Knee arthroscopy (knee scope surgery) is a minimally invasive procedure used to diagnose and treat various joint problems, such as meniscus tears or cartilage damage. Surgeons insert a small camera and specialized instruments through tiny incisions, which generally leads to a faster recovery compared to open surgery. This guide outlines what to expect during the recovery process, which is influenced by the specific procedure performed and adherence to rehabilitation protocols.
The Immediate Post-Operative Period
The first 24 to 48 hours focus on managing swelling and protecting the surgical site. Initial wound care involves keeping the incisions clean and dry. The surgeon advises when to remove the outer dressing, typically around 48 hours post-operation. Small adhesive strips (Steri-Strips) cover the incisions and remain until they fall off or are removed at a follow-up appointment.
Controlling swelling and pain relies on the R.I.C.E. principles: Rest, Ice, Compression, and Elevation. The leg should be elevated above heart level for the first 72 hours to encourage fluid drainage. Apply ice or a cold therapy unit to the knee for 15 to 20 minutes at a time, several times daily, using a thin barrier against the skin.
Some patients may use a continuous passive motion (CPM) machine, which gently moves the knee joint to prevent stiffness and promote early movement. Ankle pumps (moving the foot up and down) should be performed frequently to stimulate circulation and prevent blood clots.
Managing Pain and Mobility Milestones
Pain management begins before the local anesthetic wears off, usually six to eight hours after surgery. A scheduled approach to medication is more effective than waiting for severe discomfort, often combining prescription narcotics and over-the-counter pain relievers. The goal is to taper off the stronger narcotic quickly, usually within a few days, transitioning fully to non-opioid options like acetaminophen or ibuprofen.
Weight-bearing status varies based on the underlying issue and the extent of the repair. For simple procedures like a meniscectomy or loose body removal, patients often bear weight as tolerated (WBAT) immediately, using crutches only for balance. More complex repairs, such as a meniscus repair or microfracture, may require several weeks of strict non-weight-bearing to protect the healing tissue.
Functional milestones are individualized, but general timelines exist for returning to daily activities. Patients with sedentary jobs may return to work within a few days to one week. Driving requires the patient to be off narcotic pain medication, have regained sufficient leg control, and be walking without crutches, which takes approximately one to two weeks. Light household chores can resume within the first week, but avoid prolonged standing or heavy lifting for several weeks to prevent swelling and pain.
Structured Rehabilitation and Physical Therapy
Structured rehabilitation is essential for a successful long-term outcome after knee arthroscopy. Physical therapy (PT) typically begins within the first week, focusing on restoring motion and activating the thigh muscles. PT aims to prevent stiffness, restore full range of motion (ROM), and rebuild quadriceps strength, which can rapidly atrophy after surgery.
Rehabilitation progresses through distinct phases designed to safely stress the healing joint. Phase 1, the acute phase, focuses on gentle range-of-motion exercises like heel slides, achieving full knee extension, and performing isometric quadriceps sets. Achieving a straight knee is an important early goal to prevent long-term functional limitations.
Phase 2 introduces exercises for strength building and normalizing gait, including light resistance training, short-arc quads, and mini-squats. This stage emphasizes stability and control, often progressing balance work to single-leg stances. Patient compliance with a consistent home exercise program (HEP) is crucial, as controlled movements done multiple times daily drive recovery.
Phase 3, the advanced phase, begins around six weeks post-surgery and focuses on functional training. Exercises become more demanding, incorporating heavier resistance, plyometrics, and agility drills to prepare the knee for activity. Full clearance to return to competitive sports or heavy physical labor is granted once the strength of the operated leg is comparable to the uninjured leg, often taking three to six months.
Recognizing When to Seek Help
While some swelling, bruising, and mild to moderate pain are expected, certain signs require immediate contact with the surgical team. Signs of infection include:
- A persistent fever above 100.5°F.
- Spreading redness around the incision sites.
- Increasing warmth.
- Pus-like drainage.
Infection risk is low, but prompt treatment is necessary if it occurs.
Uncontrolled pain that suddenly worsens or does not improve after taking prescribed medication is a warning sign. Symptoms of a deep vein thrombosis (DVT), a blood clot in the leg, require urgent medical attention. These symptoms involve severe pain in the calf or thigh, significant swelling that extends below the knee, and a feeling of warmth in the lower leg.