Post-ACL Surgery Knee Flexion: Progress and Concerns - Orthopedics

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After undergoing ACL reconstruction combined with meniscus repair, it's understandable to have concerns about your knee flexion progress and the potential need for further surgical intervention. Let's break down your situation and address your questions based on current medical knowledge and rehabilitation practices.

Firstly, achieving a knee flexion of 100 to 110 degrees three and a half months post-surgery is not uncommon, but it can vary significantly among individuals. Generally, the expected range of motion (ROM) after ACL surgery is around 90 degrees by three months, with many patients aiming for full extension and flexion (around 135 degrees) by six months to a year. However, the timeline can be influenced by various factors, including the severity of the initial injury, the extent of the surgical repair, individual healing rates, and adherence to rehabilitation protocols.

Your rehabilitation team is likely monitoring your progress closely. If your physical therapist has expressed concerns about the pace of your recovery, it may be due to the potential for scar tissue formation, which can lead to adhesions and limit your range of motion. This is a common issue after knee surgeries, especially when there has been significant trauma or multiple procedures performed.
Regarding the differing opinions between your orthopedic surgeon and your physical therapist, it's essential to consider that both perspectives are valid but focus on different aspects of your recovery. Your surgeon may be emphasizing that achieving 90 degrees of flexion within three months is a standard benchmark, while your therapist may be more focused on the functional aspects of your recovery and the importance of progressing towards full range of motion.

If your knee flexion does not improve significantly in the next couple of weeks, your therapist may suggest further evaluation to determine if surgical intervention is necessary. This could involve imaging studies, such as an MRI, to assess for any adhesions or other complications that may be hindering your recovery. However, surgery is typically considered a last resort after conservative measures, such as physical therapy, have been exhausted.

It's crucial to maintain an open line of communication with both your physical therapist and orthopedic surgeon. Discuss your concerns about the possibility of another surgery and ask for their recommendations on how to proceed. They may suggest specific exercises or modalities to help improve your knee flexion without the need for additional surgery.

In the meantime, continue with your rehabilitation exercises, focusing on gentle stretching and strengthening of the quadriceps and hamstrings, as these muscles play a vital role in knee stability and function. Incorporating modalities such as ice, heat, and electrical stimulation may also help manage pain and swelling, facilitating better movement.

Lastly, remember that recovery from ACL surgery is often a gradual process, and it's essential to be patient with yourself. Each individual's healing journey is unique, and while it can be frustrating, consistent effort in rehabilitation can lead to improvements over time. If you have any further concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare providers for guidance. They are there to support you through your recovery journey.