Post-ACL Surgery Rehabilitation: Addressing Pain and Cartilage Concerns

Post-operative rehabilitation after ACL surgery involves several key phases to ensure proper healing and restoration of function. 1. Initial Phase

Dear Dr.
Luo,
I would like to ask you a question.
Previously, I experienced intermittent pain in my left knee.
After undergoing an MRI, the doctor diagnosed me with a torn anterior cruciate ligament (ACL).
Therefore, I had ACL reconstruction surgery two months ago.
As of now, I can bend my knee to 60 degrees, but I still experience occasional pain in my left knee while walking (a deep, stabbing pain), and sometimes it hurts with every step.
Is this normal?
Additionally, during the surgery, the doctor mentioned that my left knee cartilage damage was quite severe, and some of the cartilage was no longer visible.
Could you please advise me on how to protect it or if there are methods to promote cartilage regeneration? What should I do?
Perhaps due to the injury to my left leg, I have been putting more weight on my right leg.
Now, I also experience pain in my right knee, both while walking and bending, with a deep, stabbing pain on the inside of the knee.
There is also a cracking sound when I bend it.
Are these issues considered normal? I am really troubled by this, and I would greatly appreciate your guidance.
Thank you for taking the time to respond.
Sincerely,
Sandy

sandy, 20~29 year old female. Ask Date: 2003/05/04

Dr. Luo Zhaozhong reply Orthopedics

Hello! Generally speaking, if there is no obvious external injury or sports trauma, the anterior cruciate ligament (ACL) is not easily torn.
Pain around the knee may arise from issues such as cartilage damage or meniscus tears.
After ACL reconstruction, with proper rehabilitation, pain symptoms should improve, especially if it is solely a ligament issue.
Extensive cartilage defects currently cannot regenerate naturally and may sometimes require cartilage transplantation.
Research is ongoing in the field of genetic engineering for cartilage regeneration, and new therapies are expected in the near future.
Additionally, due to the inconvenience of using the affected limb, there may be increased reliance on the unaffected limb, which could lead to accelerated fatigue in the tendons of that limb.
Best wishes for health from Dr.
Luo Zhao-Chung, Orthopedics, Taoyuan Hospital, Department of Health, Executive Yuan.

Reply Date: 2003/05/04

More Info

Dear Sandy,
Thank you for reaching out with your concerns regarding your post-ACL surgery rehabilitation. It’s understandable to feel anxious about your recovery, especially when experiencing pain and discomfort. Let’s address your questions and provide some insights into your situation.

Firstly, it’s not uncommon to experience pain after ACL reconstruction, especially in the early stages of rehabilitation. The pain you describe, particularly the deep, sharp pain while walking, can be attributed to several factors. After surgery, the knee undergoes a healing process that can involve inflammation, scar tissue formation, and adjustments in how the knee functions. It’s also important to consider that the knee joint is complex, and pain can arise from various structures, including ligaments, tendons, and cartilage.

Regarding your concern about the cartilage damage noted during your surgery, it’s crucial to understand that cartilage does not regenerate easily. Once damaged, it often requires specific strategies to manage and protect it. Here are some recommendations to help you:
1. Physical Therapy: Engaging in a structured physical therapy program is essential. A physical therapist can tailor exercises to strengthen the muscles around your knee, improve your range of motion, and reduce pain. They can also guide you on how to perform movements correctly to avoid putting undue stress on your knee.

2. Pain Management: If you are experiencing significant pain, it may be beneficial to discuss pain management options with your healthcare provider. This could include medications, ice therapy, or other modalities that can help alleviate discomfort.

3. Activity Modification: It’s important to listen to your body. If certain activities exacerbate your pain, consider modifying them or reducing their frequency. Gradually increasing your activity level while monitoring your pain can help you find a balance.

4. Weight Management: Maintaining a healthy weight can reduce the stress on your knees. If you are overweight, even a small amount of weight loss can significantly decrease the load on your knee joints.

5. Nutritional Support: While there is no definitive method to regenerate cartilage, some studies suggest that certain nutrients may support joint health. Omega-3 fatty acids, glucosamine, and chondroitin sulfate are often discussed in this context. However, it’s best to consult with a healthcare provider before starting any supplements.

6. Follow-Up with Your Surgeon: Regular follow-ups with your orthopedic surgeon are crucial. They can assess your knee’s healing process, address any concerns about your pain, and make necessary adjustments to your rehabilitation plan.

As for the pain in your right knee, it’s not unusual for the opposite knee to experience discomfort, especially if it has been compensating for the injured knee. This compensation can lead to overuse injuries or strain. It’s essential to address this issue with your therapist or surgeon to ensure that both knees are receiving appropriate care.

In summary, while some pain post-surgery can be expected, persistent or worsening pain should be evaluated by your healthcare provider. They can help determine the underlying causes and adjust your rehabilitation plan accordingly. Remember, recovery is a gradual process, and it’s important to be patient with yourself as you work towards regaining strength and function in your knees.

Best wishes for your recovery, and don’t hesitate to reach out for further guidance or support.

Sincerely,
Doctor Q&A Teams

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