Loose bodies are fragments of bone or cartilage that float freely in the joint space, causing symptoms like knee pain, swelling, and locking. They are classified as stable or unstable. Individuals with joint diseases like arthritis are more at risk, as are athletes. Loose bodies are diagnosed by x-ray, CT, MRI or arthrography. Treatment options include NSAIDs, arthroscopic removal of large loose bodies, or open surgery. The focus of rehabilitation is controlling pain and restoring function through gait training and avoiding prolonged immobilization.

1. LOOSE BODIES IN KNEE
Dr.Harsha Surath

2. • Loose bodies are fragments of bone or
cartilage that are freely float in joint space.
• Single or in groups
• They effect only one joint
• They classified as stable or unstable.

3. • Stable loose bodies are in fixed position are
generally well tolerated.
• Unstable loose bodies are free to move about
the joint and cause symptoms.
• Individuals with a degenerative joint disease
(e.g., arthritis or osteochondritis dissecans)
are more likely to develop loose bodies in the
knee

5. Classification
Individuals who participate in sports are at risk of
developing loose bodies in the knee.
Loose bodies are common and affect men and
women equally
1.Fibrinous
2.Cartilagenous
3.Osteo cartilaginous

6. Fibrinous
• Due to bleeding with in joint
• from the death of the tissue lining of joints
(synovial membrane) associated
with tuberculosis, osteoarthritis,
and rheumatoid arthritis

7. • . Cartilaginous loose bodies are fragments of
cartilage and are caused by injury (trauma) to
the joint and osteoarthritis

8. • Osteocartilaginous loose bodies are fragments
of cartilage and bone caused by fractures,
bone and cartilage inflammation
(osteochondritis dissecans), osteoarthritis,
and benign tumors of the synovial membrane
(synovial chondromatosis).

9. Clinical features
• knee pain and swelling, with intermittent
locking or catching of the joint.
• The locking disappears spontaneously,
• Hearing a grating sound (crepitus) with joint
movement.
• The joint intermittently "gives way" or "goes
out" causing them to fall

10. • joint may be locked (unable to fully extend).
• There may be evidence of effusion in the joint.
• Loose bodies are rarely felt by touch
(palpation)

11. DIAGNOSIS
• Larger loose bodies are typically calcified and
thus easily visible on a plain film x-ray of the
affected joint
• small or no bone may not be visible with an x-
ray and are typically diagnosed using
either CT or arthrography or MRI .
• . Ultrasound scans may be performed to
determine the presence and location of loose
bodies

12. Treatment
• For small loose bodies, treatment may be directed
at relief of symptoms by NSAIDS
• Large loose bodies may require removal by use of
an arthroscope (arthroscopy
• Very large loose bodies and those located in the
back of the knee need to be removed by open
surgery (arthrotomy
• . In some cases, such as synovial chondromatosis,
part of the synovium may be removed
(partial synovectomy

13. REHABILITATION
The focus of rehabilitation for loose bodies in
the knee is to control pain and restore
function
The first goal is gait training with an assistive
device
Prolonged immobilization should be avoided for
non-surgical cases .

14. REFERANCES
• CAMPBELL’S OPERATIVE ORTHOPAEDDICS
12TH EDITION

15. • THANK YOU