Unstable knee with grating clicking noise

[Physio Dace]

Can you pull your knee all the way to your chest and then across your body while lying down without discomfort in the groin? Compare this to the other leg as well.

Many hip pathologies present as knee pain and in some conditions (e.g. femoral acetabular impingement, slipped capital femoral epiphysis) can result in changes in the rotational positional of the hip/femur that can alter the alignment of the patella in the femoral groove causing clunking during knee extension. Have you had an xray of the hip joint?

Beyond that it could be a local patellafemoral tracking/pain disorder possibly linked to either local (tight lateral knee structures etc) or proximal (overactive hip external rotators/TFL etc, ITB length etc) issues.

Without more info that would be first guess.

[sallyann]

Can you pull your knee all the way to your chest and then across your body while lying down without discomfort in the groin? Compare this to the other leg as well.

Many hip pathologies present as knee pain and in some conditions (e.g. femoral acetabular impingement, slipped capital femoral epiphysis) can result in changes in the rotational positional of the hip/femur that can alter the alignment of the patella in the femoral groove causing clunking during knee extension. Have you had an xray of the hip joint?

Beyond that it could be a local patellafemoral tracking/pain disorder possibly linked to either local (tight lateral knee structures etc) or proximal (overactive hip external rotators/TFL etc, ITB length etc) issues.

Without more info that would be first guess.

When i pull knee upto chest then across body there is quite severe pain in groin and at the back top of leg. I cann't compare to left leg as that leg was affected by polio.I have not had an xray yet, i think that will be the next avenue for me to go down. Many thanks for your answer.

[bikelet]

Hey sorry to hijack this post...Physio Dace
just realised that i may have FAI- I don't have bad pain but sometimes my hips just need to crack (which sometimes is painful, sometimes not). If i flex the hip and then do a hip circle, there is a major clunk and it usually hurts (depends on exact body position and certain days). If i try to do a piriformis stretch lying on my back i feel pain in the hip join (left more than right) and i feel that my hip is mechanically restricted in this movement. I can do a piriformis stretch seated and i do it especially for the left side as in the past i have had some issues with sciatica in that leg. Would you think it might be FAI, if so what should i do? I am only young and don't really want an op as it doesn't restrict me that much at the present time

[Physio Dace]

Bikelet,

Well I guess the most important fact is that it doesn't limit you too much - so you may not want to rush out too quickly for investigations etc. Without examining and asking a few hundred Q's I cannot answer your question in confidence.

My first suggestion then would be to get an assessment by a physio with a hip pathology in mind and if there's any clinical suggestion of FAI then a follow-up xray would be indicated and help differnetial diagnosis. A few surgeons in Australia are now having excellent success with a mini-incision and arthroscopically corrected Cam/Pincer/both FAI particularly if the hip joint itself is still reasonably well preserved (mild OA only) - thus early detection can be very useful.

Good luck.