First, it really depends on what was actually done. There is a big difference between a partial menisectomy, meniscus repair, articular surface chondral repair and ACL reconstruction, for instance. Weight bearing and how aggressive you can do exercises will vary significantly. However, the common goal for all surgeries is to do a stepwise approach to reducing swelling, followed by regaining motion and then work on strengthening the quadriceps and hamstrings. Usually following a meniscus repair, there will be restriction of motion to 90 degrees the first 4 weeks and limited weightbearing with crutches. Likewise after cartilage surface repairs, weightbearing may be restricted initially and an unloader brace used. ACL surgery without a meniscus repair usually allows weightbearing as tolerated protected with a brace the first 6 weeks, but often patients are off crutches the first week. Partial menisectomy and “clean up” procedures often only require a cane in the opposite hand for a few days, and much quicker recovery. Cartilage repair and ACL reconstruction cases often will require a passive motion machine the first few weeks to keep the knee moving which promotes healing. It is important that each patient work closely with their surgeon to make sure they are following the right pathway. Regarding driving, some states may have laws that have restrictions on how long after surgery you can drive, but the general consensus in the orthopedic community is that once you are not taking narcotics and have full control of the leg (i.e. quadriceps function), it may be safe to drive. Your physical therapist can be consulted first to help see if this is safe for you. Exercises are a key element of recovery, and should initially be guided by a qualified physical therapist working with your surgeon to maximize your outcome appropriately. Everyone is an individual and will meet goals differently, and it is imperative to work as a team (patient, surgeon, and therapist) for the best results.
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Intermountain Healthcare answeredHere are some guidelines for activity after arthroscopic knee surgery:
- Take it easy the first day. You should rest on the day of surgery, other than getting up for the bathroom or to get meals or medication.
- Follow your doctor's instruction about walking or bearing weight on your affected leg. For many surgeries, normal walking can begin within a couple of days. For others, you may be told to only put light weight (toe touch) or no weight at all on the affected knee. If your surgeon tells you to use crutches, be sure to use them every time you walk.
- Do range-of-motion exercises as prescribed. To help you regain strength, balance, and range of motion in your legs and knees -- and prevent blood clots -- your doctor may recommend range-of-motion exercises. Usually, you should start these on the day of surgery, and do them as often as every hour you're awake. Your exercises may include:
- Quad sets. Tighten the muscles on the top of your thigh while at the same time pushing the back of your knee down into a chair or bed. Hold for 5 seconds, then relax for 5 seconds.
- Ankle pumps. Slowly move the front of your foot up and down, as if you are pumping the brake on a car.
- Straight leg raises. Keep your bandaged leg flat and straight. Bend the other leg, with the foot flat on the floor. Slowly raise your bandaged leg until it is about 6 inches from the floor, keeping the leg as straight as you can. Hold for a count of 5 seconds and then lower the leg.
- Avoid activities that cause pain or swelling to the knee. Examples include climbing stairs or standing or sitting for long periods.
- Begin other activities as advised by your doctor. In most cases, you can start other activities a week after surgery, but talk with your doctor before you drive or do any sport or strenuous work. You should be able to bend your knee freely to 90 degrees before you do activities like biking, hiking, or lifting weights.