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Have you ever experienced intense knee pain? It may be due to a sudden fall over the knee or hitting your knee on a hard surface. Although, internal knee injuries heal themselves; however, this type of wound could leave behind fragments of cartilage or tiny bones in your synovial fluid.

 If you feel your injured knee, you may not feel these fragments; instead, experience erratic joint lockup, restricted motion, inflammation, and knee strain. These tiny particles can range from millimeters to centimeters.

Knee Pain

You may experience swelling and inflammation if the synovial membrane has a trapped fragment. The synovial membrane surrounds the knee leaving the cartilage area. So, these fragments can also become a cause of arthritis in the knee. The reason is that these particles move around and mutilate the articular cartilage. Hence, early diagnosis and appropriate treatment will help prevent more significant damage to your knee.

The Loose Fragments

You must know how the loose bodies in the joints can cause damage. These tiny fragments of bone or cartilage move freely in your joint fluid. The flexion can trap the particle which will hamper your joint movement. When these bodies mutilate the articular cartilage, you suffer from chondrosis.

What Are the Symptoms?

If there are loose bodies in the knee, you may feel that something is moving in your joint. Loose bodies also limit your knee rom (range of motion). Hence, you may feel a locked knee as if it is jammed by a foreign force.

What Are the Causes?

You may suffer from a loose body in the knee due to an injury to the cartilage, which might result from trauma or sports. The incident can lead to tiny fragments in the joints if you are suffering from osteoarthritis or Charcot’s disease and undergo direct or indirect trauma. If you have an inflamed knee, it might be due to fibrinous fragments. Some people might suffer from a rare condition, Synovial chondromatosis or synovial osteochondromatosis. In this condition, your joint fluid grows abnormally and creates cartilage lumps. Some genetic conditions may also lead to loose bodies, such as Ehlers Danlos syndrome. These conditions may lead to heritable connective tissue disorders which cause joint hypermobility. Then Loose bodies contribute to the development of knock knees.

How To Diagnose a Loose Body in Knee?

To examine and diagnose the loose bodies, doctors may use the following approaches:

• X-Ray

The basic approach used to diagnose fragments in the knee fluid is the X-ray. In most cases, the pieces have a bone chip along with them or a massive lump of cartilage that an X-ray can easily detect.

• MRI

The ideal way to identify the site and character of a loose body is through an MRI. If you have synovial chondromatosis, the cartilage fragment can also be diagnosed the same way. Accordingly, MRI is a state-of-the-art non-radiation diagnostic method that examines the entire joint. It is a beneficial pre-operative device to visualize the fragment’s size, amount, and exact spot.

• CT Scan

This technique is rarely used. The special thing about this is that it can provide complete details about the tiny fragments at the time of bone fracture.

Loose Bodies with No Symptoms

Sometimes you have broken fragments in your body that don’t produce any symptoms. The finding of loose pieces in joints is fundamentally based on X-ray findings. Hence, there is not one specified clinical diagnosis. These loose fragments in the knee joint were crucial for which arthroscopies became so popular.

• Illustration

A 50+ years old man had floating fragments in his left knee joint. It was a history and not due to a tragic event. The occasional loose piece in the cartilage causes discomfort. He was also suffering from inflammation and swelling. He could see a clear difference in his knees, as is demonstrated in many swollen knee pictures. Surgeons took him for an x-ray examination and found a loose joint in his medial gutter. As medication could not cure this, he agreed to surgical treatment.

• Treatment

Doctors gave anesthesia to the patient in the operation theater. They raised the left leg, drained the blood, and pumped a pneumatic tourniquet to 300 mmHg. A holding device lifted the leg.

At the start of the surgery, doctors inserted an arthroscope via an adjacent infrapatellar puncture site. A check-up of the suprapatellar pouch showed extra synovial fluid. Doctors also witnessed many cartilaginous loose joint builds in the joint.

The arthroscopic procedure helped remove the fragments in the knee. There were grade 3 changes of a patellofemoral joint together with the trochlea. Then doctors performed a vacillating chondroplasty.

A preoperative diagnosis of a patient showed a loose joint body of the left knee. According to the diagnosis, there were several loose joint fragments, a ripped medial meniscus, and grade 3 deviations of the patellofemoral joint. So, prolotherapy was the best approach after arthroscopy.

The Special Instruments for Treatment

Usually, doctors use a suction tip to remove the fragments. Apart from this, if you have tiny particles in your joints, surgeons may use a small needle and grasper (a surgical instrument) to remove them.

If any bodies are floating in your knee joint area, doctors use a specialized clinical instrument known as the mechanical burr or re-sector to break down the bodies. Your body can easily disregard the broken fragments through the enzyme degradation mechanism.

Suppose your body has large-sized fragments due to an injury, knee fracture, bone swelling, or cartilage inflammation. Your surgeons will reduce these particles and attach them to the original position with the help of surgical screws or pins.

If loose fragments in your knee area are due to a benign tumor of the synovial membrane, specialists recommend a verified partial synovectomy procedure to treat the condition. Your doctor uses this technique to remove the grown-out part of the synovium.

And if the fragments are present in the back of the knee, doctors use an arthrotomy procedure to treat the condition. You will have to undergo an open knee surgery where cuts are made into the joint and floating bodies are removed.

After surgery, your doctor might suggest a rehab program to ease knee pain and restore its strength and function.

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