If your knees make a cracking sound, it is likely to be related to knee degeneration. It may affect daily motor skills such as walking or climbing stairs, and may even cause pain when sitting or lying down. If this does not improve with medication, changes in activity patterns, or the use of crutches, you may consider total knee replacement. This surgery can reconstruct the damaged surface of the knee joint to reduce pain and knee deformity, hence restoring normal activity.

The four stages of osteoarthritis can be identified from the patient’s X-ray images:

Stage 1: Narrowing of the articular cavity, increase in osteophytes in the joint, decrease in elasticity of the cartilage in the joint, slight deformation of the joint appearance.

Stage 2: Narrowing of the articular cavity, continuous increase in osteophytes in the joint, holes in the cartilage, moderate deformation of the joint appearance.

Stage 3: Narrowing of the articular cavity, bone spurs on the edges of the bones, cartilage tear, drying of synovial fluid that acts as a lubricant, severe deformation of the joint appearance.

Stage 4: Complete wear of the cartilage in the joint cavity, direct rubbing between the femur and tibia, require total knee replacement.

Depending on the patient's condition, the doctor will recommend different treatment options. For example, moderate rest, weight loss, and the use of assistive devices such as crutches can reduce the strain on the knee joint. Painkillers may also be prescribed. Warm and cold compresses can be adopted to alleviate the pain as well. If possible, moderate exercise such as swimming is recommended to strengthen the tendons and the muscles around the knee, especially the quadriceps. Physical therapy such as therapeutic ultrasound can also be arranged to relieve the pain. If all of the above treatments fail, this indicates the severity of the condition and total knee replacement may be required.

Many elderly people are terrified when mentioning surgery. According to research, over 90% of patients experience a significant pain reduction after surgery, with apparent improvements in daily motor skills. Certain patients can even return to their normal exercising. However, joint replacement does have its limitations and is not suitable for every patient. Your orthopaedic surgeon will assess your medical history, X-rays and MRI scans to evaluate your knee mobility, stability, the strength of the knee muscles, leg alignment, wear and tear and the deformity of the knee joints. All the parameters determine the effectiveness of the surgery in reducing pain and improving mobility.

In conclusion, patients with knee degeneration should exercise moderately and take appropriate rest. If your knees make a cracking sound, you should seek early medical attention and treatment to ensure your mobility.