Post-ACL Surgery: Is Persistent Knee Swelling After One Month Normal? - Orthopedics

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After undergoing ACL reconstruction and meniscus repair, it is not uncommon to experience persistent swelling in the knee, especially around one month post-surgery. Swelling can be a normal part of the healing process, as the body responds to the surgical trauma. However, it is essential to monitor the swelling and any accompanying symptoms to ensure that it is not indicative of a more serious issue.


Understanding Post-Surgical Swelling
1. Normal Healing Response: After surgery, the body initiates a healing response that includes inflammation. This inflammation can lead to swelling, which is a natural part of the recovery process. The swelling may be more pronounced in the first few weeks as the body works to repair the tissues that were affected during the surgery.

2. Factors Contributing to Swelling: Several factors can contribute to swelling after ACL surgery:
- Surgical Trauma: The surgical procedure itself can cause tissue damage and inflammation, leading to swelling.

- Activity Level: Engaging in physical therapy and rehabilitation exercises can sometimes exacerbate swelling, especially if the knee is pushed too hard too soon.

- Fluid Accumulation: The accumulation of synovial fluid in the joint can also cause swelling. This is often referred to as "joint effusion."
3. Signs to Monitor: While some swelling is expected, it is crucial to monitor for signs that may indicate complications:
- Increased Pain: If the pain in the knee increases significantly or becomes sharp, it may warrant further evaluation.

- Redness and Heat: The absence of redness and heat is a good sign, as these can indicate infection.

- Mobility Issues: If the swelling is accompanied by a significant decrease in range of motion or inability to bear weight, it may require medical attention.


Recommendations for Management
1. Rest and Ice: Continue to rest the knee and apply ice to reduce swelling. Ice can be applied for 15-20 minutes every few hours, especially after activities that may aggravate the knee.

2. Elevation: Keeping the knee elevated can help reduce swelling. Try to elevate the leg above the level of the heart when resting.

3. Compression: Using a compression bandage or knee sleeve can help manage swelling. Ensure that it is not too tight, as this can impede circulation.

4. Gentle Mobilization: Engage in gentle range-of-motion exercises as advised by your physical therapist. Avoid pushing through pain, as this can lead to increased swelling.

5. Follow-Up with Your Surgeon: If the swelling persists or worsens, or if you develop new symptoms, it is essential to follow up with your orthopedic surgeon. They may perform a physical examination and possibly imaging studies to rule out complications such as infection, blood clots, or issues with the surgical repair.


Conclusion
In summary, while some swelling after ACL reconstruction and meniscus repair is normal, it is essential to keep an eye on the symptoms and manage them appropriately. If you have concerns about the swelling or if it is accompanied by other troubling symptoms, do not hesitate to reach out to your healthcare provider for further evaluation. Early intervention can help ensure a smoother recovery and address any potential complications effectively.