea, to work on getting her motion back, as well as strengthening of the hips and core, which will have a role in the mechanics of her knee.

Hope this helps - comment back with other questions.

Nov 10, 2009
What is that noise and pain?
by: Chebear

I had clicking and what I thought was two tendons crossing over one another. The pain was incredible when it unsnapped. After an MRI, my doc said the menecus was torn. Figured that was why my knee was giving out and making a clicking noise. Had the sergury in June and yes the menecus was tore in 2 places. Five days after surgery, my clicking and catching returned and I told the doc. He reassured me it was the menecus and it would go away. It is now Nov. and I'm having knee surgery tomorrow on the same knee. This time the doc says it's the plica. This guy is suppose to be the best in the NW Pacific. Wish me luck and good luck to your daughter. My suggesionl..Research a lot and always get a second opinion.

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