Knee Flexion Issues After Surgery: Pain and Recovery Insights

Joint flexion issues

1.
Dr.
Chen, I would like to ask you about my condition.
I had surgery at the end of September last year and rested for three months.
I started rehabilitation around mid-December.
Currently, my knee flexion is approximately 105 degrees.
However, I notice pain on the inner side of my right knee when I apply pressure.
It hurts slightly when I do a partial squat.
Could this pain be related to my meniscus repair, or is it possibly due to pes anserinus tendinitis or bursitis?
2.
Dr.
Chen, I have another question.
Do I need to wait until my knee is fully healed before I can continue to increase the flexion of my meniscus?

Xiao Wei, 40~49 year old female. Ask Date: 2023/05/10

Dr. Chen Bochen reply Orthopedics

Hello, Xiao Wei.
After the surgery, you need to actively participate in rehabilitation and focus on increasing your range of motion.
You should aim to achieve at least 120-130 degrees of flexion.
If you are unable to bend your joint adequately, you should consult your surgeon for a follow-up examination.

Reply Date: 2023/05/10

More Info

After knee surgery, particularly when dealing with issues such as ligament injuries, meniscus repairs, or cartilage damage, it's common for patients to experience pain and limitations in knee flexion. Your situation, where you are currently at about 105 degrees of flexion but experiencing pain in the inner side of the knee during certain movements, raises several important points worth discussing.

1. Pain During Flexion: The pain you are experiencing on the inner side of your knee during flexion could indeed be related to multiple factors. Given that you have a history of meniscus repair, it is possible that the pain is stemming from the meniscus itself, especially if there is any residual swelling or irritation in that area. Additionally, the pain could also be due to issues with the collateral ligaments, particularly the medial collateral ligament (MCL), which is located on the inner side of the knee. If you are feeling discomfort during activities like squatting or applying pressure, it may indicate that the knee is not fully stable yet, or that the healing process is still ongoing.

2. Differentiating Pain Sources: It can be challenging to pinpoint the exact source of pain without a thorough examination. Conditions such as pes anserinus tendinitis (often referred to as "goose foot" tendonitis) or bursitis can also cause pain in the inner knee area. These conditions can arise from overuse or improper mechanics during rehabilitation exercises. If the pain persists or worsens, it would be prudent to consult with your orthopedic surgeon or a physical therapist who can perform a detailed assessment and possibly recommend imaging studies like an MRI to rule out any complications.

3. Recovery Timeline for Meniscus and Cartilage: Regarding your question about whether you need to wait for complete recovery of the meniscus before continuing to improve your knee flexion, the answer is somewhat nuanced. Generally, rehabilitation protocols encourage gradual progression in range of motion and strengthening exercises as tolerated. However, if there is significant pain or swelling, it may be advisable to modify your activities temporarily. Your physical therapist can guide you on how to safely increase your knee flexion while minimizing pain and preventing further injury.

4. Importance of Rehabilitation: It is crucial to adhere to a structured rehabilitation program that focuses on both flexibility and strength. Exercises that target the quadriceps, hamstrings, and hip muscles can help stabilize the knee joint and improve overall function. Additionally, modalities such as ice, elevation, and anti-inflammatory medications can assist in managing pain and swelling.

5. Long-Term Considerations: Lastly, it’s important to recognize that recovery from knee surgery can be a lengthy process, often taking several months to achieve optimal function. Regular follow-ups with your healthcare provider and ongoing communication with your physical therapist will be key in monitoring your progress and making necessary adjustments to your rehabilitation plan.

In summary, while experiencing pain during knee flexion after surgery is not uncommon, it is essential to investigate the underlying causes and ensure that your rehabilitation is appropriately tailored to your needs. Engaging in open discussions with your healthcare team will provide you with the best strategies for recovery and help you achieve your functional goals.

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