Post-Operative Care for Femoral Head Osteonecrosis: Can I Move My Knee? - Orthopedics

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Continuation #139582: Decompression Surgery for Avascular Necrosis of the Femoral Head


Hello Dr.
Shi: Thank you for your response.
I would like to ask if, after undergoing femoral decompression surgery, in addition to using crutches to avoid fractures, is it permissible to move and bend the knee joint? I am currently very concerned that avoiding joint movement post-surgery may lead to knee joint adhesions, resulting in further rehabilitation difficulties.

Cathy, 40~49 year old female. Ask Date: 2018/09/09

Dr. Shi Guozheng reply Orthopedics


You can move, but you cannot put weight on it for the time being and must use a cane for assistance.

Reply Date: 2018/09/09

More Info


Post-operative care following a femoral head osteonecrosis surgery, particularly after a decompression procedure, is crucial for ensuring optimal recovery and minimizing complications. Your concern about whether you can move your knee after the surgery is valid, as maintaining joint mobility is essential to prevent stiffness and adhesions, which can lead to further complications.

After a femoral head decompression surgery, the primary goal is to allow the femoral head to heal while minimizing the risk of further injury. Typically, patients are advised to use crutches or a walker to avoid putting weight on the affected leg for a specified period, usually ranging from a few weeks to a couple of months, depending on the surgeon's assessment and the extent of the osteonecrosis.

Regarding knee movement, it is generally encouraged to maintain some degree of mobility in the knee joint, as long as it does not place undue stress on the hip joint. Gentle range-of-motion exercises for the knee can be beneficial and are often recommended to prevent stiffness. However, the specifics of your rehabilitation program should be tailored to your individual situation and guided by your orthopedic surgeon or physical therapist.

Here are some key points to consider for your post-operative care:
1. Follow Your Surgeon’s Instructions: Always adhere to the post-operative guidelines provided by your surgeon. They will give you specific instructions regarding weight-bearing status and the timing for resuming knee movements.

2. Gentle Range of Motion Exercises: Once cleared by your surgeon, gentle knee flexion and extension exercises can help maintain mobility. These exercises should be performed within a pain-free range and can be gradually increased as tolerated.

3. Physical Therapy: Engaging in physical therapy can be highly beneficial. A physical therapist can design a rehabilitation program that focuses on strengthening the muscles around the knee and hip while ensuring that you do not compromise the healing femoral head.

4. Avoid High-Impact Activities: While it is important to keep the knee moving, avoid high-impact activities that could stress the hip joint during the early stages of recovery. Activities such as running or jumping should be avoided until your surgeon gives you the green light.

5. Monitor for Pain and Swelling: Pay attention to any pain or swelling in the knee or hip during your rehabilitation. If you experience increased discomfort, it may be a sign that you are overdoing it, and you should consult your healthcare provider.

6. Gradual Return to Activities: As you progress in your recovery, you can gradually return to your normal activities. However, this should be done under the guidance of your healthcare team to ensure that you are not putting your recovery at risk.

7. Long-term Considerations: Keep in mind that the recovery process can take time, and it is essential to be patient. Osteonecrosis can lead to complications such as arthritis in the long term, so ongoing monitoring and management of your hip joint health will be important.

In summary, while it is generally advisable to maintain some movement in your knee post-surgery, the specifics of your rehabilitation should be guided by your surgeon's recommendations. Engaging in gentle exercises, working with a physical therapist, and monitoring your symptoms will help you achieve the best possible outcome while minimizing the risk of complications. Always prioritize communication with your healthcare team to ensure that your recovery is on track.

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