Why does my knee click or creak after ACL reconstruction?

Michael de Levie fysio en kniespecialist

Written by Michael de Levie

February 17, 2024

Does your knee click or creak while bending and stretching? After undergoing anterior cruciate ligament reconstruction, you may be wondering if this clicking or creaking is harmful to the knee. In this blog series, we address the most common questions after anterior cruciate ligament surgery. Today's focus is on the clicking and creaking of the knee. You will get answers to questions such as: what is the clicking or cracking, how and why does it occur? Of course, we also answer the two most important questions: is it harmful to the knee and what can you do to reduce the clicking or cracking?

Help my knee makes noise

What clicks or creaks in the knee after anterior cruciate ligament reconstruction?

A knee functions as a hinge that opens and closes. Movement can cause friction, which can cause sound. In the knee, this sound can be caused by cartilage that is no longer completely smooth. After anterior cruciate ligament reconstruction, it is often caused by fluid in the knee. Another possibility is that the kneecap does not slide smoothly through its designated "channel," or due to tendons and shifting fascia layers. In some cases, the sound may be caused by scar tissue or meniscus tear.

How and why does a clicking or creaking sound occur?

After anterior cruciate ligament reconstruction, swelling is always present to a greater or lesser degree. The clicking or creaking usually begins after several weeks to months, once the swelling subsides. The fluid in the knee can cause crepitating and creaking noises. Another effect of swelling in the knee is the decrease of muscle strength in the upper leg muscles. This leads to decreased control of the kneecap and affects the movement of tendons and fascia layers. As a result, you may feel a click or creak during bending and stretching of the knee.

Does the knee wear out faster by cracking or clicking?

The clicking and cracking of the knee, as annoying as it is, generally does not hurt the knee. 

What can you do about a creaking or clicking knee? 

Creaking or clicking in the knee when moving is irritating and often reported during many anterior cruciate ligament rehabs. The good news is that it almost always subsides over weeks and sometimes months. Because it takes time, confidence in the process is important. Talk to peers who are further along in anterior cruciate ligament rehabilitation. Whether the clicking and creaking disappear depends mainly on the amount of fluid in the knee and the muscle strength of the quadriceps. Once training goes well and strength is restored, there is less and less complaining about it.

Sometimes the knee clicks or creaks through scar tissue This is often accompanied by restriction of extension. If these symptoms do not resolve over time, sometimes keyhole surgery is needed to remove excess scar tissue. Another cause for a snap in the knee is a meniscus tear. If this is accompanied by locking symptoms, pain or persistent swelling, keyhole surgery may resolve the symptoms.

What is your experience?
Share your story below this blog

In 2023 heb ik een voorste kruisband reconstructie gehad. Heel lang kraakte mijn knie met trainen. Vooral bij leg extension maakte mijn knie veel geluid. Ik heb het vaak tegen mijn fysio verteld, maar die gaf aan dat het niet erg was. Hij kreeg gelijk. Na enkele weken werd het gekraak minder.
Martijn

Mijn revalidatie ging erg goed. Ben toen een weekje op vakantie geweest en toen begon de ellende. Tijdens de vakantie kreeg ik meer last en mijn knie begon geluid te maken. Bij terugkomst ben ik meteen weer gaan trainen, maar mijn knie kraakte met squats en andere oefeningen. Na een maand trok het weg en kon ik zonder klachten weer verder trainen.
René

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