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Locked knee: what is it?

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A locked knee is when the knee joint becomes stuck, often due to a meniscus tear. Surgery is usually required to remove the torn cartilage and restore mobility. Other causes include ligament tears, loose tissue, and fractures. Arthroscopy is a minimally invasive surgical option.

A locked knee is a condition in which bending the knee locks it in place, often at a 45-degree angle, and the person is unable to straighten the leg or bend it any further. It is usually possible to return the leg to a straightened position using the hands. Often, the condition is caused by a tear in a piece of cartilage, called the meniscus, that sits inside the joint. When the knee joint moves, the torn meniscus fragment gets caught and prevents movement from continuing normally. When a locked knee is caused by a meniscus tear, the problem is usually treated surgically and the torn section of cartilage is removed so that it no longer interferes with joint mobility.

Other causes of a locked knee can include a ligament tear, pieces of loose tissue other than cartilage that become lodged within the joint, and some fractures. Sometimes a swollen and injured knee may feel locked, but the lack of motion is due to the muscles having gone into a spasm. A torn meniscus is probably the most common knee ailment that results in a locked knee. While a ligament injury can cause blockage, it is more typically associated with knee failure, a condition sometimes referred to as a “deceptive knee.”

Inside each knee are two menisci, known as the medial meniscus and lateral meniscus. Each has what’s called a semilunar cartilage, which is a crescent-shaped piece of strong, flexible tissue. The tibia and femur meet at the knee, and the semilunar cartilages are positioned between the ends of these bones to help distribute the weight-bearing forces acting on the joint. If you twist while the joint is weight bearing, one of the cartilages can become trapped, causing a tear. The detached portion of the cartilage can then wedge itself within the joint, causing it to seize and resulting in a locked knee.

When knee joints lock, treatment often involves surgery, as the damage is likely too severe to improve with more conservative measures, such as resting the joint. A type of keyhole surgery, known as arthroscopy, may be performed. Here, a special elongated, telescope-like surgical instrument is inserted into the knee, allowing the surgeon to view the inside of the joint as the surgery is performed using thin instruments. The technique has the advantage that only small cuts in the skin are needed to operate. Patients generally recover more quickly, experience less pain and have a lower risk of infection than those undergoing traditional surgery.

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