Diagnose your Knee Symptoms or Learn More About a Prior Diagnosis 

Do you have a symptom in your knee such as pain or popping sounds? Click "Find Your Symptoms" below to see common knee symptoms and learn about our treatment options and approach. Have you been recommended a surgical procedure or diagnosed with a condition by a doctor? Learn about our approach to diagnosing and treating joint injuries by clicking "Diagnosed With:" below.

To hear what other patients have to say about their diagnosis, treatment, and recovery at The Stone Clinic, please click here.

Find your Knee Symptoms

Select from one of the options below that best matches the knee symptom you are experiencing to learn more about the symptom and treatment options.

Knee Swelling

Knee swelling is divided into three groups. The first type of swelling occurs after you injure your knee, twist your knee, hear it pop, or fall down the football field and the knee swells. That swelling is due to trauma or injury to one of the tissues in or around the joint. 



The second type of swelling occurs if a tissue inside the joint such as the ACL or meniscus or articular cartilage is damaged. The joint will swell from the bleeding that occurs from the injury. This is usually an indication that something serious is wrong with the knee. A careful exam and often an x-ray and/or an MRI is required to determine what caused the knee to swell.

If it is just swelling on the outside of the knee from a bruise, ice and soft tissue massage can often take care of that swelling.

The third type of swelling is chronic swelling which occurs without a specific new injury and is sometimes due to arthritis, a chronic meniscus tear, something wrong inside the joint that produces fluid due to abnormal motion, or grinding surfaces in the joint. It is important to find the cause of the swelling because swelling has what we call degradative enzymes in it--components that break down cartilage and tissue in the joint. Chronic swelling of the joint is not good for the joint surfaces; therefore, careful diagnosis and a treatment plan should be started.

Knee Pain or Stiffness

Pain and stiffness in the joint can be divided into two groups: acute and chronic.

Acute pain and stiffness occurs from an injury such as falling on the knee or hitting it on the corner of a table. This is the sort of pain that can be treated with ice, soft tissue massage, and gentle range of motion through physical therapy.



Chronic pain and stiffness can often be due to joint arthritis or damage to the joint lining or the articular cartilage surfaces. Treatment involves first making a careful diagnosis to determine the cause of the pain and stiffness. Simple remedies such as soft tissue massage, glucosamine, ice, bicycling, and pool exercises can often relieve the symptoms. A physical exam, history, x-rays, and MRI are often necessary to determine the underlying cause of the pain and stiffness. This is most important if the pain and stiffness persist.

 
Symptoms of Catching or Locking

Catching or locking of the knee is due to a mechanical block of knee motion. This is often due to a torn meniscus cartilage, the shock absorber of the joint, or due to a loose body that may be floating around the joint. Catching occurs when a joint tries to go from straight to bending and as it arcs through that motion, something gets caught between the joint surfaces. Catching and locking is a symptom of something significantly wrong inside the joint that needs to be treated. A careful physical exam, history, x-ray, and MRI will often result in an accurate diagnosis. Repeated catching and locking will damage the joint surfaces and should be treated.

MRI of a Bucket-Handle Meniscus Tear

Knee Instability or Giving Way

Knee instability can be due to a tear of a ligament that stabilize two bones and causes those bones to be unstable or loose. Usually this is related to the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), or the medial collateral ligament (MCL) of the knee joint.



When ligaments are torn, they sometimes heal well if they have a good blood supply; such is the case with the MCL. However, if the ligaments do not have a good blood supply or are within the joint, they often will not heal; such is the case with the ACL, which often does not heal after a complete ligament tear. Ligaments are important stabilizers of the joint. They guide normal joint motion, and when instability of the joint occurs, often it is better to repair or replace the ligament than permit the joint to be unbalanced and move through an abnormal pathway which would lead to arthritis.

Knee Cracking or Popping Sounds

Most commonly, this is either scar tissue or a rough area between the kneecap and the femur where the knee cap rubs. Cracking and popping inside of the knee is very common, and usually does not need any treatment at all. If the knee produces pain and swelling, then treatment can be performed; often non-operative treatment consisting of specific exercises and physical therapy helps.



Drinking glucosamine increases joint lubrication. If these symptoms persist, a careful physical examination, x-rays, and an MRI are usually performed to make the diagnosis. Sometimes damaged articular cartilage or scar tissue can be smoothed, removed, or re-grown in order to diminish the pain with popping. Catching in the knee is most commonly either torn meniscus cartilage, scar tissue, or sometimes a loose body. The diagnosis is confirmed by history and physical examination, x-ray, and MRI.

Hearing a Pop in the Knee Followed by Swelling and Pain

“Hey, Doc. I twisted my knee and heard a pop. My knee swelled and I had pain.” This is a story which over 90% of the time is due to a serious injury inside the knee from tearing the cruciate ligament, the meniscus cartilage, or damaging the joint surface.



Numerous studies have been performed that show the history of, “I heard it pop. I had swelling and pain,” is the story of an important injury in that the knee and is best treated with a careful physical exam followed by treatment of the damaged tissue.

Stiffness, Swelling, and Limited Motion

Limited motion is due to either swelling of the joint, scar tissue, or a bony or cartilage abnormality that blocks the normal motion of the knee. Limited motion is unhealthy for the joint; similar to a car that is out of alignment. The unaligned car wears the tires out more rapidly if the motion is limited.



A smaller arc of the joint is used, and so stress is concentrated on a smaller area and the wear and tear occurs more rapidly. Efforts to regain range of motion are very important and include stretching, soft tissue massage, and a careful diagnosis to determine what is causing the limited motion with treatment of the cause.

Select a diagnosis you may have received

Have you been diagnosed with needing a knee replacement?

If you have been previously diagnosed with needing a knee replacement, this is often due to a physical exam and an x-ray that indicates changes in the joint space. An artificial knee replacement involves placing a metal end on the femur and a metal and plastic tray on the tibia. This is an excellent treatment when there has been severe cartilage loss throughout the knee; however, these days there are other treatments for cartilage loss that may be used to delay the time in which a joint replacement is required.



One example is a partial knee replacement where only one side of the joint is replaced, usually using a robotic device during an out-patient procedure.

Does BKR Work?
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Another option is a biologic knee replacement where the cartilage is grafted and the meniscus tissue is replaced. We demonstrated over the years that this can be very effective even in the arthritic knee, delaying the time when a stronger replacement is required. 
 

Have you been told you have osteoarthritis?

Osteoarthritis is one form of damage to the joint cartilage and tissues in the joint. Osteoarthritis may be a genetic disease but the term is often interchanged with traumatic arthritis where trauma or injury to the joint occurs, the cartilage surfaces are damaged, and bone is exposed causing a bone-on-bone or bone-on-soft tissue condition for the knee joint. The underlying bone becomes deformed, the cartilage surfaces become worn off, and the lining of the joint becomes irritated causing the symptoms of pain, swelling, and loss of motion.



Osteoarthritis is clearly a treatable disease where many of the causes can be identified and treated. There are new treatments involving the use of stem cells, articular cartilage paste grafts, meniscus replacement, and joint lubrication are quite helpful as are the oral supplements glucosamine and chondroitin sulfate. Glucosamine, when taken at approximately 3,000 milligrams per day, is often extremely helpful and can diminish the symptoms of osteoarthritis. Joint lubrication injections are also a new way of improving the status of the joint in the setting of osteoarthritis.

Have you been told you are "bone-on-bone"?

Many patients are told that they have bone-on-bone changes in their joint. Sometimes this verbiage is used in error because the x-ray may be taken at an angle that appears to show bone-on-bone when in fact, x-rays taken at another angle might show a different picture.



However, even bone-on-bone, which means the cartilage surface has been worn off on both sides of the joint, is not necessarily a condition that requires a joint replacement. Sometimes a knee that is bone-on-bone can be treated with either partial joint replacement or grafting of the articular cartilage and replacement of the meniscus cartilage, depending on the findings. Any joint that has cartilage can develop a bone-on-bone change, and there are effective treatments for re-growing repair tissue that can effectively delay the time in which replacement is required. 

Have a Meniscus Tear?
If you have been told you have a meniscus tear, this is damage to the important shock absorber in the joint. Some meniscus tears will heal on their own in young people with an acute injury. In some chronic meniscus tears in elderly people, the patients are not symptomatic, but most meniscus tears in active people act like a loose piece in a smooth-feeling joint, irritate the joint, damage the opposing articular cartilage, and decrease the function of the joint. The earlier the diagnosis is made, the earlier a surgical repair can be carried out and many meniscus cartilage tears that were previously thought as irreparable are reparable with new suturing techniques and the addition of growth factors to the repair site.

Have a Ligament Tear?
A ligament tear is when the tissues that stabilize two bones is torn causing those bones to be unstable or loose. Usually this is related to the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), or the medial collateral ligament (MCL) of the knee joint or other joints.

When ligaments are torn, they sometimes heal well if they have a good blood supply; such is the case with the MCL. However, if the ligaments do not have a good blood supply or are within the joint, they often will not heal; such is the case with the ACL, which often does not heal after a complete ligament tear. Ligaments are important stabilizers of the joint. They guide normal joint motion, and when instability of the joint occurs, often it is better to repair or replace the ligament than permit the joint to be unbalanced and move through an abnormal pathway which would lead to arthritis.