"Knee Locking & Early Arthritis"

Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board

Knee Pain Explained #AskUs - Knee locking & early arthritis

May 14, 2017

I have early patella osteoarthritis and one leg is a bit longer. I just developed locking knee in my left leg...what do you suggest to read?  Is a strap wise? Treatment? Judith

Knee Pain Explained #AskUs - Get answers to all things knee related

Chloe Wilson - Knee Pain Explained Team
May 14, 2017

Hi Judith. If there is true locking in the joint - where the knee gets stuck in one position and you can't move the knee, then it is likely that a piece of cartilage is getting stuck in the joint, which may need to be removed with arthroscopic surgery.

If not, then I would suggest working on strengthening exercises for the knee and kneecap muscles.

While you are working on the strengthening exercises, you may find a knee strap helps - I would recommend trying a double strap rather than a single one so you get more support. Hope that helps. Best wishes, Chloe

Knee Pain Explained #AskUs - Knee locking & early arthritis

May 16, 2017

Chloe - Very helpful...I am a Clinical psychologist who teaches in a medical school at the University of Pennsylvania. I have best medical help available and am accessing it. But this is a mystery....here are more questions...

1. What do you mean by "locking?" what happens is that a tiny muscle (?) in my rump shifts slightly...that is what it feels like...and suddenly it is hard to stand up and put weight on that left leg...this lasts for 15-30 minutes. I take 2 Aleve or ibuprofen and massage my knee or dangle it and swing it and, little by little the knee returns to normal and I can put weight on the leg again.  Is that what you mean by locking?

2. It only happens when I sit, but almost happened while i was lying in bed....if I sit on a pillow and the little muscle in my rump does not touch the chair it is ok...it happens at simple dining room chairs and when I sit on my padded leather office rolling chair...

3. It hurts to put weight on the leg and the knee does not want to stretch fully when it hurts...then it is better again til the next time..while locked I need a cane or a crutch to walk because it is painful.

4. are there books on this? is there research?

5. I know of arthroscopic surgery but read that it is often not effective...what do you know of this? how can I determine if this is worthwhile? I do NOT want to remove cartilage and then not have it work....

6. I started very serious water aerobics 3 months ago. I love it. I also bike, walk, do Pilates, swim, etc...I am active...should I stop this or does it help the knee?  How do we know if we know?

7. I am starting physical therapy for the imbalance in leg length...I have an orthotic for my shoes from a superb foot specialist but...is this throwing off the natural state of the knee and adding to the problem? Do  you know anyone who treats this that knows tons about it?

Many many thanks...I am a detective who needs to unlock this mystery. Judith

Knee Pain Explained #AskUs - Get answers to all things knee related

Chloe Wilson - Knee Pain Explained Team
May 15, 2017

Hi Judith. That's a lot of questions! Let me go in order:

1) Locking is when something gets stuck inside the joint and the knee can't move until you have wiggled it around to get the thing that is stuck out of the way - usually a small fragment of torn cartilage or bone. It doesn't sound like this is your problem

4) Without a diagnosis, I can't make a specific recommendation! But I'm sure there will be plenty of research out there

5) Arthroscopic surgery can be extremely effective if done for the right reasons, which is why accurate diagnosis is vital.

6) If it's not causing you any problems, keep going. The stronger your knee is, the better it should be

7) Orthotics to correct leg length can certainly be helpful but it is important to start by only wearing them for short periods.  If the leg length difference has been there a while, your body will have accommodated to it and if you suddenly correct it, that can throw things out of balance

8) I think you need a combination of a good orthopedist and good physical therapist. It's important to get to the bottom of what is going on

Hope that helps! Best wishes. Chloe

Knee Pain Explained #AskUs - Knee locking & early arthritis

May 23, 2017

Hi Chloe You are truly helpful!!!! Thanks for the wisdom and the time....

I have been busy..because I teach at the Medical School here at Univ of Pennsylvania, I have organized best care...

I have seen a sport med internist who is justly famous in Phila..it is medial meniscus, likely bucket handle tear, left knee...we are waiting for the MRI results..he has taught me how to keep the left leg extended when I sit down and how to lean away from that spot when I get up...and there have been zero incidents since I was taught how to manage this...

I have seen a famous foot and ankle doc here who says the right leg is a bit higher and has prescribed and supplied minimal, soft orthotics

I have seen his physical therapist who says I probably don't need physical therapy because, other than the meniscus, I look very very good for age 74..he says to do the surgery...get it done..and he will do the therapy if asked...he says NOT to wear orthotics now ...not wise to upset the balance as it is..I agree

A medical resident I train has double meniscus with no surgery... and suggested alpha omega and glucosamine..I already take both daily

Now my question is this...assuming the MRI supports all the clinical data...would shots help? and what kind of shots? I heard of a study that found saline solution as effective as other liquids

I already have mild arthritis of the patella in both knees.. lf I do surgery I worry that lack of cartilage will worsen the arthritis...what do you know? One expert told me not to worry because I am 74 but that is stupid thinking..I need to remain strong to age well. Other thoughts???

This meniscus club is a little oasis in the darkness of medical expertise. Judith

Knee Pain Explained #AskUs - Get answers to all things knee related

Chloe Wilson - Knee Pain Explained Team
May 23, 2017

If it is a bucket handle tear, I would advise having surgery - the flap of knee cartilage will keep getting stuck in the joint and cause more problems. Same goes if you develop instability in the knee and it starts giving way. 

Injections can help for arthritis pain - they can help to reduce swelling and pain, but they won't heal the cartilage I'm afraid.

Some people do indeed find supplements really helpful too with knee arthritis, but it's important to check with your doctor before taking them.

Keep going with the knee strengthening exercises - they will help speed up recovery after surgery. Best wishes, Chloe

Knee Pain Explained #AskUs - Knee locking & early arthritis

May 24, 2017

MRI is next week.... many thanks. Judith

Knee Pain Explained #AskUs - Get answers to all things knee related

Chloe Wilson - Knee Pain Explained Team
May 24, 2017

Good luck with it all! Chloe 

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