When Something’s “Floating” in Your Joint: Understanding Loose Bodies in the Knee, Ankle, and Shoulder

By Dr. Nicholas Wessling, Orthopedic Surgeon

Imagine trying to walk with a pebble in

Loose body in knee joint

your shoe. Sometimes you barely notice it—but other times, it rolls into just the wrong spot and forces you to stop in your tracks. That’s exactly what a loose body can feel like inside a joint.

What Is a Loose Body?

A loose body is a small fragment of bone or cartilage that breaks off and floats freely within a joint. These fragments can result from trauma, repetitive stress, or conditions like osteoarthritis or osteochondritis dissecans. Depending on their size and location, they can cause clicking, locking, pain, or even complete loss of motion in the joint.

Let’s break it down by joint:

Knee: The Most Common Site

The knee is the most frequent joint to develop loose bodies, often due to meniscus tears, ligament injuries, or cartilage damage. Patients may describe:

    •    Sudden locking or catching while bending or straightening the knee

    •    Sharp, localized pain that comes and goes

    •    Swelling and joint instability

Left untreated, a loose body in the knee can damage the smooth cartilage lining and accelerate arthritis. Fortunately, many cases can be treated arthroscopically, meaning a minimally invasive procedure to remove the loose fragment and smooth out the joint.

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Ankle: The Overlooked Culprit

Loose bodies in the ankle are often the result of recurrent sprains or osteochondral injuries (injuries to the bone and cartilage surface). While less common than in the knee, they can be just as disruptive.

Patients often report:

    •    A catching sensation with ankle movement

    •    Deep joint pain during activity

    •    Occasional swelling and stiffness

Because ankle symptoms can be subtle, these loose bodies often go undiagnosed until symptoms persist. Imaging like MRI or CT scans can help confirm the diagnosis. Like with the knee, ankle arthroscopy can be both diagnostic and therapeutic.

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Shoulder: When Grinding Isn’t Just From Use

In the shoulder, loose bodies can develop from labral tears, rotator cuff injuries, or degenerative changes. Though less common, they can be especially problematic for overhead athletes or those with repetitive shoulder use.

Key symptoms may include:

    •    Painful grinding or clicking during arm movement

    •    Reduced range of motion, especially overhead

    •    Intermittent “locking” sensation in the joint

In some cases, these fragments may be visible on X-ray. Shoulder arthroscopy allows for precise removal and inspection of associated soft tissue damage.

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When to Seek Help

Loose bodies don’t always cause symptoms—but when they do, they rarely go away on their own. If you’re experiencing joint locking, unexplained pain, or mechanical symptoms, it’s worth getting evaluated. Timely diagnosis and treatment can relieve symptoms and protect the long-term health of your joint.

As a dual fellowship-trained orthopedic surgeon in sports medicine and foot & ankle surgery, I specialize in minimally invasive solutions for joint problems like these. Whether it’s your knee, ankle, or shoulder, I can help get you moving freely again.

Have symptoms that won’t go away? Schedule a consultation today.