Download Patient Introduction to Knee Surgery Rehabilitation and Return to

Shane K. Woolf, MD
Associate Professor of Arthroscopy,
Sports Medicine, and Shoulder Reconstruction
Chief, Sports Medicine
Medical University of South Carolina
Administrative Assistant: M. Annie Justiss
Office: (843) 792-1081 Fax: (843) 792-3674
Patient Instructions After Outpatient Knee Surgery
Return to Activity and Rehabilitation
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. Comply with the activity restrictions described below. Each patient’s
recovery is different. If you have questions or concerns, check with your surgeon.
Return to Driving after Knee Surgery:
There are no medical rules with regard to when you may return to driving after
knee surgery. There are, however, legal implications, and you may be held liable if
a mishap occurs when you are driving in the weeks after surgery. Each patient
must determine on an individual case-by-case basis when she/he feels it is safe for
to drive. This may be done in consultation with the physician and/or physical
therapist.
In general, if you do not feel you can safely drive, then you should not drive. Your
physician cannot recommend specifically when to return to driving but can offer
the following guidelines:
 Do not drive home from the hospital after knee surgery
 Do not drive if impaired due to pain or due to the use of narcotic pain
medications or other medications
 Do not drive if the knee brace limits her/his ability to safely operate
the automobile
Return to Work after Knee Surgery:
There are no medical rules with regard to when you may return to work after knee
surgery unless specifically instructed by your surgeon. Patients must determine on
an individual basis when she/he feels able to return to work. This can be done in
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consultation with the physician, case manager, and/or physical therapist. In
general, a functional level of knee motion and strength is required before returning
to work that involves standing, walking, or more strenuous activity. Patients with
Workman’s Compensation Claims will be released for full or restricted duty work
according to the surgeon’s assessment of her/his 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 the 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 10-12 weeks and only after
obtaining the doctor’s clearance.
Patients having ACL reconstruction, meniscus transplant, or patellar realignment
should not return to moderate work activities (eg moderate physical work, walking,
prolonged standing) for at least 10-12 weeks or to strenuous activities (eg heavy
physical work, carrying, climbing) for at least 12 weeks and only after obtaining
the doctor’s clearance. A functional knee brace may be prescribed and may be
recommended for strenuous activities, as well as moderate activities that involve
knee pivoting, for at least 4-6 months.
Return to Sports Activity after Knee Surgery:
In general, there are no medical rules with regard to when you may return to sports
after knee surgery. You must determine on an individual basis when you feel able
to return to sports. This should be done in consultation with the physician and/or
physical therapist, as certain restrictions may apply.
Patients with weight-bearing restrictions or bracing requirements must comply
with these requirements, even if this limits the ability to return to sports.
Patients having meniscus repair should not return to moderate activities like
running or jogging for at least 10 weeks. In addition, patients having meniscus
repair should not return to strenuous activities (eg golf, tennis), or to very
strenuous activities involving jumping or pivoting (eg football, basketball, soccer,
skiing), for at least 12 weeks.
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Patients having microfracture should not return to moderate activities like running
or jogging for at least 10-12 weeks. Strenuous activities may resume after 3-4
months.
Patients having ACL reconstruction, meniscus transplant, or patellar realignment
should not return to strenuous activities like (eg skiing, tennis) for at least 4 months
and should not return to very strenuous activities involving jumping and pivoting
(eg basketball, soccer) for 4-6 months. In some cases, a functional knee brace will
be provided to patients and may be recommended for strenuous or very strenuous
activities.
Furthermore, return of complete knee motion and strength is required prior to
safely returning to sports. Patients must be aware that recurrent injury and further
damage are distinct possibilities despite appropriate treatment and rehabilitation.
Rehabilitation after Knee Surgery:
Knee Arthroscopy:
Patients having knee arthroscopy, including partial medial and/or lateral
meniscectomy (trimming a torn meniscus), loose body removal, synovectomy
(removing painful inflamed joint lining), or chondroplasty (smoothing rough
cartilage), must follow the post-operative instruction sheets and may gradually
resume activities. At the first follow-up office visit, formal physical therapy may
be recommended for patients with significant swelling, stiffness, weakness, or
pain, but will not be prescribed in all cases.
Meniscus Repair or Transplant (with or without ACL Reconstruction):
Patients having meniscus repair or transplant (with or without ACL
Reconstruction) may be instructed to start formal physical therapy prior to the first
follow-up office visit and may be prescribed a Continuous Passive Motion (CPM)
machine for 2-3 weeks. These patients may bear full weight but must do so with
the knee brace locked in full extension for at least 6-8 weeks. The brace may be
unlocked or removed when not bearing weight.
Anterior Cruciate Ligament (ACL) Reconstruction:
Patients having ACL reconstruction may be instructed to start formal physical
therapy prior to the first follow-up office visit.
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Microfracture:
Patients having microfracture may be instructed to start formal physical therapy
prior to the first follow-up office visit and may be prescribed use of a Continuous
Passive Motion (CPM) machine for at least 2-3 weeks.
 Those having Patella (kneecap) microfracture may bear full weight but
must do so with the knee in a brace locked to allow only 30 degrees of
flexion for 7-8 weeks. The brace may be unlocked or removed when not
bearing weight.
 Those having Femoral and/or Tibial (thigh bone and/or leg bone)
microfracture may not bear weight on the operated leg for at least 8 weeks.
Patellar Realignment Procedures:
Patients having a patellar (kneecap) realignment procedure, including lateral
retinacular release, may be instructed to begin physical therapy prior to the first
follow-up office visit. Patients may be permitted to bear full weight but must do so
with the knee in a brace locked to allow only 30 degrees of flexion for 6-8 weeks,
unless instructed otherwise. The brace must be worn at all times except when
cleaning the operated knee.
Special Instructions:
Please Call (843) 573-1550 or 792-2123 (after hours) for:
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Any Questions or Concerns
o For medical emergencies call 911
Excessive redness of the incisions
Drainage of more than 4 days
Fever of more than 101.5° F
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 You should have a follow up appointment with your surgeon 7-10 days after surgery. If
one is not already scheduled, call (843) 876-0111 for an appointment.
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