Anterior cruciate ligament (ACL) and meniscus surgery is a common procedure for those who have suffered significant knee injuries, particularly athletes and active individuals.
The operation often combines minimally invasive techniques to repair or reconstruct the damaged ligament and cartilage, aiming to restore stability and function to the knee.
After the operation, you will need to adhere to the necessary recovery process, which will include physical therapy sessions to ensure a successful recovery and regain full knee function.
When does rehabilitation start?
Rehabilitation typically begins almost immediately after surgery, often within the first few days. Early movement and gentle exercises are encouraged to prevent stiffness and promote healing under the supervision of your physiotherapist.
You may initially need to use crutches after surgery for comfort. Afterwards, you can gradually increase the weight you put on your affected leg until you can bear the full weight.
It typically takes 7 to 10 days after the procedure until the patient is comfortable without the assistance of a crutch.
An exception to this rule is if the patient also underwent a meniscal repair or other reconstruction of an additional ligament. In these cases, weight bearing may be restricted for several weeks.
What to expect during the recovery time?
Recovery from ACL surgery and meniscus surgery is a gradual process that can take anywhere from six months to a year, depending on the extent of the injury, the type of surgery performed, and individual factors such as age and general health.
In the early stages, you may experience swelling, discomfort, and limited mobility, but these symptoms should improve as you progress through your recovery.
Braces and crutches
Bracing after ACL surgery is purely dependent on patient and surgeon preference. Some orthopaedic surgeons never use bracing, some always use a brace, and others just use a brace during the immediate post-operative or rehabilitation phases.
If you require bracing, after surgery, you will likely be fitted with a knee brace to protect the joint and limit movement, particularly in the first four to six weeks.
Crutches are usually required during this period to reduce weight-bearing on the operated leg and help with mobility.
Pain management
It is normal to experience some swelling and feel pain after surgery. You can manage these with prescribed painkillers, ice packs, and by elevating the leg.
It is important to follow your medical team's advice to keep discomfort under control and prevent you from experiencing any additional pain. Full transparency will help support the healing process.
If you are experiencing extreme knee pain after surgery, please inform your doctor or any healthcare professional so they can properly assess and advise you.
Physical therapy
Physical therapy is a cornerstone of recovery, beginning with gentle range-of-motion and strengthening exercises. The program will gradually become more intense as you regain strength and flexibility in your knees. For optimal recovery, it is best to adhere to your physiotherapist’s advice and guidance throughout the recovery period.
ACL and meniscus surgery recovery timeline
Immediate post-surgery (weeks 0-2)
The first week after the surgery focuses on managing pain, protecting the surgical site, and initiating gentle movements to prevent stiffness.
Managing pain and swelling:
It is common to experience swelling and feel pain after surgery.
Pain relief medication can help alleviate discomfort, and applying ice to the knee and elevating the leg while resting may reduce swelling and promote healing.
If you are experiencing extreme pain after surgery, please inform your doctor or any healthcare professional so they can properly assess and advise you.
Protecting the surgical area:
A knee brace will be used to immobilise the joint, prevent stress, and reduce pain after surgery.
Crutches are recommended to avoid putting weight on the operated leg.
Following the surgery, you may be able to resume weight-bearing sooner, but we still advise caution.
Gentle movements:
Gentle movements are encouraged early to prevent stiffness.
However, it is important to note that after the surgery, movements are more restricted to prevent you from feeling severe pain and adding stress on the repaired tissue.
Follow-up appointments:
Regular follow-up appointments are scheduled to monitor healing progress. The frequency of follow-ups and the specific assessments may vary.
Early rehabilitation (weeks 2-6)
This phase focuses on restoring knee mobility, starting weight-bearing exercises, and introducing physical therapy.
Restoring knee mobility:
Exercises for meniscus repair focus on achieving full extension and carefully increasing flexion without stressing the repaired tissue.
Weight-bearing activities:
Partial weight-bearing may begin later in this phase, often with the use of crutches and a brace to protect the repair.
After the surgeries, patients may start partial weight-bearing activities sooner, depending on their comfort and healing progress.
Monitoring progress:
Rehabilitation progress is closely monitored. The rehabilitation plan is adjusted based on the type of surgery and how the knee responds to therapy.
Intermediate rehabilitation (weeks 6-16)
During this phase, the focus is on strengthening the knee, improving flexibility, and incorporating more dynamic exercises.
Strengthening and flexibility:
Strengthening exercises are introduced cautiously, focusing on low-impact activities.
Flexibility exercises aim for a full range of motion with controlled progression.
After the surgery, strengthening and flexibility exercises may progress more rapidly, with a wider range of activities introduced sooner.
Dynamic exercises:
After the surgery, dynamic exercises, such as light jogging and lateral movements, are carefully incorporated once the tissue has healed sufficiently.
These exercises may be introduced earlier, depending on the patient's progress.
Monitoring for complications:
Regular monitoring of complications is necessary to detect any signs of pain, swelling, or instability.
Those who have undergone the surgery may require more careful monitoring to ensure the repair is not compromised.
Advanced rehabilitation (weeks 16-20)
This phase aims to restore full knee function and prepare for a return to more demanding physical activities.
Intensive strengthening and conditioning:
After the surgery, intensive strengthening and conditioning exercises are gradually introduced to avoid stressing the repaired meniscus, focusing on carefully building endurance and stability.
Ongoing evaluation:
Regular evaluations are necessary to track progress.
Meniscus repair often requires more cautious assessments to ensure the knee is stable and healing as expected.
Returning to sports (week 20+)
The timeline for returning to activities varies based on the type of surgery.
Gradual progression to high-impact movements:
During this phase, the rehabilitation plan gradually increases in intensity.
You may begin incorporating higher-impact exercises such as jogging, jumping, and more dynamic movements earlier in this period.
In contrast, meniscus repair patients typically require a slower progression, starting with low-impact activities like cycling or swimming before moving to more strenuous activities.
Functional testing and readiness assessments:
Throughout this phase, your surgeon & physical therapist will evaluate the knee's strength, stability, and endurance to ensure it can tolerate increased physical demands.
Functional tests, including sport-specific drills or movement-based assessments, may be used to determine when it's safe to advance to more complex activities.
Meniscus repair patients, in particular, will undergo more careful testing to protect the healing cartilage.
Clearance for full activity:
Before returning to high-impact activities, a final clearance is required.
This clearance is based on the knee's ability to withstand physical challenges without pain or instability.
This clearance often comes after 9-12 months to allow for full tissue healing.
The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.
Factors affecting the recovery process
Type of graft used
The choice of graft (autograft or allograft) for ACL surgeries can influence healing time and the rehabilitation approach.
Autografts (your own tissue) tend to heal faster, whereas allografts (donor tissue) may require longer recovery and have a slightly higher risk of re-injury in younger athletes.
Age and physical health
Overall health, physical activity level, and nutrition status are significant factors in recovery. Maintaining a healthy lifestyle with regular exercise and a balanced diet may aid in a faster recovery. However, those with underlying health conditions, such as diabetes, obesity, or poor nutrition, may slow the process.
Adherence to rehabilitation protocol
Consistently performing recommended exercises and attending physical therapy sessions are necessary for steady progress. Following your orthopaedic surgeon and physiotherapist's guidance helps keep the recovery process on track.
FAQ
How long does it take to walk after meniscus and ACL surgery?
Most patients can begin walking with crutches within the first few days and may walk unaided after two to three weeks, depending on their progress and the specific procedures performed.
What is the average recovery time for ACL and meniscus surgery?
Recovery typically takes six to twelve months, with most people returning to normal activities by six months and high-impact sports by nine to twelve months.
What is the fastest way to recover from ACL and meniscus surgery?
The fastest recovery comes from strict adherence to the rehabilitation plan, attending all physiotherapy sessions, managing pain and swelling, and avoiding activities that could risk re-injury.
How long do you have to wear a brace after ACL and meniscus surgery?
A knee brace is generally worn for four to six weeks after surgery to protect the joint during early healing.
When can I fully bend my knee after ACL and meniscus surgery?
Full knee bending is gradually achieved over the first six to twelve weeks, depending on healing and your physiotherapist’s guidance.
Can ACL and meniscus surgery be done together?
Yes, it is common for both ACL reconstruction and meniscus repair to be performed in the same surgical session if both structures are injured.
The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.
For more information, contact us:
Thomson Specialists (Thomson Medical Centre) — Orthopaedic
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