Clicking or Noise After Knee Replacement

Clicking, clunking, popping or other sounds can occur after knee replacement because an artificial joint has metal and polyethylene surfaces with defined shapes. These surfaces, the kneecap, tendons and surrounding scar tissue may produce sensations that were not present in the natural knee. An occasional painless sound is often less concerning than a sound accompanied by pain, swelling, instability or loss of function.

The sound should be interpreted by its timing, location, consistency and associated symptoms. A click present from early recovery without pain is different from a sudden new clunk years later after a fall. A recording can help describe the problem, but it cannot determine whether the cause is normal component contact, weakness, scar tissue, infection or implant failure.

Quick Answer: Is Clicking Normal?

Painless clicking can occur in a well-functioning knee replacement, particularly during early recovery or specific movements. It is more reassuring when the wound is healed, swelling is improving, the knee is stable and walking capacity is progressing. New painful noise, recurrent giving way, locking, swelling or a sudden decline requires orthopedic assessment.

Why an Artificial Knee Can Sound Different

A natural knee has cartilage, menisci and soft tissues that dampen movement. A replacement uses smooth metal components moving against a polyethylene bearing. Small separations and re-contact can be audible. Some implant designs have additional stabilising features that engage during bending and straightening. Sound alone does not prove that parts are rubbing abnormally or becoming loose.

Common Painless Clicking Patterns

Patients may notice a light click during walking, rising from a chair, stair use or changing direction. Early swelling and reduced muscle control can make the movement less smooth and the sound more noticeable. As gait, quadriceps strength and confidence improve, the noise may become less prominent even though the implant has not changed.

Posterior-Stabilised Implant Sounds

Some total knee designs use a post-and-cam mechanism to provide stability when the posterior cruciate ligament is not retained. Contact between these parts can produce a reproducible click during part of the movement arc. A painless, stable and unchanged sensation may be expected. Pain, recurrent swelling, instability or a sudden change requires assessment.

Kneecap Tracking, Grinding and Patellar Clunk

The kneecap moves over the front of the femoral component. Swelling, quadriceps weakness, scar tissue, component rotation or altered tracking can create grinding, catching or a clunk during extension. A specific scar-tissue problem sometimes called patellar clunk can occur after certain implant designs. Painful catching, recurrent swelling or inability to straighten the knee needs examination rather than repeated testing at home.

Tendons, Ligaments and Scar Tissue

A tendon or band of scar tissue can move over a bony edge or component and create a snap. This may occur at the front, inner or outer knee and can be position-specific. Soft-tissue sounds may improve with swelling control, gait correction and targeted rehabilitation. A painful reproducible snap requires localisation because implant revision is not the correct treatment for every soft-tissue symptom.

Weakness and Altered Gait

Quadriceps weakness, incomplete knee straightening and a limp can allow less controlled component movement. Patients may feel a click when the knee suddenly engages during stance or chair rise. Continued use of the prescribed walking aid and focused gait and strength work may reduce the symptom when weakness is the principal cause.

Read Walking After Knee Replacement and Physiotherapy After Knee Replacement.

Instability and Recurrent Giving Way

A clunk associated with shifting, recurrent buckling or a sense that the knee is loose may indicate instability. Causes include muscle weakness, ligament imbalance, component position, wear or trauma. Mechanical instability may be most noticeable on stairs, uneven ground or when rising from a chair. It should be examined because simply strengthening harder may not correct a structural imbalance.

Wear, Loosening and Late-Onset Noise

New noise months or years after a previously quiet, comfortable replacement may accompany polyethylene wear, loosening, instability or bone loss. These problems more often cause pain, recurrent swelling, altered alignment or reduced function rather than noise alone. Weight-bearing X-rays and comparison with earlier films are important.

Read Loose Knee Implant Symptoms.

Noise After a Fall or Sudden Injury

A new pop or clunk after a fall can occur with bruising, tendon injury, fracture around the replacement, instability or component damage. Severe pain, deformity, sudden swelling, inability to straighten the knee or inability to bear weight requires prompt assessment and usually X-rays. Do not attempt to repeatedly reproduce the sound.

Can Infection Cause Clicking or Clunking?

Infection is not usually diagnosed from noise alone, but infection can cause swelling, stiffness and instability that make mechanical sensations more noticeable. Increasing pain, recurrent swelling, wound drainage, redness or declining function must be evaluated. Fever may be absent.

Read Infection After Knee Replacement.

How a Noisy Knee Replacement Is Evaluated

The history records when the noise began, whether it is painful, which movement produces it, whether swelling or instability is present, and whether the knee initially functioned well. Examination assesses gait, range of motion, ligament stability, patellar tracking, quadriceps strength, tenderness and the exact movement that reproduces the sound.

Standing X-rays assess component position, alignment, fracture, wear and loosening. CT, ultrasound or other imaging is used selectively. Blood tests and joint aspiration may be required when infection is suspected. The examination and imaging must be interpreted together because many painless implant sounds are not visible on X-ray.

Treatment Depends on the Cause

Painless stable clicking may require explanation, observation and routine follow-up. Weakness or poor gait may improve with targeted rehabilitation. Swelling and tendon irritation may require activity modification and symptom control. Persistent painful scar-tissue or patellar problems may occasionally need a procedure. Revision is reserved for an established correctable problem such as instability, loosening, wear, fracture or implant malposition.

Partial, Total, Robotic and Revision Replacement

Partial and total replacements have different geometry and may produce different sensations. Robotic assistance supports planning and execution but does not make an artificial knee silent. The mini-subvastus approach concerns surgical access and quadriceps preservation; it does not eliminate component contact or scar sensitivity. Revision implants may use more constrained mechanisms that feel or sound more mechanical.

When Prompt or Emergency Care Is Needed

Seek prompt assessment for new painful clicking, repeated giving way, locking, increasing swelling, drainage, fever, loss of movement or a sudden change after a fall. Severe pain, visible deformity, inability to bear weight or a cold pale foot requires urgent care. Chest pain, sudden breathlessness, coughing blood or fainting requires emergency care.

Questions Patients Commonly Ask

Is painless clicking normal?

It can be. Stability, pain, swelling and function are more important than the sound alone.

Why does the knee click during chair rise?

Component contact, quadriceps weakness, patellar movement or scar tissue can become noticeable during this transition.

Does clicking mean the implant is loose?

No. Loosening usually produces a broader pattern such as pain, swelling or reduced function and must be assessed with examination and imaging.

Can the kneecap cause a clunk?

Yes. Patellar tracking and scar tissue can cause catching or clunking in selected patients.

Can physiotherapy reduce clicking?

It may when weakness, swelling or gait control is the cause. It will not correct every mechanical implant problem.

Should I avoid the movement that clicks?

Avoid repeatedly forcing a painful clunk. Painless routine movement can usually continue while the symptom is monitored.

Can infection cause noise without fever?

Infection may occur without fever, but noise alone is not diagnostic. Pain, swelling, drainage and declining function are more important.

Does robotic surgery make the knee quieter?

No guarantee can be made. Robotic assistance supports precision but an artificial joint can still make sounds.

Can a video diagnose the cause?

A video can document the sound and movement but cannot replace examination, X-rays or infection testing when indicated.

When is revision considered?

Only when a surgically correctable cause is established and the expected benefit outweighs the risks.

Clinical References and Further Reading

AAOS OrthoInfo: Total Knee Replacement

AAOS OrthoInfo: Revision Total Knee Replacement

NICE NG157: Joint Replacement Information and Follow-Up

About Dr. Mayur Rabhadiya

Dr. Mayur Rabhadiya is an Orthopedic and Joint Replacement Surgeon in Mumbai. His focused knee practice includes minimally invasive mini-subvastus robotic knee replacement, painful or noisy implant assessment, instability and loosening evaluation, and revision planning when a correctable diagnosis is established. His qualifications are MBBS, D’Ortho, DNB (Orthopedics), MNAMS (Orthopedics) and FIJR (Robotic & Navigation).

Last medically reviewed: 24 July 2026. Medical reviewer: Dr. Mayur Rabhadiya.

Book a Noisy Knee-Replacement Assessment

Patients with painful clicking, clunking, locking, recurrent swelling or instability after knee replacement can consult Dr. Mayur Rabhadiya in Ghatkopar East or Ghatkopar West, Mumbai. Bring earlier X-rays and implant records when available. Call or WhatsApp +91 84249 03913 or +91 96113 30063, or use the orthopedic appointment page.

Medical Disclaimer

This guide provides general education and does not diagnose the cause of a noisy knee replacement. New pain, swelling, instability, locking or loss of function requires individual assessment.