![]() 27 28) Although various hypotheses have been proposed regarding the origin of cracking sounds, the underlying mechanism remains unknown. Joint sounds occurring repeatedly with range of motion typically arise when anatomical structures rub against each other, but cracking sounds have a refractory period before being repeated, even with ongoing motion. 2 9) However, joint sounds are commonly labeled as crepitus by doctors because this term is familiar due to the use for describing lung sounds. 1) The terms “grinding” and “grating” are used to describe a continuous scratching noise grinding or grating is common in degenerative OA and patellofemoral pain syndrome. 8) The term “clicking” is used to describe a tiny, singular noise that occurs during one cycle of knee extension and flexion it is commonly associated with meniscal tears. 7) The term “clunking” is used to describe a loud, singular noise occurring due to release against resistance patellofemoral clunking after TKA is caused by entrapment of fibrotic nodule at the junction of the superior pole of the patella and the distal quadriceps tendon within the superior aspect of the intercondylar box of the femoral component during knee flexion to extension. ![]() The term “popping” is used to describe a sudden sharp explosion and well perceived sound in an injury situation popping can occur at the root tear of the degenerative medial meniscus and at the detachment of the cruciate or collateral ligaments of the knee. These terms can be used to differentiate noises in terms of frequency, duration, and loudness, but it is not easy to describe the nature of the sounds precisely. The sounds around the knee have been described using various terms, including popping, snapping, catching, clicking, crunching, cracking, crackling, creaking, grinding, grating, and clunking. Keywords: Knee, Noise, Crepitus, Physiological, Pathological In total knee arthroplasty, every attempt should be made to avoid patellar crepitus and clunk by using modern prostheses with proper patellofemoral conformity and by avoiding surgical errors. Following surgical principles and providing accurate information about physiological noise can decrease the risk of both pathological noise and patient dissatisfaction. Minor problems associated with surgery, such as postoperative noise, can decrease patient satisfaction, especially among patients with high expectations. In most cases, noise after surgery is simply the perception of noise that had been present previously due to emotional concerns. It is important to differentiate between physiological noise and pathologic noise. An appropriate review of the characteristics of noise, its pathophysiology, and factors for differentiation between physiological and pathological noises can facilitate patient guidance. In addition, we will describe causes of the physiological and pathological noises and management of noise in the knee. We will review the noise characteristics according to sound nature and onset as well as factors for differentiation between physiological and pathological noises. However, there have been no previous review articles regarding noise around the knee despite its high prevalence. Noise in the knee joint is a common symptom that often leads to outpatient clinic visits.
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