Post-Arthroscopic Surgery Concerns: Knee Noises and Recovery Tips

Questions After Arthroscopic Reconstruction Surgery

Hello, doctor.
Last year, I underwent arthroscopic surgery, during which the physician examined my meniscus and said there were no issues.
They only performed a reconstruction of the anterior cruciate ligament (ACL).
After the surgery, I returned for follow-up visits, and the doctor mentioned that my recovery was progressing well.
I was advised to return only if I experienced pain.
However, in recent months, I have noticed that my knee makes sounds when I move.
When sitting and lifting my lower leg, there is a sound at the top position, and I also hear sounds while walking.
My knee does not hurt; it just feels a bit strange with the noises.
I am hesitant to engage in other exercises and have only been climbing stairs to build muscle endurance, but my knee still makes sounds.
What could be the issue? It has been about six months since the surgery.
What exercises can I do at this point? Please advise.
Thank you.

NIKE, 20~29 year old female. Ask Date: 2006/05/30

Dr. Shi Guozheng reply Orthopedics

After anterior cruciate ligament reconstruction, if there are sounds coming from the knee, it may be due to the patella sliding over the synovium.
As long as there is no pain associated with it, there is no cause for concern.
Six months post-surgery, you can engage in some light activities (such as walking or hiking), but it may take up to nine months to fully return to pre-injury status.

Reply Date: 2006/05/30

More Info

After undergoing arthroscopic knee surgery, it is not uncommon for patients to experience various concerns, including noises from the knee joint during movement. In your case, you mentioned that you have been experiencing sounds when moving your knee, particularly when lifting your lower leg or walking, but without accompanying pain. This situation raises several important considerations regarding your recovery and the potential causes of these noises.

Understanding Knee Noises Post-Surgery
1. Types of Noises: The sounds you hear from your knee can vary. Common descriptions include popping, cracking, or grinding noises. These sounds can arise from several sources:
- Tendons and Ligaments: As tendons and ligaments move over bony prominences, they can create a snapping or popping sound. This is often harmless and is referred to as "crepitus."
- Cartilage Changes: After surgery, the cartilage may not have fully returned to its original state, leading to changes in how the joint surfaces interact.

- Synovial Fluid Movement: The movement of synovial fluid within the joint can also create sounds, especially if there are changes in the joint structure post-surgery.

2. When to Be Concerned: Since you are not experiencing pain, swelling, or instability, the noises may not indicate a serious problem. However, if you notice any of the following, it would be wise to consult your physician:
- Increased pain or discomfort during activities.

- Swelling or inflammation around the knee.

- A feeling of instability or giving way in the knee.

Recovery and Rehabilitation
1. Post-Surgical Recovery: Six months post-surgery is a critical time for recovery. It is essential to continue your rehabilitation exercises to strengthen the muscles around the knee, improve flexibility, and enhance overall function. Engaging in low-impact activities, such as swimming or cycling, can be beneficial.

2. Recommended Exercises: Here are some exercises that can help improve your knee strength and stability:
- Quadriceps Strengthening: Straight leg raises and wall sits can help strengthen the quadriceps without putting too much strain on the knee.

- Hamstring Strengthening: Hamstring curls can be performed standing or lying down to strengthen the back of the thigh.

- Balance Exercises: Standing on one leg or using a balance board can improve proprioception and stability.

- Flexibility Exercises: Gentle stretching of the quadriceps, hamstrings, and calf muscles can help maintain flexibility.

3. Gradual Return to Activities: As you feel more comfortable, you can gradually reintroduce activities such as stair climbing, walking, and light jogging. Always listen to your body and avoid pushing through pain.

Conclusion
In summary, the noises you are experiencing in your knee after arthroscopic surgery may be a normal part of the healing process, especially if they are not accompanied by pain or swelling. Continue to engage in your rehabilitation exercises and consider incorporating low-impact activities to enhance your recovery. If you have any concerns or if the noises change in nature or are accompanied by other symptoms, it is advisable to follow up with your orthopedic surgeon for a thorough evaluation. Regular check-ups are essential to ensure that your knee is healing properly and to address any concerns that may arise during your recovery journey.

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