From the Guidelines
A knee replacement may still exhibit some degree of crepitance, but significant crepitance accompanied by other symptoms such as pain, swelling, or instability warrants further evaluation by an orthopedic surgeon. According to the American College of Radiology's 2023 update on imaging after total knee arthroplasty 1, the patient satisfaction rate for TKA is relatively high, ranging from 75% to 89%, but around 10% to 30% of patients report ongoing pain or are not satisfied with the result. Factors contributing to patient dissatisfaction include unmet expectations, functional limitations, and postoperative complications, including pain 1.
Some key points to consider when evaluating crepitance after knee replacement include:
- The cause of crepitance can be multifactorial, including implant loosening, component wear, or soft tissue irritation
- Mild crepitance during the first few months following surgery is generally considered normal
- Significant crepitance accompanied by other symptoms such as pain, swelling, or instability requires further evaluation
- Regular follow-up appointments with X-rays can help detect any developing issues before they become serious problems, as recommended by the American College of Radiology's 2023 update 1
It's essential to note that the artificial knee components, typically made of metal and plastic, don't perfectly replicate the natural knee's smooth cartilage surfaces, which can lead to some degree of crepitance 1. However, if you experience significant crepitance or other concerning symptoms, it's crucial to consult your orthopedic surgeon to rule out any potential complications.
From the Research
Knee Replacement and Crepitance
- Crepitance, a grating or creaking sensation in the knee, can be a concern after knee replacement surgery.
- However, the provided studies do not directly address whether a knee replacement should still have crepitance 2, 3, 4, 5, 6.
- Study 2 discusses normal and abnormal postoperative imaging findings after knee replacement, but does not mention crepitance.
- Study 3 reviews the epidemiology and risk factors for knee replacement, as well as assessment of surgery outcomes, but also does not address crepitance.
- Study 4 focuses on magnetic resonance imaging of knee cartilage repair, which may be relevant to understanding knee joint health, but does not specifically discuss crepitance after knee replacement.
- Study 5 investigates radiolucent lines and revision risk in total knee arthroplasty, but does not mention crepitance as a factor.
- Study 6 emphasizes the importance of clinical reasoning in the era of evidence-based medicine, highlighting the need for individualized decision-making in patient care, which may be relevant to evaluating and addressing crepitance after knee replacement.
Clinical Implications
- The absence of direct evidence on crepitance after knee replacement suggests that clinicians must rely on their expertise and clinical reasoning to evaluate and manage this symptom 6.
- Further research may be needed to understand the relationship between knee replacement and crepitance, as well as to develop evidence-based guidelines for managing this symptom.