Lateral release knee surgery corrects patellar maltracking, which occurs when the kneecap does not glide properly within the groove at the end of the thigh bone (femur). The procedure involves cutting the tight lateral retinaculum on the outside of the knee to relieve tension and allow the patella to sit correctly in its groove. The recovery process requires careful management to ensure the best possible realignment and function of the knee joint.
Immediate Post-Operative Care (First 72 Hours)
The first three days following lateral release surgery focus on managing pain and minimizing swelling around the knee joint. You will likely be prescribed a combination of pain medications, including narcotics for severe initial pain and non-narcotic options, like ibuprofen, to manage inflammation. Staggering the use of these medications is often recommended to maintain consistent pain control.
Keeping the leg elevated above the heart level is highly effective for reducing internal swelling, especially during the first 48 hours. Applying ice for 15 to 20 minutes multiple times a day helps control pain and inflammation. The initial surgical dressing will typically remain in place for the first two or three days to keep the small incisions clean and dry.
Weight-bearing is usually restricted initially, requiring the use of crutches to protect the knee, sometimes for only five to seven days depending on your surgeon’s instructions. Physical therapy begins immediately with gentle exercises like ankle pumps, quad sets, and straight-leg raises. These movements are designed to maintain muscle activation and circulation without stressing the repaired tissue.
Early Recovery Milestones (Weeks 1-6)
The transition from the acute phase begins around the end of the first week, focusing on wound care and the progression of mobility. You will typically remove the initial dressing around day three, covering the small incisions with clean gauze or waterproof bandages for showering. Soaking the knee in a bath or pool is restricted for at least two weeks to prevent infection while the incisions heal.
Bruising and persistent swelling are common during this period, and you should continue to use ice and elevation consistently to manage these symptoms. By the second or third week, if you can walk with a normal, pain-free gait, you may be cleared to discontinue using crutches. The goal during this time is to achieve full knee extension, which is crucial for proper healing and long-term function.
Initial, gentle range-of-motion exercises, including passive and active bending, are introduced before formal physical therapy begins. These early movements prevent stiffness and ensure the kneecap begins to glide correctly in its newly released position. You will also begin to wean off narcotic pain medications, relying more on over-the-counter anti-inflammatories as pain levels decrease.
Physical Therapy and Restoring Mobility
Physical therapy (PT) is the primary determinant of success after lateral release surgery, guiding the knee through a structured rehabilitation process that can last three to six months. Initial PT goals focus on regaining full, pain-free range of motion and establishing control over the quadriceps muscle group. A specific focus is placed on strengthening the vastus medialis oblique (VMO), because its weakness often contributes to the original patellar maltracking.
Therapists utilize closed-chain strengthening exercises, such as mini-squats or leg presses, which are safer for the joint and better engage the VMO to guide the kneecap. Gait re-education ensures you relearn how to walk using the corrected patellar alignment and a balanced muscle pattern. As strength improves, exercises progress to include balance work, such as single-leg stance drills, and cardiovascular activities like using a stationary bike or elliptical trainer.
Returning to daily activities follows a gradual timeline dictated by progress in PT. You may resume driving approximately one to two weeks after surgery, provided you are no longer taking narcotic medication and can confidently operate the brake pedal. Light desk work can usually be resumed within the first week. Low-impact activities, such as swimming or cycling on a stationary bike, can typically be introduced around six weeks, once the surgical site is fully healed and basic strength is established.
Realistic Long-Term Outcomes
Full recovery from lateral release surgery extends to six months, with some patients continuing to see improvements up to a year. The procedure has a high success rate, and most patients experience a reduction in symptoms once rehabilitation is complete. Long-term success in preventing the kneecap from returning to a misaligned position is reported in over 85% of patients.
For patients who underwent the procedure primarily for pain relief without patellar instability, around 70% report satisfactory long-term outcomes. For those with a history of recurrent kneecap dislocation, the long-term satisfaction rate may be lower, as this procedure alone may not fully address all factors contributing to instability. Returning to high-impact sports or demanding physical labor is a final milestone, achieved between six and twelve months after surgery, depending on the initial condition and the intensity of the activity.