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Anyone encountered 'Pseudo locking knee'?

 Poster: A snowHead
Poster: A snowHead
Anyone encountered the condition 'Pseudo locking knee' on their knackered knee travels?

A friend of mines wife has been diagnosed with this and basically has been told there is very little that can be done other than massive doses of anti-inflammatories when it flares up.
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I went through a period of about 18 months when me knee would occasionally lock, especially when kneeling down, side stepping up a steep slope or negotiating ski recovery in deep snow.

A little painful, not a desperate inconvenience, I put it down to unsurprising meniscal damage that would slowly get worse and need repair.

Anyway, it seems to have gone away. Hasn't happened in maybe 2 years?
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I thought that locking up is (or can be) caused by a damaged meniscus, and therefore trimming it is the cure. "Pseudo locking knee" doesn't sound so much a diagnosis as a description of symptoms. Can she get a referral for a scan or further expert opinion?

Ah I've now found this http://www.londonorthopaedic.com/knee-locking/
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Yeah its more to do with muscles and nerves going into spasm rather than something 'mechanical' in the joint going awry - although that doesn't mean something isn't wrong in there either. She's had an MRI and it was after that the diagnosis was made that there wasn't anything wrong with the actual mechanics of the joint.
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Knees can be very pulled about by all the other muscles in the leg - and impacted from even further away. (I'm no expert, but am constantly looking to understand my own problems)

As a minor example, the last few days I've been getting sporadic meniscus-type pains in my knee which I discovered are alleviated by simply stretching out my inner thigh.

In the absence of a specific cure, I would be looking at many different avenues to see what improves things in the long term. I wish her luck in finding something that helps.
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It does sound pretty rough - she's been trapped in her own car before now when her knee locked up while she was driving and literally couldn't get out by herself, and she ended up in A&E the other night when it locked up for hours and wouldn't release.
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I suffered from it as a teenager (playing football/hurling every spare second of the day was likely the cause). I would get a burning sensation in the joint and then it would stop and I would fall over looking like a complete eejit. Never had a scan or x-ray for it. Some interesting anti-inflammatories (Phenylbutazone which is no longer approved for human use), magic sponge and lots of Deep Heat usually did the trick. It went away after a couple of years with no other treatment.
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^^ What motyl said. Go to a good osteopath, or a good sports physio. My knees can give way when going down stairs and my ankle will sometimes hurt like mad going up stairs, both are related to the issues I have in my hips and thighs. Both are sorted by my Osteo though sadly only temporarily because ligament damage causes my muscles to be overworked and thus tighten everything up!
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It may be worth consulting a muscle activation specialist. It's a relatively new technique, with few practitioners in the UK. The focus is not on fixing any particular problem that you have, but ensuring that you are functioning optimally. Some of it sounds like hocus pocus, but the results have been very significant as far as I am concerned.
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I certainly had some kind of pseudo lock during my early to mid recovering phase after ACL / MCL and whatever else injury.
Whether the same as yours or others' I don't know; I called it 'catching', but if I didn't stop it would effectively lock and was pretty worrying.
It seems to have gone away, and I think was very related to muscle and soft tissue irritation, which I suffered a lot from. One physio thought it might be 'fat pad' ( in the knee) related, or maybe adhesions. Seemed to ease a bit with calf and hamstring stretching in my case, and worsen when I'd over used, and therefore irritated, the knee/leg.
But that's just my knees: might be completely different for everyone else.
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Thanks all - will pass this on. Hopefully they might find it helpful, at least they might be able to discuss some of this with the doctors.
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@Richard_Sideways, pseudo locking is a term used when the knee jams or catches typically at about 90 of flexion. It can be due to advanced wear or if a flap of joint surface gets caught and lifts up.
It’s not serious but painful.
It’s safe to push through even if not pleasant. It is one occasion where keyhole surgery can help a worn knee.
I have had some success with hyaluronic acid injections.
It may be worth seeing if a physio can help.
See if the doctor can help with any of those suggestions

Jonathan Bell
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I have something like this in my left knee. background is that I tore an ACL about 25 years ago, didn't have it repaired (I wasn't diagnosed) and I have pretty good stability because of muscle bulk. It started locking/sticking mainly as I descended stairs or sat in a chair. It hurts but is more this uncomfortable/unpleasant sensation. Had an MRI and suggested an arthroscope to clean the knee out. This fixed it for about 9 months. What I have worked out though is that I don't think its mechanical and related to knee joint itself, but more to do with the muscles, especially the IBT which runs down the side of the Quad. If I roll this regularly, I get almost no locking which leads me to anecdotally conclude that the locking is more muscular than the joint. (PS: post arthroscope the knee joint itself feels great - no pain or anything)
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@FrediKanoute, Interesting. I had a fair amount of ITB (or something very similar and in same place) issues at around the same time during early to mid recovery/rehab. Resolved at some point, in its own time.
Today I noticed when doing some squats and ski-related exercises that it's being a bit 'catchy' again in the worse knee as I pass through about 90 degrees of bend, both downwards and upwards. Seems to let me do it without pain though, so I'm putting it down to doing a bit more (mainly quads) exercise again in the last few days so probably a bit more irritation or tiredness somewhere.
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@FrediKanoute, @Grizzler,

It would be unusual for the ITB itself to lock but the pain from ITB syndrome tends to occur specifically at 20 to 30 deg and can be v uncomfortable which may give a sense of some catching.
However a catching at 90 is more likely the patella catching in the trochlear ( which is the same as the knee cap groove) this is quite common if a bit of wear occurred. This may pass on its own. Tight itb can cause patella maltracking and overload hence why itb stretching is often part of a “
Patella femoral “ program.

Jonathan Bell
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Thanks Jonathan, appreciate your input and have passed this on to them.
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@Jonathan Bell, Thanks. "Pat Fem" was as far as my consultant ever got (and that was way back at the start), and I did have a brief telephone discussion with Claire (sp?) at Wimbledon a bit later; sounds like a catch-all (ooops Laughing ) descriptor for a number of specific and doubtless annoying presenting issues.
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At the risk of sounding like a broken record, has she has a steroid injection?

Jonathan, is this something that is now out of fashion?

Particularly for those who want a few months relief e.g. a ski season, I've had good results with these.
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Steroid injection is a useful, rapid ( but sometimes) temporary fix for a very swollen knee. Generally not helpful for a mechanical problem as they act by reducing inflammation. They can help achieve a longer term success if the problem was likely to eventually improve anyway. I find they can help facilitate a strength program because they make it possible for you to do the exercises for a window of a few weeks without the restrictions imposed by the swelling

Jonathan Bell
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Steroid injection is a useful, rapid ( but sometimes) temporary fix for a very swollen knee. Generally not helpful for a mechanical problem as they act by reducing inflammation. They can help achieve a longer term success if the problem was likely to eventually improve anyway. I find they can help facilitate a strength program because they make it possible for you to do the exercises for a window of a few weeks without the restrictions imposed by the swelling

Jonathan Bell
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@Richard_Sideways,

Hi, my wife seems to have a similar condition. In Feb 2019, she twisted her left knee and the collateral ligament was slightly torn. Her leg stayed at 30 degrees and would not straigthen. MRI did not show anything relevant to explain the lock. After a mobilisation in narcosis in April and a lot of physio (one doctor said the muscles contracted) she can straighten the leg e.g. when on a bed but when walking, she still limbs, leg gets quickly to its "locked" position. If I may ask, what did help eventually your wife to recover...
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@jcn,
See my earlier posts on pseudo locking. If the scan doesn’t show much then physio very frequently - even daily for a week or so can break the problem. If that doesn’t work then an examination under anaesthetic and possibly arthroscopy
Jonathan Bell
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@jcn Can I ask how your wife is getting on?
My left knee has been locked between 20 and (on the very best day, after massage) 75 degrees since May. I have a torn ACL and damaged collateral ligament and I can only do light physio for the injuries because of the limited movement.
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RunnerBeanAA wrote:
@jcn Can I ask how your wife is getting on?
My left knee has been locked between 20 and (on the very best day, after massage) 75 degrees since May. I have a torn ACL and damaged collateral ligament and I can only do light physio for the injuries because of the limited movement.


That needs a bit more clarity on either the diagnosis or at least an understanding of hwhy the knee is so stiff.

It shouldn't be like that at this stage unless something is blocking movement eg a displaced meniscus tear or has healed up too tight eg the MCL

Jonathan Bell
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It's just possible that knees "giving way" can be a result of a trigger point in the VMO - https://lifeafterpain.com/info/trigger-point/knee-trigger-points-the-case-of-mysterious-falls/ Have a feel around, on the spot indicated on the diagram, to see whether you have a sore spot in there.

Worth a go - made a big difference to a friend of mine.
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