Post-ACL Surgery: Managing Pain and Knee Mobility - Orthopedics

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After undergoing surgery for an ACL reconstruction along with meniscus repair and fibula treatment, it is common to experience pain and limited mobility in the knee during the recovery phase. Your concerns about the inability to fully bend your knee and the associated pain are valid and warrant a thorough understanding of the post-operative healing process.

Firstly, it is important to recognize that post-surgical pain and stiffness are typical outcomes following ACL surgery. The knee joint is complex, and the surgical intervention can lead to inflammation, swelling, and the formation of scar tissue, which may contribute to the sensation of tightness and pain during movement. The pain you are experiencing, especially when attempting to bend your knee beyond 90 degrees, could indeed be related to adhesions or scar tissue formation around the surgical site, which can restrict the range of motion.

In your case, the recommendation from your physician to consider a second procedure to remove adhesions is not uncommon. This type of surgery, often referred to as arthroscopic lysis of adhesions, aims to improve knee mobility by addressing the scar tissue that may be limiting your range of motion. However, it is essential to weigh the benefits and risks of any additional surgical intervention. While this procedure can potentially alleviate pain and improve mobility, it also carries risks, including infection, further scarring, and the need for additional rehabilitation.

In the meantime, there are several strategies you can employ to manage your pain and improve your knee mobility:
1. Physical Therapy: Engaging in a structured physical therapy program is crucial. A physical therapist can provide you with specific exercises tailored to your condition, focusing on improving flexibility, strength, and range of motion. They can also utilize modalities such as ultrasound or electrical stimulation to help manage pain and promote healing.

2. Pain Management: Over-the-counter pain medications, such as NSAIDs (e.g., ibuprofen or naproxen), can help reduce inflammation and alleviate pain. Always consult with your physician before starting any medication to ensure it is appropriate for your situation.

3. Ice and Elevation: Applying ice to the knee for 15-20 minutes several times a day can help reduce swelling and numb the pain. Elevating your leg can also assist in minimizing swelling.

4. Gradual Mobilization: While it may be uncomfortable, gently working on bending your knee within a pain-free range can help prevent stiffness. Using a stationary bike or engaging in aquatic therapy can provide a low-impact way to improve mobility without placing excessive strain on the knee.

5. Assistive Devices: If necessary, using a knee brace or support can provide stability and comfort during your recovery. However, it is essential to use these devices as directed by your healthcare provider.

6. Nutrition and Supplements: Maintaining a balanced diet rich in anti-inflammatory foods can support your recovery. Some patients find that supplements like glucosamine and chondroitin may help with joint health, although scientific evidence is mixed.

7. Regular Follow-ups: Keep in close contact with your orthopedic surgeon or healthcare provider. Regular assessments can help monitor your progress and determine if further interventions are necessary.

In conclusion, while post-operative pain and limited mobility are common following ACL reconstruction, proactive management through physical therapy, pain relief strategies, and regular follow-ups with your healthcare provider can significantly enhance your recovery. If the pain persists or worsens, or if you have concerns about the adhesions, discussing these with your physician will be crucial in determining the best course of action for your knee health. Remember, recovery is a gradual process, and patience, along with consistent effort, will be key to regaining full function of your knee.