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Knee FAQ

I am facing knee surgery for a torn anterior cruciate ligament (ACL). What is the recovery time for being able to move around after this type of surgery?

Plan on getting up and moving the same day or the day after surgery. You’ll be using crutches or a walker to get started. Usually you can discard the walking aid in two to four weeks, depending on how fast your thigh strength returns and the swelling goes down. Don’t expect to return immediately to the activities that resulted in your injury.

Returning to sports activities really depends on the treatment plan set up by your doctor and physical therapist. It also depends on your progress in rehabilitation after surgery. Treatment protocols after ACL surgery are generally designed to take between four and six months. Be sure to ask your doctor if you have questions about the activities you’d like to do.

I had an ACL repair a week ago. The doctor doesn't think I'm getting my motion back fast enough. What should I do differently?
Motion and mobility after ACL repair is a key factor in the long-term success of the operation. Studies show that without good motion, the joint is compressed and wears out faster. Ten years down the road, the patient develops degenerative arthritis and the ACL repair looks like a failure. Patellar mobility (kneecap motion) is a key factor in regaining overall knee motion. It is always advised to get your motion back before you start strengthening exercises. Your physical therapist or surgeon can assess patellar motion and teach you how to manually move it side to side, up and down, and along the diagonal planes of motion. This type of motion will help prevent scarring from occurring between the patellar tendon and the tibia and between the patella and the tibia. Without an 80 percent return of motion early on, there’s a good chance another operation will be needed to release adhesions in the joint. You should have full motion by the end of six weeks. The right rehab program must match the type of surgery you had while regaining motion. Strength training comes after joint mobility is restored.
What can be done to keep my leg muscles from shrinking after knee surgery?
A new technique called vascular occlusion has been found to help reduce the amount of muscle wasting that follows surgery. This technique involves applying five minutes of squeezing pressure to the thigh muscles several times a day in the first week or two after surgery. A large blood pressure cuff can be used to put the squeeze on the thigh. The pressure triggers the muscle to produce enzymes and hormones that actually promote muscle development. Vascular occlusion by itself will not completely stop muscle wasting. But it can slow the process down. Low-intensity resistance exercises, such as straightening the leg over a pillow, or straight leg raises can also help reduce muscle shrinkage. Patellar mobility (kneecap motion) is a key factor in regaining overall knee motion. It is always advised to get your motion back before you start strengthening exercises. Your physical therapist or surgeon can assess patellar motion and teach you how to manually move it side to side, up and down, and along the diagonal planes of motion. This type of motion will help prevent scarring from occurring between the patellar tendon and the tibia and between the patella and the tibia. Without an 80 percent return of motion early on, there’s a good chance another operation will be needed to release adhesions in the joint. You should have full motion by the end of six weeks. The right rehab program must match the type of surgery you had while regaining motion. Strength training comes after joint mobility is restored.
I'm starting to do more exercises since my knee surgery. How much exercise is too much?
Let swelling and pain be your guides. Pain is an indicator that something isn’t right. You may feel some discomfort with your exercises, but it should be “reasonable” discomfort. If you end up feeling a lot of pain that lasts more than one hour after exercise, you’re probably overdoing it. If you have pain with exercise or activity, you need to make some changes. Reduce the intensity, time, or repetitions of your exercise or activity. If you see swelling around your knee late in the day, this could also be a sign that you are overdoing it. Vascular occlusion by itself will not completely stop muscle wasting. But it can slow the process down. Low-intensity resistance exercises, such as straightening the leg over a pillow, or straight leg raises can also help reduce muscle shrinkage. Patellar mobility (kneecap motion) is a key factor in regaining overall knee motion. It is always advised to get your motion back before you start strengthening exercises. Your physical therapist or surgeon can assess patellar motion and teach you how to manually move it side to side, up and down, and along the diagonal planes of motion. This type of motion will help prevent scarring from occurring between the patellar tendon and the tibia and between the patella and the tibia. Without an 80 percent return of motion early on, there’s a good chance another operation will be needed to release adhesions in the joint. You should have full motion by the end of six weeks. The right rehab program must match the type of surgery you had while regaining motion. Strength training comes after joint mobility is restored.

 

 

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