Dear Dr. Sports, I have bone chips in both knees. Is there is any chance of them “traveling” to other places and doing damage? If not, do I need to have them removed? – Janie L.
An object that moves from one body region to another, Janie, most always does so through a blood vessel. To gain access to one, it must either be VERY tiny, or form inside the vessel like some blood clots. Physicians learn to be careful about using words like “clot” to patients, who often have known persons whose clots indeed did break loose and travel to places like their lungs or brain, with disastrous results. This only happens to clots that originate inside blood vessels. Bone chips follow the same rules, and remain confined to the joint where they formed.
“Loose bodies,” as orthopedists call these chips, form in several ways. Sometimes bone spurs, formed after years of arthritis, can break off into a joint space, as can bits of worn-down cartilage on the ends of bones. In some cases a piece of a torn “meniscus,” the cartilage discs that lie between the femur and tibia inside the knee, can also be knocked loose.
Some loose bodies take the form of a “joint mouse.” I thought my orthopedic instructor was pulling my leg when he first spoke of little critters that move around inside the knee and periodically pooch out along the edges of the joint. Then I encountered a patient with one, and years later developed one myself. Years after suffering a crack in my own knee cartilage that had not bothered me for years, I periodically got a sharp pain associated with feeling a grisly knot on either side of the knee.
My own orthopedist said I could either skewer the little “mouse” with a needle next time it appeared, or I could have it fished out surgically, along with whatever other debris might lurk inside. Not into self-mutilation, I wisely chose the latter.
If you are not having such pains, and the chips don’t get wedged between the bone ends and cause your knee to “lock,” most orthopedists would suggest you “let sleeping dogs lie.”
When Dr. Steve Fahey isn’t playing tennis or enjoying the National Trivia Network competition, he’s a sports doctor for the University of Maryland’s Terps. E-mail him your medical questions at [email protected]. Put “Dr. Sports” in the subject line.
