Patient Introduction to Knee Surgery Rehabilitation and Return to Activities

REMEMBER: After surgery your body, including your knee, may not respond as it has in the past. Be cautious and test your body and knee before you resume activity. Each patient’s recovery is different: if you have questions, check with your doctor.

Return to Driving after Knee Surgery:

There are no medical rules with regard to when a patient may return to driving after knee surgery. Driving can be dangerous or result in accidents even for people who do not have knee surgery. This is well known as motor vehicle accidents occur every day.

Patients must determine on an individual case-by-case basis when they feel it is safe for them to drive in consultation with their physician and/or physical therapist. This has legal implications, and Taos Orthopaedic Institute can not recommend return to driving but can offer the following guidelines: a patient may not drive home from the hospital after knee surgery; a patient may not drive if impaired due to pain or due to the use of narcotic pain medications or other medications. In general, if a patient is not sure that they feel it is safe for them to drive, then the patient should not drive.

Return to Work after Knee Surgery:

There are no medical rules with regard to when a patient may return to work after knee surgery. Patients must determine on an individual case-by-case basis when they feel they are able to return to work in consultation with their physician and/or physical therapist.

Patients with Workman’s Compensation Claims will be released for full or restricted duty work according to their surgeon’s assessment of their abilities to a reasonable degree of medical probability as required by law.

Patients with weight-bearing restrictions or bracing requirements must comply with these requirements, even if this limits their ability to return to full or restricted duty work.

Patients having meniscus repair or microfracture should not return to strenuous activities like heavy physical work for at least 8 weeks and only after patients ask for and receive doctor’s clearance.

Patients having ACL reconstruction should not return to moderate activities like moderate physical work for at least 8 weeks and only after patients ask for and receive doctor’s clearance. In addition, patients having ACL reconstruction should not return to strenuous activities like heavy physical work for at least 12 weeks and only after patients ask for and receive doctor’s clearance. A functional knee brace will be provided to patients having ACL reconstruction and is recommended for strenuous activities like heavy physical work (as well as for moderate activities like moderate physical work if these moderate activities involve pivoting) for at least 12 months.

Return to Sports after Knee Surgery:

There are no medical rules with regard to when a patient may return to sports after knee surgery. Patients must determine on an individual case-by-case basis when they feel they are able to return to sports in consultation with their physician and/or physical therapist.

Patients with weight-bearing restrictions or bracing requirements must comply with these requirements, even if this limits their ability to return to sports.

Patients having meniscus repair should not return to moderate activities like running or jogging for at least 6 weeks. In addition, patients having meniscus repair should not return to strenuous activities like skiing or tennis or to very strenuous activities like jumping or pivoting as in basketball or soccer for at least 8 weeks.

Patients having microfracture should not return to moderate activities like running or jogging or to strenuous activities like skiing or tennis for at least 8 weeks. In addition, patients having microfracture should not return to very strenuous activities like jumping or pivoting as in basketball or soccer for at least 12 weeks.

Patients having ACL reconstruction should not return to strenuous activities like skiing or tennis for at least 4 months. (An exception may be made for advanced skiers in season who achieve 85% of the strength of their normal knee and have minimal or no swelling and who understand and consent to assuming the increased risk of reinjury associated with accelerated return to skiing. Such skiers may return to groomed slopes on short skis with properly adjusted bindings after at least 8 weeks in consultation with their physician and/or physical therapist).

Patients having ACL reconstruction should not return to very strenuous activities like jumping or pivoting as in basketball or soccer for 6 months. (Exceptions may be made for athletes in season who achieve 85% of the strength of their normal knee and have minimal or no swelling and who understand and consent to assuming the increased risk of reinjury associated with accelerated return to sport. Such athletes may return to sport as soon as 8 weeks after reconstruction in extreme cases after consultation with their physician and/or physical therapist).

A functional knee brace will be provided to patients having ACL reconstruction and is recommended for strenuous activities like skiing or tennis or for very strenuous activities like jumping or pivoting as in basketball or soccer for the rest of the athletes life.

Rehabilitation after Knee Surgery:

Knee Arthroscopy:

Patients having Knee Arthroscopy including partial medial or lateral meniscectomy (trimming a torn meniscus), loose body removal, synovectomy (removing painful joint lining), or chondroplasty (smoothing rough cartilage) must follow their post-operative instruction sheets and may gradually resume activities. At their first follow-up office visit (1½ weeks), formal physical therapy may be recommended for patients with significant swelling, weakness, stiffness or pain. (Formal physical therapy will not be prescribed in all cases).

Lateral Retinacular Release:

Patients having Lateral Retinacular Release may be instructed to start formal physical therapy prior to their first follow-up office visit (1½ weeks).

Anterior Cruciate Ligament (ACL) Reconstruction:

Patients having ACL Reconstruction may be instructed to start formal physical therapy prior to their first follow-up office visit (1½ weeks) and may be instructed to use a Continuous Passive Motion (CPM) machine for 3 weeks.

Meniscus Repair (with or without ACL reconstruction):

Patients having Meniscus Repair (with or without ACL reconstruction) may be instructed to start formal physical therapy prior to their first follow-up office visit (1½ weeks) and may be instructed to use a Continuous Passive Motion (CPM) machine for 3 weeks. In addition, patients may bear full weight but must bear weight with their knee locked in a brace in full extension for at least 6 weeks. (The brace may be unlocked or removed when non-weight bearing).

Microfracture:

Patients having Microfracture may be instructed to start formal physical therapy prior to their first follow-up office visit (1½ weeks) and may be instructed to use a Continuous Passive Motion (CPM) machine for at least 3 weeks.

Patients having Patella (kneecap) Microfracture may bear full weight but must bear weight with their knee locked in a brace allowing 0-30 degrees of flexion for 6 weeks. (The brace may be unlocked or removed when non-weight bearing).

Patients having Femoral or Tibial (thigh bone or leg bone) Microfracture may not bear weight on the operated leg for at least 6 weeks.

Published Articles for Patient Education