When you walk, your knees crunch what to do. Crunch in the knee joint - causes and treatment. Orange juice compress

A crunch in the joints does not always mean that some terrible things are happening in them. destructive processes, however, this is a sure sign of some articular (structural and functional) disorders. The knees crunch especially often, since the knee is the most active participant in any motor process and the main victim of large static loads. Only the ankle can compete with him, because the entire weight of our body presses on the feet. Articular noises, crackling or crackling, which are very different in terms of sound background, sometimes accompany flexion / extension movements of the knee. Often, when squatting, twisting the lower leg, even with simple walking, a crunch is heard in the knees. Any noise in the joint is called crepitus. What could be the reasons for this phenomenon?

We used to treat crunch as one of the external symptoms degenerative inflammatory process- osteoarthritis, or we consider it a sign of the development of deforming arthrosis. But why do very young people creak their knees? And this is a very annoying phenomenon for them: who wants to look like an old man or an old woman in their youth.

So, why do the knees of young people click?

Knee crunching when bending or walking in childhood, adolescence or young years can be explained by such factors:

1. A slight crunch in the knees can occur with sudden movement in a perfectly healthy young man. This sound in character may resemble a muffled pop from a bursting balloon. The reasons here are in the characteristic structure of the synovial capsule of the joint and the fluid in it: when moving, the articular membrane is stretched, bubbles with gas are formed in the synovium, when they burst, strange sounds are heard.
2. Immaturity of the musculoskeletal system of children and adolescents: growth occurs so rapidly that the process of ossification lags behind cartilage formation. The teenage bone is always softer than the adult one, and the joints are more mobile due to the weakness of the muscles and ligaments. This leads to the fact that the articular surfaces go beyond the restrictions and contact with each other. Someone is probably familiar with the situation from childhood, when there is an irresistible desire to snap your knees or fingers. This frightening habit for moms is based on a reflex desire to return the joint to a comfortable position. Such a return is usually accompanied by a distinct ringing click.
3. Congenital joint hypermobility caused by connective tissue dysplasia. It's rare systemic disease, which is impossible to ignore. In addition to turning the joint to angles impossible for a healthy person, a number of additional signs are observed: chest; damage to the heart and respiratory activity, pathology of blood vessels and organs, etc. In each case, their manifestations are possible, to a greater or lesser extent. Do not confuse this dangerous disease with acquired training hypermobility and flexibility.

This painful flexibility...

If your knees crackle all your life when squatting, it is quite possible that the flexibility of the joints, caused by genetic disorders in collagen synthesis, is to blame. Ligaments become superelastic and stretch more. This weakens the joint itself and can subsequently provoke the development of arthrosis.

Flexible joints are more common in women. This disease cannot be cured because its causes are hereditary. It is only possible to maintain the ligaments with strengthening exercises, while the now popular hyperextension exercises should be performed with pathological flexibility with caution.

A crunch in the knee joint for the above reasons may not be accompanied by other serious symptoms with a mild degree. pathological disorders or genetic mutations.

Joint hypermobility in adolescents is often associated with pulling pain in the knees, because due to the growth of bones, their deformation inevitably begins to develop, the alignment of the femur and tibia is disturbed. Pathology also affects the spine, leading to scoliosis.

The real causes of crunching in the knees

A crunch in the knees is a familiar sound background for the following diseases (let's call real, not all kinds):

• arthrosis;
• calcific tendinitis;
• rheumatoid arthritis;
• gout;
• consequences of injury;
• chondromatosis;
• Koenig's disease.

It hurts, crunches and creaks with arthrosis

Arthrosis of the knee is very often manifested by symptoms of crepitus, but the nature of the crunch, sensations and other signs vary, depending on the stage:

• In the first stages, when the cartilage is still preserved, the sound in the joint is more clear and superficial, pain in the knee is not felt.

If the knee crunches, but does not hurt, such a sign is in favor of early arthrosis.

• At a later stage, the sounds become muffled and deeper: this indicates that the degenerative-dystrophic process has reached the subchondral bone, the tissues of which are permeated with nerve endings.

A deaf crunch in the knee during flexion and extension, simultaneously with the onset of pain, indicates a more mature arthrosis.

• In the last stages of osteoarthritis, a crunch in the knee when walking and pain can almost disappear, creating a deceptive illusion of recovery. But the knee loses freedom of movement, the leg does not unbend and does not bend fully, and this situation already gives rise to overcoming pain during deep flexion movements, associated with contractures in the muscles and ligaments that have arisen.
• By that time, the joint, instead of cartilage, has hard calcium deposits (osteophytes) on its surface, which leads to changes in the sound background: with advanced arthrosis, the knees crunch when squatting in a peculiar way - this sound is similar to creaking.

Osteoarthritis is considered an age-related disease, starting somewhere after 40.

Calcific tendonitis

Cracking not only directly in the knee itself, but also in the areas near it, they speak of calcific tendinitis, that is, that calcium deposits already occur in the tissues of the tendons.

This phenomenon is accompanied at first by moderate pains, but with the destruction of calcifications in the ligaments, the painful symptoms become simply painful.

Tendinitis has many causes:

• it may accompany osteoarthritis;
• develop simultaneously with arthrosis as tendinosis;
• occur as a result of trauma.

Cracking and pain in the knee with arthritis

One of the heavy chronic forms arthritis is rheumatoid arthritis. He is the sword of Damocles of all health, not just joints. The reasons for this are frequent exacerbations, chronic inflammation, and a destructive effect on many organs and tissues.

All the membranes of the joints become inflamed, which leads to their swelling.

Synovitis is a common occurrence in rheumatoid arthritis. The constant overproduction of synovial fluid soon depletes the membrane itself and lowers the quality of the synovium in it, which becomes less hyaluronic acid- an important natural lubrication of the joints.

Rheumatoid joints always click, especially in advanced stages, precisely because of the lack of lubrication, but these sounds can be muffled due to the presence of fluid in the joint.

The crunching and pain in the knee in rheumatoid arthritis usually occurs at the beginning of walking, but as the joint warms up with movement, these symptoms subside.

If the pain and crunch do not go away with the onset of movement, and the joint is thickened and has pronounced deformities, these signs indicate an advanced stage of the disease.

Alas, rheumatoid arthritis also affects very young people.

Pain and crunch in the knee with gout

Gout can hardly be attributed to the hidden causes of crunching in the knees. This disease has an acute onset:

• the knee swells greatly and becomes purplish;
• temperature jumps to 39˚;
• ugly formations appear on the surface, from which salt pours;
• biological analysis shows excess uric acid in blood;
• when moving in the joint, creaking and grinding are heard (urate salts are to blame for this).

Such a trouble rarely begins with the knees. Usually the feet and hands are affected.

Crackling and sore knees after an injury

If before the injury you didn’t hear any sounds in the joints when moving, and after the injury your knees crunch, what should you do in this case?

Even if there is no pain, the appearance of a crunch in the knees after a fall is a signal for an immediate examination. You need to contact a competent orthopedic doctor so that he can carry out functional diagnostics. Often, crepitus in the knee occurs due to a rupture of the meniscus, but the ligaments of the knee stabilize it and the injury can be hidden, or manifest itself during descent or ascent, rotational rotations of the lower leg. By performing knee flexion/extension and rotation tests, the doctor can identify or suspect an injury and refer for further investigations.

Causes of knee crunch in osteochondropathy

Sources of crunching can be chondromatosis of the joints and Koenig's disease.

Chondromatosis occurs on the basis of deforming arthrosis. The essence of this pathology is the formation of cartilaginous bodies inside the synovial membrane of the joint, which are initially attached to it on legs, like polyps, but then, as they grow, they can come off and form a free body, that is, an articular mouse.

• crepitus (crunching);
• swelling of the joint;
• intermittent blockage of the joint,
• muscle atrophy.

Rice. 1 Chondromatosis

Koenig's disease (dissecting osteochondrosis) is associated with aseptic necrosis of a separate limited area of ​​the joint, which is cut off over time. The gap that has arisen on the surface of the cartilage is overgrown with bone.

Clinical symptoms are the same as in chondromatosis, but the x-ray shows the presence of a lesion on the bone in the early stage, and in the later stage - an area of ​​bone regeneration.

Rice. 2 Koenig's disease

How to treat crunchy knees

In case of post-traumatic crunch, you can directly contact an orthopedic traumatologist, who is obliged to take an anamnesis and perform an examination using standard tests.

The doctor supplements the diagnosis with the necessary hardware methods:

• functional radiography;
• CT / MRI (if necessary);
• arthroscopy;
• study of synovial fluid.

If the causes of crepitus in the knee are unknown, refer to family therapist. Then he selectively directs the patient to a traumatologist or rheumatologist.

What family doctor will write out a referral to a rheumatologist, should not be frightening, since this specialist deals with all unexplained problems in the joints at the first stage.

The problem of crunching in the knees can cause a lot of anxiety in the patient. Knee pain and crunching can be a symptom of the development of a pathological process - arthritis, gout, rheumatoid arthritis or Bechterew's disease.

Also, a crunch in the knee joint can be a completely harmless manifestation of the mechanical processes that occur inside the joint bag during physical activity or age-related changes.

This symptom occurs in people, regardless of gender and age. Knees can crunch in both a small child and a pensioner. The difference will be in causes and consequences.

If in children such a phenomenon most often accompanies the active phase of growth, when muscles and ligaments stretch in an attempt to catch up with the growing skeleton, then in adults, on the contrary, the articular crunch becomes an alarming signal that indicates problems with the musculoskeletal system. This is not necessarily some kind of serious pathology, a crunch can mean that a person is not moving much or is overweight.

If you pay attention to such “calls” in a timely manner, then serious problems quite avoidable.

The reasons

What can cause the appearance of a crunch in the knee joint. There can be many factors causing such a phenomenon, and sometimes they will manifest themselves in a complex.

• Injury to the knee joint. This includes damage, rupture of the meniscus, dislocation of the knee, fracture of the bones that make up the joint. It may also turn out that ligaments or tendons are damaged. In these cases, the fixation of the joint weakens and the contact of the cartilage begins, which causes a crunch.
• Excessive mobility or hypermobility of the joint can also cause clicks.
• Inflammatory processes caused by various kinds of arthritis - rheumatoid, gouty. Possible bursitis. In the process of inflammation, the joint can be affected by infectious pathogens, which causes degenerative processes leading to its partial destruction. The contact of the articular heads in this case will give not only clicks and crunch, but also very painful sensations.
• Salt deposits in the joints due to metabolic disorders - osteophytes, impaired phosphorus-calcium metabolism.
• Increased stress on the joint due to excess weight.
• Osteochondritis, chondromalacia, chondromatosis and a number of other diseases during which deformities occur articular cartilage.

This entire list can give an answer to why your knees crunch. The etiology can be very different - from the destruction of cartilage, inflammatory processes, to the deposition of salts and the growth of periarticular tissues that block the work of the joint.

It is important to remember that a crunch in the knee when walking is most likely a symptom associated with joint dysfunction due to injury or neoplasms. If an adult has discovered this in himself and pain is felt at the same time, then a visit to the doctor is necessary.

A crunch in the knees of a child, which is not accompanied by painful sensations, is most likely due to the developmental processes of his musculoskeletal system and does not have any serious consequences.

If the child complains of soreness or tends to get knee injuries too often, then it makes sense to consult a doctor and undergo an examination. The crackling can be caused by loose ligaments and will need to be corrected. Otherwise, it cannot be guaranteed that the child will not be injured during physical activity due to joint instability.

Crack in the knee during flexion and extension

A person produces flexion and extension of the knee almost constantly. The crunch that appears in the knee when bending can be fixed when climbing stairs or when you sit down on a chair. A crunch during extension can be heard when you stand up or straighten your legs.

If clicks are heard without pain, then it is likely that the matter is in the mechanical processes inside the joint. The articular bag and adjacent ligaments adjust to the change in position, possibly creating increased pressure due to depreciation on the joint, which leads to the collapse of gas bubbles inside the joint fluid. When this happens, the tension within the joint is visibly relieved.

However, the cause of the crunch can be very serious diseases. The joint will begin to click if, for some reason, the shock-absorbing ability of the bursa has decreased and the heads of the bones have begun to touch. It should be noted that such contact can occur in certain unnatural positions of the body, or as a result of a pathological process that has started.

When bending the knee, a crunch appears due to the deposition of salts. This is primarily due to metabolic disorders, when oxidation products are not excreted in the urine, but are gradually deposited in the joints and can form whole conglomerates of tophi - tubercles that are visible through the skin.

Often people with overweight and those suffering from diabetes endocrine diseases. Here you may need the help of a specialist endocrinologist and nutritionist, who would normalize the composition of the patient's diet.

The crunch under the knee from behind is quite serious symptom, as it can signal meniscus injuries, neoplasms in the form of tumors, arthritis.

Crunchy knees also signal an excess of physical inactivity. If a person moves little, giving preference sedentary image life, then the joint, which is in a passive state, receives less nutrients and water.

In the process of microcirculation, cartilage should receive enough collagen, which provides their mobility. Otherwise, with a lack of moisture and nutrition, the shock-absorbing ability of the joint begins to decrease, which leads to the appearance of a crunch.

Cracking knees when squatting

One of the most common phenomena during the first classes in the gym is a strong crunch in the knee joints.

Such a sonorous accompaniment of squats often discourages the guest and makes them worry. In fact, signs of pathology can be observed when the crunch during squatting is also accompanied by painful sensations in the joint or periarticular formations.

There are a lot of reasons for the “sound accompaniment” when doing squats, but most often the joints crackle, because inside there is an unusual hitherto stretching of the ligaments and the collapse of gas bubbles that can accumulate in the bursae. When performing the exercise, the pressure inside the synovial fluid changes and the gas bubbles collapse.

The problem is serious if, in addition to the crunch, during classes, there is a pronounced soreness. This can be a symptom of both the development of an inflammatory process and a harbinger of joint destruction due to onset arthritis or arthrosis. In this case, the crunch will mean friction of the articular cartilage due to a decrease in the amount of cushioning synovial fluid between the articular heads.

If the pain persists after training, you should consult a doctor, you may need immobilization of the joint and its therapy to eliminate pathological causes crunch that appeared in the joint.

Treatment

When knees crunch when walking or exercising, you need to understand that if the process is painless, then most likely there is no pathology, it's just a reaction of the ligamentous apparatus to a change in pressure or excessive stretching.

If you decide to try to get rid of the “misfortune” with folk remedies, then first you should find out the true cause, after which, after agreeing on the therapy with your doctor, start experimenting.

A preliminary examination is very important, because without finding out the reasons, the procedures can seriously aggravate the situation. This applies to cases where the crunch is caused by trauma or suppuration inside the joint bag. In this case, for example, warming compresses will not only be useless, but even harmful.

The basis of homemade ointments from the knee crunch often includes honey, iodine, glycerin. In combination with such active substances like pine essential oils, they have a local effect on the joint, helping to relieve tension and inflammation from the joint.

Depending on the results of the examination, the doctor may prescribe an ointment for crunching in the knees, which may contain NSAIDs at its core, if the mobility is accompanied by pain. Also, prescribed ointments can be warming in nature to activate blood microcirculation in the joint and protective when the drug contains chondroprotective substances.

If the clicks are associated with an injury to the knee segment or the consequences of an injury, then the doctor will act here based on the situation. It is possible that the same torn meniscus will need to be operated on, and if we are talking about the contact of the heads of the bones, then injections of a joint fluid substitute with parallel therapy can help restore the function of the joint and the disappearance of an unpleasant crunch.

How to treat a clicking joint so that it does not lose mobility and remains functional. To begin with, follow all the doctor's prescriptions, and if, in addition to the drugs, massage, physiotherapy and exercise therapy were prescribed, then all recommendations must be followed strictly.

If the clicks are bothering a patient who has already had joint replacement surgery, then there are 2 options for what is happening:

1. The parts of the joint are still new and internal lapping continues.
2. If the joint has been installed for a long time, then clicking can signal that it is time to change the endoprosthesis.

It is not necessary that you need to remove the crunch in the knees. Perhaps this is just a normal physiological reaction and nothing to worry about. If you are not sure about the safety of this state of affairs, then it is best to consult a doctor who, after an examination, will name the cause of the crunch and recommend methods of treatment.

Crunching in the joints is a phenomenon that can be found in both young children and athletes, manual workers, office workers and retirees. Everyone, without exception, needs to understand that in the event of the appearance anxiety symptoms accompanying a crunch in the knee, you must immediately visit a doctor and find out the cause of unpleasant manifestations.

Get rid of the problem early stages much easier, so you need to take a responsible approach to your health. Sometimes, in order to restore the normal state of the joint, it will be enough to establish a drinking regimen, slightly change the diet and do more exercise. In a neglected form, you can experience severe restrictions all your life due to the possibility of another unpleasant exacerbation, as happens with gout.

A crunch in the joints does not necessarily accompany pathology, quite often it does not pose a danger. But it is impossible to ignore the constantly occurring sounds, especially if they are combined with discomfort and pain. The causes and treatment of crunching in the knees is the topic of today's conversation.

Why do joints crackle

Physiological crunch

The structure of the knee joint resembles a hinge: the head of another comes into the cavity of one bone, during movement they move relative to each other. To facilitate sliding and reduce friction, joint (synovial) fluid is produced in the joint.

The liquid is heterogeneous, it contains foreign inclusions, among which the least "dangerous" ones are bubbles. carbon dioxide. If, when bending and unbending the knees, soft clicks are heard, a crunch that does not manifest itself physically in any way, bursting gas bubbles become the cause of such a crunch. After some time, they form again and the crunch resumes.

Knees can crunch barely noticeable or, on the contrary, quite loudly. Such sounds are not a pathology and do not pose a danger.

Another reason for the “safe” crunch is the contact between the ligamentous apparatus and the bone sections that form the joint. Such sounds are especially frequent during adolescence during the formation of the skeleton.

However, according to statistics, approximately 15% of people whose knees click and crackle suffer from an initial form of arthrosis. How not to miss the onset of the disease?

Pathological crunch

If the joint crunches during physical activity:, squats, then the causes of extraneous sounds can be:

• joint inflammation, as the tissues swell, deform, increase in size, which leads to constant contact with the articular surfaces. A characteristic symptom of arthritis and similar diseases is pain;
• joint deformity and disruption of its functioning. Arthrosis is not rarely accompanied by a decrease in the amount of joint fluid;
• violation of water-salt metabolism. The accumulation of uric acid salts in the tissues leads to limited mobility, tissue swelling and severe pain. Without treatment, with gout, bumps, protrusions, tubercles are formed on the surfaces of the bones;
• joint injury, fractures, cracks interfere with normal functioning. Incorrectly fused bones, unrecovered joints can cause the development of arthrosis;
• pathological processes in the liver, violate the synthesis of collagen and reduce the mobility of the ligaments, hence the pain and crunch in the joints;
• obesity- being overweight causes additional, sometimes, excessive load on the joints. It is especially difficult for the knees and the hip joint, since the main load falls on them;
• high heel shoes. Physiologically, nature provides for walking on a flat foot, the heel causes a redistribution of the load, gives additional stress to the knees.

What to do if your knees are crunchy

To understand what a crunch in the knees means - harmless gas bubbles or the onset of a serious illness, you should undergo an examination, diagnose the cause of unpleasant sounds. AT urgently you need to see a doctor if pain, swelling, swelling of the joint, limited mobility, numbness are added to the sounds.

Among the diagnostic methods used:

1. Visual inspection, palpation of the joint;
2. Collection of analyzes;
3. radiography;

Magnetic resonance therapy provides the clearest picture of the situation. Along with a direct examination of the joint, a study of the condition of the kidneys and liver is carried out.

On LocalLab.ru you can find a clinic for MRI, CT, radiography or ultrasound diagnostics of the knee joint... Choose the best price in a convenient place!

Treatment methods of traditional medicine

Physiological crunch, if it does not cause psychological discomfort, does not need to be treated, it is not dangerous.

After the examination, it becomes clear what the cause is and what disease needs to be treated in order to eliminate the unpleasant symptom as well.

The therapy includes several stages:

• reduction (elimination) of pain - non-steroidal anti-inflammatory drugs (ibufen, nimesulide, diclofenac and others);
• removal of inflammation and swelling - ointments based on pepper, snake venom, dimexide improve blood circulation and nutrition, promote lymph outflow;
• restoration of cartilage tissue functions and joint mobility in general - chondroprotectors that can be drunk in the form of capsules or tablets (teraflex), injected intramuscularly (alflutop), injected directly into the joint cavity (only in a hospital, the doctor does!).

How to treat a crunch in the knees with folk remedies

If the joint creaks and crunches, but there is no opportunity to visit a doctor urgently, you can try the recipes offered by alternative medicine.

Dishes with gelatin

To increase joint mobility, treat and prevent diseases, recover from injuries and fractures, it is recommended to use jelly, aspic, and aspic daily.

When preparing jelly, they do not leave it to solidify, but drink warm broth obtained after 4-5 hours of boiling beef on the bone. You need to drink 1.5 cups 3-4 times a day for a month.

Parsley

Substances rich in fresh parsley, stimulate the liver, which, in turn, favorably affects the health of the joints.

If the knee joint crunches, you need to prepare an infusion of parsley and take it for 14 days.

For cooking, parsley roots are washed, finely chopped and put into a thermos, after which ½ l of hot boiled milk is poured. After 12 hours, the infusion is ready, it must be filtered through cheesecloth. The resulting liquid is the daily dose that you need to drink in three doses.

Celery

Chop the roots and parsley grass (100 g each) and mix, pour ½ liter of hot water. Bring to a boil and simmer over low heat for another 5-6 minutes, then cool and strain.

To the broth add 1-2 tbsp. l. honey and juice of one lemon. Drink in the morning, taking 6-7 sips. Store in the refrigerator for no more than 3 days.

oranges

Mix the freshly squeezed juice of one medium orange with 0.1 l of vegetable oil, moisten the gauze folded in several layers with the resulting mixture. Apply a compress to the sore joint, cover with cling film and a warm diaper on top. The duration of the procedure is 30 minutes, the duration of the course is 2 weeks.

Bran

Bran grind and pour warm milk. After swelling, after about 20-30 minutes, the mass is applied to a gauze bandage and a compress is made. The duration of the procedure is 1 hour. Similarly, you can use cereals(3-4 tsp per 0.2 l of boiling water).

Prevention of crunching in the knees

plays an important role in maintaining joint health proper nutrition. The diet should include:

• rich foods - milk and dairy products, hard cheeses, sesame, dill, basil, parsley, fatty sea ​​fish, nuts, seafood, chocolate;
• vitamin A (carrots, egg yolk, watermelon, peaches, blueberries), B 1 (cabbage, carrots, peas, potatoes), B 2 (milk, cottage cheese, nuts, eggs), B 6 (tomatoes, potatoes, strawberries, oranges) , D (red fish, dairy products), E (vegetable oil, sea buckthorn, almond nuts, sweet cherry), C (citrus fruits, rose hips, parsley, black currant, Bell pepper), K (pumpkin, tomatoes, peas);
• products containing .

Smoked and salty foods are not useful for joints.

Physical education, swimming will benefit.

A set of exercises for knee pain according to Bubnovsky

sharp pain in the back and knees will help to remove physical exercises:

1. Forward knee lunges (for each step). To perform the exercise, you need to get on all fours, crawl forward at each step, straightening one leg and dropping your body to the floor.
2. Lying on your back, hands behind your head, do twisting. Feet should be firmly pressed to the floor. Put under your back salt heating pad.
3. In the same position, simultaneously raise the leg, bent at the knee, and pull the knee to the opposite elbow.
4. Move on your knees (back straight).
5. Get on your knees, straighten your back, put a gymnastic mat or a towel rolled up on your calves. Lower the pelvis on the mat as low as possible, stay in this position for 20-30 seconds, take the starting position. Repeat the exercise without the mat.
6. Sit on the floor, stretch your legs in front of you. Holding the toe of the foot with your hand, bend the leg at the knee, then straighten and hold on weight. Return to starting position and repeat with the other leg.
7. "Walk" on the buttocks, hands clasped in front of the chest.
8. Push up from the floor, crossing your legs at the knees and lifting them off the floor.

A simple exercise to develop the knee joint

In this video, you will learn one simple exercise that will help develop a joint after an injury and simply strengthen the knee. Do it and be healthy!

Crunchy knees are just a symptom that can be quite harmless if not accompanied by pain and discomfort. You need to listen to your body, take care of it, eat right and provide feasible physical activity. No doctor will help if you do not take care of your health yourself.

The structure of the knee joint ensures that flexion and extension movements are performed smoothly and silently. As a rule, a crunch in the knees indicates a problem in the joint. If you notice that your knees have begun to crackle, you should see a doctor as soon as possible to determine the possible cause.

The structure of the knee joint ensures that flexion and extension movements are performed smoothly and silently. As a rule, a crunch in the knees indicates a problem in the joint.

If you notice that your knees have begun to crackle, you should see a doctor as soon as possible to determine the possible cause.

The reasons

Before answering the question: “What to do? How to treat a crunch? ”, Consider the causes of its occurrence. There is a physiological crunch, which sometimes happens to all people, and a pathological crunch in the knees.

The causes of pathological crunch in the knee joints are most often violations of comparability, or congruence, of articular articular surfaces.

When it is important to strictly adhere to the recommendations.

Prevention of joint diseases

What can be done to prevent such diseases? To prevent dysfunction of the joints and the appearance of a crunch in them, it is recommended to adhere to the following simple rules:

Following these recommendations will help prevent the development of diseases of the knee joints and the appearance of a crunch in them. But if you still have a crunch, pain or other symptoms, you should definitely consult a doctor.

Video

Why do knees crackle?

At the advent crunching and clicking in the knee joints most frequently complained by patients over the age of 50 years. In young people, such complaints are more rare and are usually associated with sports injuries, long exhausting workouts. In medical terminology, crunching in the joints is called crepitus. Crepitus in the knee can occur due to the rupture of air bubbles that form in the synovial fluid during movement in the knee joint, and is usually associated with a sedentary lifestyle. This condition is transient and is not considered a pathology. In the event of knee pathologies, the mechanism for the formation of a crunch consists in rubbing against each other of the articular surfaces or other elements of the joint. Crepitus in the knee can be isolated symptom, and be accompanied by symptoms such as pain, swelling, limitation of mobility.

One of the most common causes of crunching and clicking in the knee is injuries. Also common cause the appearance of a crunch in the knee joint is obesity, in which there is an excessive load on the knee joint, the structures of which begin to gradually collapse. Often, improperly selected shoes, especially those with flat soles or high heels, lead to a crunch in the knee joint, which contributes to the increased load on the knee joint. As a result, there is a gradual deformation of the articular cartilage.

Anatomy of the knee area

Anterior knee area

In the anterior region of the knee are the following structures:

• fascia;
• tendons of the thigh muscles;
• patella.

Fascia
Fascia is a sheath of connective tissue. The knee area is covered by own and superficial fascia. Own fascia is a continuation of the wide fascia of the thigh. Under it is the vascular network ( knee articular network), which provides blood supply to the anterior sections of the knee joint. The superficial fascia consists of two sheets, between which are subcutaneous bags ( cavities that are lined with synovium and filled with synovial fluid).

Tendons of the thigh muscles
The tendon of the quadriceps femoris muscle passes through the knee area. It is thrown over the patella and is attached to the tibia and, at the same time, serves as a ligament of the patella.

Patella
The patella is the largest sesamoid bone ( located in the tendon) of the human skeleton. It is located in the thickness of the tendon of the quadriceps femoris. In the patella, the apex and base are distinguished. The posterior surface of the patella is adjacent to the patella surface of the femur.

Back of the knee

The following structures are located in the posterior region of the knee:

• skin and subcutaneous fat;
• fascia;
• tendons;
• popliteal fossa.

Fascia
The popliteal fascia is a continuation of the broad fascia of the thigh. It is dense, it has holes for the passage of nerves and blood vessels.

Tendons
The biceps femoris tendon attaches to the head of the fibula, and the semitendinosus tendon attaches to the tibia. The semimembranosus tendon inserts partly on the medial condyle of the tibia and partly on the capsule of the knee joint.

Popliteal fossa
The popliteal fossa is diamond-shaped and bounded by tendons. The bottom of the popliteal fossa is the capsule of the knee joint.

The popliteal fossa is limited by the tendons of the following muscles:

• semimembranosus and semitendinosus muscles;
• biceps femoris;
• lateral and medial heads of the gastrocnemius muscle.

Knee-joint

The ligaments that strengthen the knee joint are:

• patellar ligament;
• peroneal collateral ligament;
• tibial collateral ligament;
• oblique popliteal ligament;
• arcuate popliteal ligament;
• transverse ligament of the knee;
• anterior and posterior cruciate ligaments;
• posterior menisco-femoral ligament.

The following types of movements are possible in the knee joint:

• bending;
• extension;
• external and internal rotation ( rotation).

What structures can crackle in the knee?

Structures, the defeat of which can lead to the appearance of a crunch in the knee, are:

• distal femur;
• proximal tibia;
• patella;
• menisci;
• articular cartilage;
• joint capsule.

The main causes of a crunch in the knee

The main causes of a crunch in the knee are:

• gonarthrosis;
• rheumatoid arthritis of the knee joint;
• gouty arthritis knee joint;
• hypermobility of the knee joint;
• violation of phosphorus-calcium metabolism;
• obesity;
• chondromatosis of the knee joint;
• bursitis of the knee joint;
• dissecting osteochondritis;
• osteophytes of the knee joint;
• dislocation of the knee joint;
• fracture of the bones that form the knee joint;
• damage to the ligaments of the knee joint;
• tendon injury;
• chondromalacia of the patella.

Gonarthrosis as the cause of a crunch in the knee

The main cause of gonarthrosis is an imbalance between the mechanical pressure acting on the joint and regenerative ( restorative) tissue abilities.

There are the following types of gonarthrosis:

• Primary gonarthrosis, which can occur due to hormonal imbalance, genetic and metabolic disorders, circulatory disorders, etc.
• Secondary gonarthrosis arises from the action of intra-articular and extra-articular causes. Intra-articular causes include intra-articular trauma ( fracture), meniscal injury, meniscectomy ( knee meniscus surgery). An extra-articular cause may be damage to the knee joint in pathologies of the hip joint - dislocation, improperly performed arthrodesis ( an operation that is performed to ensure complete immobility of the joint).

During gonarthrosis, five stages are distinguished:

• 1 stage. There is a primary lesion of hyaline cartilage. Cartilage cells degenerate ( are destroyed) and cannot perform their functions ( cartilage growth and regeneration).
• 2 stage. Fissures appear in the cartilage, which may extend to the subchondral cartilage plate ( the layer of bone just below the cartilage). Fragments of cartilage appear that irritate the synovial membrane and lead to its inflammation ( synovitis).
• 3 stage. The synovial membrane is hyperplastic ( increases in size), appear marginal osteophytes (growths on the surface of the bone).
• 4 stage. The subchondral cartilage plate is destroyed, which may be accompanied by the formation of cysts and thickening of the articular capsule.
• 5 stage. Characteristic appearance granulation tissue (tissue that appears during the healing of inflammatory foci) in the affected area. Articular surfaces at this stage are significantly deformed.

The first symptom of gonarthrosis is pain in the knee joint. The pain increases when climbing stairs, walking, squatting, hypothermia and depends on meteorological conditions ( in damp and cold weather, the pain intensifies). AT initial stages disease, pain bothers mainly in the morning, and gradually disappears during the day. When moving in the knee joint, a crunch is heard, associated with the friction of the affected articular surfaces against each other and often accompanied by a restriction of movement in the joint, which occurs due to the infringement of hypertrophied articular surfaces ( increased in volume and mass) synovial villi. Also, gonarthrosis is characterized by the development of contracture ( restriction of movement accompanied by an inability to fully flex or extend the leg at the knee joint), joint swelling. In the last stages of gonarthrosis, patients have difficulty walking.

Damage to the menisci as the cause of the crunch in the knee

The menisci can be damaged by direct or indirect action damaging factor on them. The most common causes are a sharp extension of the knee joint, jumping, a sharp turn of the lower leg inward or outward.

The main clinical manifestations of damage to the menisci of the knee joint are:

• Joint blockade - this is the resistance that appears when you try to unbend. Blockade is a temporary phenomenon and often appears when squatting, walking.
• Pain in the knee joint, which often appear when walking, increased stress on the joint. Particularly pronounced are pain when descending and climbing stairs.
• "click" symptom usually appears when walking and is associated with the “rolling” of the lower leg over an obstacle ( affected meniscus).
• Effusion ( accumulation of synovial fluid) in the cavity of the knee joint. Its appearance is associated with inflammation of the synovial membrane.
• Hemarthrosis (accumulation of blood in the cavity of the knee joint).

Rheumatoid arthritis of the knee

The causes of rheumatoid arthritis are unknown. It is believed that trauma, hypothermia, physical overstrain, etc. can be provoking factors.

In the first stages of rheumatoid arthritis of the knee, patients can perform daily activities, and in the last stages of movement are limited or completely impossible.

The main symptoms of rheumatoid arthritis of the knee are:

• Pain, which appears both during movement and during palpation ( feeling).
• Knee swelling associated with the accumulation of fluid in the joint cavity, as well as swelling of the periarticular tissues.
• Morning stiffness in the joints, the severity of which depends on the severity of the disease.
• Deformation ( violation of the form) knee joints.
• Contracture of the knee joint- this is a limitation of movements in the knee joint due to its inflammation, which is manifested by resistance when trying to make movements.
• Atrophy of the quadriceps femoris(malnutrition, structure and function of muscle cells).

Gouty arthritis of the knee

Gouty arthritis can have many clinical forms. The most common forms this disease are acute and chronic gouty arthritis. This disease mainly manifests itself in the form of seizures, which most often appear at night and are accompanied by a very intense ( strong) pain in the joint , which is not stopped by painkillers . In the interictal period, the symptoms subside. When you try to carry out movements in the knee joint, a crunch appears, movements are limited. Swelling, hyperemia appears in the area of ​​the affected joint ( redness), local boost temperature .

Syndrome of hypermobility of the knee

A crunch in the knee is the main symptom of this disease. This symptom is often accompanied by joint pain. Pain usually appears during exercise. Swelling may appear in the area of ​​the knee joint due to the development of inflammation of the synovial membrane. A clinical examination reveals one of the main symptoms of the disease - excessive mobility.

Violation of phosphorus-calcium metabolism as a cause of a crunch in the knee

The main symptoms of impaired phosphorus-calcium metabolism are:

• crunching and clicking in the knee when moving;
• restriction of mobility;
• pain on movement and severe violations and at rest;
• joint deformity.

Obesity

Obesity may be due to hypodynamia ( immobility), overeating, genetic predisposition, hormonal failure.

There are 4 degrees of obesity:

• 1 degree. Normal body weight is exceeded by 20 - 30%.
• 2 degree. Excess weight is 30 - 40%.
• 3 degree. Body weight exceeds the norm by 50 - 99%.
• 4 degree. Exceeding ideal body weight by 100% or more.

Chondromatosis of the knee

Chondromatosis can occur in the form of a stable and progressive form. With a stable form, 10 - 25 cartilaginous bodies are produced, and on this pathological process stops. The progressive form is characterized by the constant formation of cartilaginous bodies that accumulate in the joint and can completely cover the synovial membrane.

Chondromatosis of the knee joint is characterized by a unilateral lesion. Involvement of both knee joints is rare.

Symptoms of chondromatosis of the knee are:

• pain in the knee joint;
• crunch when moving in the knee joint;
• limited movement;
• frequent blockades;
• swelling of the knee joint.

Bursitis of the knee

The main clinical manifestations of bursitis of the knee joint are:

• pain in the knee area;
• swelling;
• limited movement;
• crunching when trying to move.

Dissecting osteochondritis as the cause of a crunch in the knee

This disease most commonly affects adults 20 - 40 years old), predominantly men. The causes of osteochondritis dissecans have not been fully elucidated. The main factors that can lead to the development of this disease are injuries, impaired blood supply to the knee area, constant excessive loads.

In the development of osteochondritis dissecans of the knee, there are 3 stages:

• 1 stage. Characterized by inflammation of the synovial membrane, accompanied by pain and swelling of the joint, which usually appear after exercise and disappear after rest.
• 2 stage. Pain becomes more pronounced and persists long time.
• 3 stage. The pain becomes constant. When the cartilage fragment is completely exfoliated, it can turn into a loose body and lead to blockade of the joint and the appearance of a crunch during movement.

Osteophytes of the knee joint

Dislocations of the knee joint

Dislocations of the knee include:

• Dislocation of the leg. Dislocation of the lower leg is a disease that is quite rare and is accompanied by a displacement of the bones of the lower leg relative to the femur. This disease is very severe course, since in addition to dislocation of the bones of the lower leg, there is a rupture of the joint capsule, damage to the ligaments and articular surfaces, menisci, nerves and blood vessels. With a dislocation of the lower leg, the direction of its displacement can be anterior, posterior, lateral ( lateral and medial), mixed. The most common is the anterolateral direction of the leg displacement. Immediately after the injury appears sharp pain, the joint is deformed. It is impossible to perform active movements, and it is dangerous to perform passive movements, as it can damage the vessels or nerves of the knee. With a complete dislocation, the leg remains in a straightened position and is shortened. In subluxation, the leg remains in flexion and is not shortened.
• Dislocation of the head of the fibula occurs very rarely with rupture of the tibiofibular syndesmosis ( junction of the tibia and fibula). The most common cause is a fall on a bent knee. Dislocation of the head of the fibula can be complicated by damage to the peroneal nerve.
• Dislocation of the patella. Patellar luxation is usually caused by trauma or dysplasia ( violation of the development of an organ or tissue at the stage of intrauterine development or after birth) patella. Patellar dysplasia leads to its lateroposition ( location of the patella on the lateral condyle), which is manifested by underdevelopment of the external condyle of the thigh and patella, deformity of the knee joint. There are traumatic and habitual dislocation of the patella. Traumatic dislocation can be lateral, rotational ( rotation of the patella around a vertical axis) and vertical ( rotation of the patella around a horizontal axis with its introduction into the joint space). A habitual dislocation is a dislocation that occurs repeatedly. Even a minor injury can lead to it. Dislocation of the patella is accompanied by severe pain. The position of the limb depends on the direction of displacement of the patella. So, with a lateral dislocation, the leg is in a bent position, with a rotational dislocation, the leg is straightened. Movement in the knee joint is limited.

Fractures of the bones that form the knee joint

Fracture of the proximal tibia occurs about five times more often than fractures of other bones that form the knee joint. Almost always, fractures damage the soft tissues, the joint capsule. Displacement of bone fragments can lead to damage to the tibial nerve or the neurovascular bundle of the knee.

A fracture of the distal femur implies a fracture of the condyles. The most common cause is a fall from a height, an accident ( traffic accident), osteoporosis ( ). A condylar fracture may be intra-articular or extra-articular, depending on the location of the fracture line.

The most common cause of a patella fracture is a fall onto a bent knee or a direct blow to the front of the knee. Most often, a horizontal fracture of the patella occurs, which is due to the fact that the tendon of the quadriceps femoris muscle is attached to its upper part and, under the action of a traumatic factor, it pulls the patella up. As a rule, there is a displacement of fragments. Less common are vertical and multi-comminuted fractures of the patella.

Knee ligament injury

Ligament injury can lead to anterior, posterior, medial, or lateral joint instability. The type of instability depends on the location of the damaged ligament. In some cases, rotational instability occurs, which usually occurs when several ligaments are damaged at the same time.

Ligament damage is an indirect cause of a crunch in the knee. The crunch and clicks appear due to the fact that the normal anatomy of the joint is disturbed, and the load exerted on different parts of the joint is uneven. When the ligaments are torn, the joint wears out, it is damaged and deformed.

Knee tendon injury

Chondromalacia of the patella as the cause of a crunch in the knee

Which doctor should I contact if the knee crunches?

If a crunch appears in the knee, you can also contact the following specialists:

• family doctor;
• therapist;
• nutritionist.

The family doctor diagnoses crunching, which is more often associated with chronic, slowly progressive diseases of the knee joint. The therapist diagnoses the causes of a crunch in the knee associated with inflammatory diseases ( arthritis). A nutritionist should be consulted for obesity, which often contributes to problems with knee joints.

Diagnosis of the causes of a crunch in the knee

The main methods for diagnosing the causes of a crunch in the knee are:

• clinical examination;
• ultrasound ( ultrasound procedure) knee joint;
• x-ray examination of the knee joint;
• study of synovial fluid;
• arthroscopy of the knee joint;
• CT ( CT scan) knee joint;
• MRI ( Magnetic resonance imaging) knee joint;
• scintigraphy.

Clinical examination

The examination begins with an analysis of the patient's complaints. Complaints of a crunch in the knee are usually presented by patients over the age of 40, which is associated with age-related degenerative changes in the structures of the joint. Along with complaining of a crunch in the knee joint, patients complain of pain, discomfort, limited mobility, and morning stiffness in the knee joint.

When collecting an anamnesis, special attention should be paid to the presence of injuries and diseases of the musculoskeletal system. The doctor finds out during which movements a crunch appears in the knee ( flexion, extension, squatting, running, walking). It is also important to analyze the professional activity of the examined patient, since this problem is very common among athletes and representatives of other professions associated with heavy loads on the lower limbs. It is necessary to find out if a crunch in the knee is a sign of a hereditary disease ( the presence of the same symptoms in close relatives).

On examination, the following symptoms of knee pathology can be detected:

• swelling of the knee area;
• hematoma ( limited collection of blood subcutaneous tissue );
• knee deformity;
• symmetry of pathological changes;
• defeat skin and soft tissues.

Auscultation in this case is carried out directly ( without the help of a stethoscope), during which the patient performs active or passive movements of the limb and a crunch or clicks are heard.

When determining the range of motion in the knee joint, first evaluate active movements (performed by the patient), and then passive ( performed with the help of a physician). The volume of movements is determined using a special tool ( goniometer). When measuring the range of motion in the knee joint, the leg is initially in a straightened position.

General blood analysis

Blood chemistry

General urine analysis

Ultrasound of the knee joint

When visualizing the anterior and lateral sections of the joint, the patient lies on his back, and in order to better visualize the menisci, the doctor asks the patient to bend his knees. For visualization posterior divisions knee joint, the patient is asked to lie on his stomach.

Signs of knee pathology that can be detected by ultrasound are:

• Presence of effusion in the joint cavity.
• Synovial inflammation, which is accompanied by its thickening, proliferation ( overgrowth) synovial villi.
• Torn tendons and ligaments are displayed as a violation of their anatomical integrity of the ligament and rupture of the fibers.
• The defeat of the menisci. When the meniscus is damaged, there is a violation of the meniscus contour line, the presence of meniscus deformation, their fragmentation and degeneration.
• The presence of foreign bodies in the joint cavity can be with penetrating wounds, fractures.
• Presence of Becker's cyst, which looks like a cavity filled with liquid.
• Joint space narrowing can talk about synovitis, osteoarthritis, rheumatoid arthritis.
• Irregular contours of the joint (in inflammatory and degenerative diseases).
• thinning of hyaline cartilage commonly seen in osteoarthritis.
• Inflammation of synovial bags manifested by the presence of anechoic ( black color) or hyperechoic ( white color) zones.

X-ray examination of the knee joint

Radiological signs of knee pathology are:

• Changing the position of the bones observed with dislocations of the knee joint, fractures of the femur and lower leg bones, as well as congenital anomalies musculoskeletal system.
• Change in bone structure occurs, as a rule, with bone fractures and is expressed in the interruption of contact between the bone beams ( areas of cancellous bone). Changes in the bone structure also include its restructuring - osteoporosis ( decrease in bone density), osteosclerosis ( increased bone density).
• Joint space narrowing observed in dystrophic and inflammatory lesions of the knee joint. The narrowing can be uniform and uneven. Uneven narrowing of the joint space is usually observed in arthritis.
• Foci of destruction appear on the x-ray as dark or bright areas.
• fracture line. The fracture line looks like a light strip with jagged edges. The fracture line indicates the exact location of the fracture ( intraarticular, extraarticular). Also evaluate the direction and extent of the fracture line.
• Displacement of bone fragments can be transverse, longitudinal, lateral, angular.
• Cartilaginous inclusions and chondromic bodies various shapes and sizes are observed with chondromatosis.

X-ray examination is also carried out after reduction of dislocations, treatment of fractures in order to monitor the effectiveness of treatment.

The study of synovial fluid

In the pathology of the knee, changes in the following indicators can be detected:

• Color. Yellow synovial fluid can be with osteoarthritis, bloody coloration is characteristic of traumatic lesions of the knee joint. In inflammatory diseases of the knee joint, the color of the synovial fluid can vary from yellow to brown.
• Transparency. In osteoarthritis, the synovial fluid is translucent, in inflammatory diseases it is cloudy, translucent.
• Sediment. In rheumatoid arthritis, a sediment in the synovial fluid is often found, formed from necrotic areas of the synovium and resembling rice grains ( "rice bodies").
• Cytosis ( number of cellular elements). Normally, cytosis is 0.1 - 0.5x10 9 / l. For degenerative diseases and traumatic lesions knee joint, this indicator can reach 2 - 3x10 9 / l, and in inflammatory diseases up to 80x10 9 / l.
• Microscopic examination. Microscopic examination of native ( unpainted) smear can be detected ragocytes ( granular cells), the number of which in rheumatoid arthritis can reach half of the total cellular composition of the synovial fluid. In gouty arthritis, uric acid crystals may be found in a native smear.
• non-cellular elements. In traumatic lesions, fragments of cartilage and damaged ligaments can be found in the synovial fluid.
• Cell composition. The predominance of one or the other cellular element in the synovial fluid helps in clarifying the diagnosis and determining the severity of the pathology. In inflammatory diseases, synovial fluid is dominated by neutrophils, in degenerative diseases - by lymphocytes. Thus, in rheumatoid arthritis, the number of neutrophils can reach 90%, in osteoarthritis, the number of lymphocytes can reach 70%.

Arthroscopy of the knee

Pathological changes that can be detected during arthroscopy of the knee joint are:

• meniscus tear;
• the presence of chondromic bodies;
• cartilage damage;
• dissecting osteochondritis;
• damage to the cruciate ligaments;
• synovial inflammation.

CT scan of the knee

At computed tomography layer-by-layer images of the area under study are carried out, which allows for a complete assessment of the state of the knee area.

With the help of CT of the knee joint, the following pathological conditions can be detected:

• bone fracture;
• inflammation of the synovial membrane;
• arthritis;
• osteoarthritis;
• the presence of foreign bodies in the joint cavity;
• anomalies in the development of the joint;
• dissecting osteochondritis.

CT of the knee joint can be performed using contrast agents, which improve the visualization of the state of blood supply to the area under study.

MRI of the knee

No special preparation is required before an MRI of the knee joint. The patient may be given a sedative if they are claustrophobic ( fear of closed space), since during the procedure the subject is placed in the tomograph tunnel. MRI is contraindicated in patients with prostheses and implants with metal parts.

MRI of the knee joint allows diagnosing the following pathological conditions:

• swelling of the periarticular tissues;
• the presence of effusion in the joint cavity;
• stretching of ligaments and tendons;
• damage to the patella;
• Baker's cyst;
• hemarthrosis;
• synovitis;
• bursitis.

Scintigraphy

What to do so that the knees do not crunch?

In case of traumatic injuries of the knee, it is necessary to immobilize the limb, that is, to carry out transport immobilization using special splints to fix the limb or other improvised structures.

Treatment of pathologies leading to a crunch in the knee should include the following main components:

• dieting;
• drug treatment;
• surgery;
• restorative treatment.

Compliance with a diet with a crunch in the knee

In the fight against obesity, diet plays essential role. In each case, the diet should be selected individually by a nutritionist. Along with the diet, for successful results, it is necessary to resort to physical exercises. Following a diet without first consulting a doctor is fraught with complications.

To normalize phosphorus-calcium metabolism, it is necessary to increase the amount of foods rich in easily digestible calcium and phosphorus in the diet. Such products are cheese, milk, cottage cheese, fish products.

Drug treatment of crunch in the knee

Due to the fact that there are many causes of a crunch in the knee, different groups of medicines can be used in the treatment.

Drug treatment of the causes of a crunch in the knee

Surgical treatment of crunch in the knee

The main types of surgical interventions that are performed to treat knee pathologies are:

• arthrotomy of the knee joint;
• tenorrhy;
• knee arthroplasty;
• therapeutic puncture of the knee joint;
• synovectomy;
• synovcapsulectomy;
• arthroscopy;
• osteosynthesis;
• meniscectomy;
• ligament injury treatment.

The knee joint is practically not covered by muscles, so access to it is not difficult. Access can be anterior, posterior and parapatellar ( on the side of the patella). The most gentle is the parapatellar incision, in which the ligamentous apparatus is minimally damaged.

Tenoraffia
Tenoraffia is surgical intervention, which is carried out for the purpose of suturing the tendons. The operation is indicated for incised, stab wounds with damage to the tendons. During the operation, tendon sutures are applied, and then the limb is immobilized in order to provide conditions for normal fusion. The immobilization period usually lasts 4-6 weeks. The sutures must be reliable, not contribute to disruption of the blood supply to the tendon, and maintain a smooth surface of the tendons.

Knee Arthroplasty
Arthroplasty is a type of surgical intervention aimed at restoring the structure and function of a joint. Knee arthroplasty is often prescribed for knee pathologies accompanied by contracture.

Knee arthroplasty is performed in several stages:

• arthrotomy of the knee joint;
• separation of articular surfaces
• joint modeling ( the configuration of the articular surfaces is re-formed);
• immobilization of the limb with a plaster splint or skeletal traction;
• development of the joint using a set of exercises.

Therapeutic puncture knee joint
Therapeutic puncture of the knee joint is prescribed for the introduction of drugs into the joint cavity, as well as for the evacuation of pathological contents from the joint cavity ( with long-term healing hematomas, hemarthrosis), which helps to reduce intra-articular pressure.

Before performing a puncture, it is necessary to make sure that the pathological fluid is in the joint cavity, and not in the periarticular structures ( bursitis). During the puncture, the patient is in the supine position with the limb extended at the knee joint. The needle is inserted at the inner or outer edge of the base of the patella to a depth of 3-4 cm. For better aspiration of the contents of the joint, they press on the patella. After puncture, an aseptic ( sterile) bandage.

Synovectomy
A synovectomy is a surgical procedure in which the synovium of the knee joint is removed. This operation usually prescribed for rheumatoid arthritis, when inflammation of the synovial membrane does not go away with drug treatment. The removed synovium is replaced with a synthetic one. The operation is performed with severe inflammation of the synovial membrane with the growth of its villi. Synovectomy is contraindicated in exacerbation and a high degree of activity of the pathological process.

Synovcapsulectomy
A synovcapsulectomy is an operation during which the synovial membrane and capsule of the knee joint are removed. This operation is prescribed in the late stages of arthritis of the knee joint with a total pronounced lesion of the synovial membrane, involvement of the joint capsule in the pathological process.

Arthroscopy of the knee
Knee arthroscopy is one of the most frequently performed knee surgeries. it effective method endoscopic surgery. The operation is performed using an arthroscope, a video system, and various instruments. Anesthesia can be local, spinal or general. The choice of the method of anesthesia is carried out by the attending physician together with the anesthesiologist, based on the patient's condition, the severity of the disease. Depending on the location of the pathological site, the place of arthroscopic access is chosen ( lateral, medial, parapatellar).

Arthroscopy can be performed with lesions of the meniscus, osteoarthritis, damage to the ligaments of the knee joint. During the operation, the joint is constantly supplied with saline from a reservoir, which provides better visualization of the joint cavity due to changes in intra-articular pressure, as well as constant washing of the joint cavity. The operation is minimally traumatic, recovery is as fast as possible.

Osteosynthesis
Osteosynthesis is a surgical intervention that is performed with the aim of repositioning ( comparison) bone fragments at a fracture. The operation is performed using various fixing devices ( screws, plates). Fixation can be done with splinting and compression. When splinting, the fixation of fragments is carried out due to the transfer of the load to the tire. Compression is carried out using special tightening screws. Fragments are fixed in the correct position. Fixation of bone fragments continues until their complete union. Osteosynthesis can be intraosseous, extraosseous and transosseous.

Meniscectomy
A meniscectomy is the surgical removal of the meniscus of the knee. Meniscectomy can be complete or partial. This operation can be performed with open access to the knee joint or using endoscopic access. At open operation a layer-by-layer opening of the articular cavity is performed, the meniscus is removed, and then the tissues are sutured in layers. Open meniscectomy is performed quite rarely due to the fact that it is more traumatic. The most commonly performed is endoscopic meniscectomy, which is less traumatic and does not require a large incision. Small incisions are made in the knee area up to 0.5 cm). A miniature video camera connected to a monitor is inserted through one incision. Through the second incision, the instruments necessary for the operation are inserted. During the operation, fluid is injected into the joint cavity, which provides visualization of the joint cavity.

Treatment of ligament injury
Surgical treatment is performed with a complete rupture of the ligaments of the knee joint. The torn ligament is sutured. In severe cases, autoplasty is performed ( using grafts from the patient's own tissues) or alloplasty ( with synthetic tissue grafts) links. After the operation, the limb is immobilized for 4-6 weeks.

Rehabilitation treatment for a crunch in the knee

To restore the functions of the joint, the following methods are prescribed:

• exercise therapy. Physiotherapy- this is an integral stage in the treatment of knee pathologies, however, its use should be rational and timely, since too early start physical activity can lead to even more tissue damage, and late start of exercise is fraught with problems with the restoration of the functions of the knee joint.
• Physiotherapy. Physiotherapy is the use of physical factors for therapeutic purposes. The physiotherapeutic methods used in the fight against the causes of a crunch in the knee include electrophoresis ( drug administration with electric current ), massage, thermal treatments. The use of these methods in combination makes it possible to achieve good results.
• Swimming influences positively on metabolic processes in the body. The undeniable advantage of swimming with knee pathologies is the lack of load on the knee joint, unlike other sports.

Features of a crunch in the knee

Why do knees crackle when unbending and bending?

Such a crunch can be physiological ( with a sedentary lifestyle) and pathological ( in diseases of the knee). A pathological crunch during flexion and extension is formed due to the friction of the affected articular surfaces. This is usually associated with deformation of the articular cartilage, inflammation of the synovial bags of the knee joint.

Why does the knee crackle when squatting?

In the presence of a pathology of the knee, this exercise leads to mechanical irritation of the components of the joint, which leads to inflammation of the synovial membrane, as a result of which the nutrition of the articular cartilage is disturbed. As a result, the cartilage is destroyed, the articular surfaces are damaged and they rub against each other. Pathologies that are accompanied by a crunch when squatting are ligament damage, osteoarthritis, arthritis, and meniscus injuries.

Why does the knee crackle and hurt?

The mechanism of pain and crunch in the knee, as a rule, consists in a violation of the congruence of the knee joint, thinning of the hyaline cartilage, as a result of which the articular surfaces rub against each other, which is accompanied by a crunch and pain and sensations. Crunching and pain usually appear when performing various movements. These symptoms may appear in the morning immediately after waking up or in the evening after prolonged stress on the joint.

Why does a child's knee crackle?

A crunch in the knee in a child may appear as a result of the following pathological conditions:

• Congenital pathologies. Congenital pathologies, in which a crunch in the knee may appear, there may be developmental disorders of bones and joints, a violation of collagen synthesis, varus ( O-shaped) and valgus ( X-shaped) deformation lower extremities.
• Knee joint injuries in childhood can lead to serious damage to it with deformation due to the fact that bones and joints are more fragile in childhood. The most common knee injury in children occurs during a fall. In newborns, injuries can be generic, that is, occur during childbirth.
• Deficiency of certain elements in the diet. important role in maintaining normal state bones and joints are played by elements such as calcium, phosphorus, vitamin D. Vitamin D deficiency leads to the development of rickets, which is manifested by damage to the bones, joints, nervous system, and muscles. Violation of phosphorus-calcium metabolism leads to increased fragility of bones, disruption of their development.
• Juvenile rheumatoid arthritis is a joint disease that affects children. The causes of this disease have not been elucidated. The mechanism of development of juvenile rheumatoid arthritis is the defeat of the immune system, which begins to perceive the body's own tissues as foreign, damaging them. The disease is characterized by inflammation of the synovial membrane of the joint, excessive accumulation of synovial fluid in the joint cavity, destruction of the articular cartilage. Main clinical symptoms is pain in the joints, crunching and clicking when moving, swelling of the knee area.
• Osteoporosis is a pathological condition that is characterized by a decrease in bone density, as a result of which the bones become very fragile. Osteoporosis in children can be congenital as a result of intrauterine development disorders and acquired due to malnutrition of the child, taking certain medications.

Why do knees crack when climbing stairs?

• Gonarthrosis is a degenerative disease that becomes more common with age. With gonarthrosis, there is a violation in the synthesis of synovial fluid, as a result of which the articular cartilage becomes unable to withstand mechanical stress. Gradually, the destruction of the hyaline cartilage of the knee joint occurs, and then the bones are also affected. The crunch appears as a result of the destruction of the structures of the joint.
• Meniscus injury. Meniscal injury is one of the most common knee injuries. In most cases, the inner meniscus is damaged, which is due to the fact that it is inactive. When a meniscus is torn, its part can move freely in the cavity of the knee joint and be infringed between the articular surfaces, causing a crunch, pain and blockade ( strong resistance when trying to move the joint), as well as contributing to the destruction of articular cartilage.
• Rheumatoid arthritis accompanied by inflammation of the synovial membrane with increased secretion of synovial fluid. Gradually, the destruction of hyaline cartilage occurs. The main symptoms of rheumatoid arthritis are pain and morning stiffness in the knee joints, swelling of the knee, crunching and clicking when moving.
• Damage to the ligaments of the knee joint. If the ligaments of the knee joint are damaged, the load exerted on the joint becomes uneven ( especially with unilateral ligament injury). The lesion of the ligaments is accompanied by clicks and a crunch on movement, pain on palpation and movement. Instability of the knee joint can also occur, which often occurs with a complete rupture of the ligaments.

Why do my knees swell and crack?

Most often, the knees swell and crackle in the following pathological conditions:

• Arthritis of the knee. Arthritis is an inflammatory disease of the joints, which is characterized by pain in the knee, swelling and redness of the knee area. There is a violation of the functions of the joint, movements are accompanied by pain and a crunch in the knee. The knee is most commonly affected by rheumatoid arthritis.
• Damage to the meniscus of the knee joint. The most common is a meniscus tear. A meniscus tear can occur at the level of the anterior or posterior horn, the body of the meniscus. In this case, a section of the meniscus is torn off, which can lead to blockade of the joint. The most commonly diagnosed chronic damage to the menisci, accompanied by the destruction of the articular cartilage.
• Bursitis of the knee. With inflammation of the synovial bags of the knee joint, movements become difficult. Bursitis can appear as a result of injuries or inflammatory diseases of the knee ( rheumatoid arthritis, gouty arthritis). The most common is prepatellar bursitis, which is manifested by swelling just above the patella, pain and crunching when trying to make movements in the knee joint.
• Gonarthrosis. With gonarthrosis, age-related degenerative changes occur in the knee joint, that is, there is a gradual destruction of the structures of the joint. The risk of developing osteoarthritis increases with age. This disease is often accompanied by a crunch in the knee and pain, which initially appear with heavy loads on the joint, and then at rest.

Why do knees crackle after running?

A crunch in the knee after running can be caused by the following pathologies:

• Osteoarthritis of the knee ( gonarthrosis) . With gonarthrosis, there is a gradual destruction of the articular cartilage and other structures of the knee joint. In this disease, running is not recommended, as this can help accelerate degenerative processes.
• Sprain. On a microscopic level, a sprain looks like a complete or partial break fibers. Sprains occur very often if a person runs without first warming up.
• Meniscus injury- This is a common pathological condition that is accompanied by a crunch in the joint during and after running.
• Bursitis of the knee. Bursitis is an inflammation of the synovial bags of the knee joint. Bursitis can occur as a result of excessive stress on the knee joint when running.
• Intra-articular free bodies. Intra-articular free bodies are called structures that move freely in the joint cavity. Such structures can be fragments of articular cartilage, menisci, torn ligaments, synovial villi. Some loose bodies can be over 1 cm in size. These structures lead to blockade of the joint, limitation of mobility. Crunch and clicks appear as a result of cartilage damage.