You have just undergone knee arthroscopy, and you have many questions about the recovery time?
Or, you are gathering information before considering knee arthroscopy for osteoarthritis or meniscus issues, or as a healthcare professional seeking better ways to support your patients?
In this article, I address the most common questions from internet users and patients I work with in physical therapy, regarding the rehabilitation and recovery timeline after an arthroscopic knee surgery.
I rely on my professional experience as well as research from international medical publications. All references are provided at the end of the article.Happy reading 🙂!
Last update: August 2023
Why is there a recovery time after knee arthroscopy?
There are at least two reasons why you need some recovery time after knee arthroscopy:
1. Direct consequences of the operation: You need to recover from the local anesthesia and the surgical procedure. Despite being a minimally invasive operation designed to minimize recovery time, your tissues still need to heal.
The incisions made during the procedure are tiny, but the surgeon still had to insert instruments beneath the skin surface, into the joint. As a result, your body will likely respond with inflammation in the knee, a natural process that aids in tissue healing and recovery.
2. Consequences of discomfort and pain prior to the operation:
Your arthroscopy was likely performed due to:
- Knee osteoarthritis
- Meniscus problems
- Cartilage injuries
- Anterior cruciate ligament (ACL) rupture
- Knee CRPS
- Patello femoral pain syndrome
- or another issue causing knee pain, a sense of locking or stiffness, instability, or giving way.
Your body needs time to recover from the weeks, months, or even years when it was not at its best due to these problems. You have probably lost muscle strength and flexibility before the operation. It takes some time to regain those.That’s why patients are called… patients 😊. Hence the need for a few days or weeks to fully recover and resume all the activities you want to do!
Let’s now take a closer look at how long it takes to recover from knee arthroscopy.
What is the recovery time after a knee arthroscopy?
Not everyone recovers at the same pace after a knee arthroscopy. It is difficult to predict in advance whether you will be one of those who recover extremely quickly (in a few days), or one of those who recover slowly (several months). There are also many people in between, the majority, who recover in a few weeks.
Below is a table summarizing the average recovery durations for specific milestones.
|Significant reduction in pain||Few days|
|Reduced swelling in the knee||Few days to few weeks|
|Walking with crutches||Immediate|
|Walking without crutches||Few days, up to a few weeks|
|Able to drive a car||Few days to few weeks|
|Able to fully bend the knee||Few days to few weeks|
|Able to return to work||Immediate to a few days or weeks, depending on the nature of the job|
|Able to resume cycling||Few days (gradual return)|
|Able to resume running||Few weeks. Longer if anterior cruciate ligament reconstruction was performed|
|Able to resume more intense sports||Few weeks. Longer if anterior cruciate ligament reconstruction was performed|
The typical recovery time after a knee arthroscopy may vary depending on individual factors and the specific procedures performed during the surgery. The provided timeframes are average estimates, and actual recovery times may differ from person to person!
When can you bend your knee after arthroscopy?
Firstly, it’s important to know that there are no contraindications or risks to bending the knee immediately after arthroscopy, except for very specific cases. If such restrictions apply to you, they will be clearly documented in your day hospitalization reports and will have been verbally communicated to you. You would have been informed if knee flexion is prohibited or limited.
However, even if you are allowed to bend your knee, you may encounter some difficulty in doing so, whether it’s a little or a lot. It’s highly likely that your knee will not bend as much as the non-operated leg and might even have limited extension (in this case, it’s referred to as complicated knee extension).
This is a completely normal and typical reaction.
It’s due to the inflammation in your knee, a natural process that aids in tissue healing. The inflammation leads to an accumulation of fluid in the joint, causing knee swelling, discomfort, and difficulty in bending or straightening the knee.
You will regain normal knee flexion as soon as the inflammation subsides, typically within a few days to a few weeks at most.
During this recovery period, maintain knee flexion by staying as active as possible and varying your positions (bending and flexing the knee). Specific knee flexion and extension exercises may not be necessary as long as you remain active and vary your knee positions throughout the day.
How long does the knee remain swollen after arthroscopy?
The knee becomes swollen after arthroscopy for the same reason it may sometimes be difficult to bend: due to inflammation, which brings all the necessary nutrients to aid in its healing.
This swelling is referred to as edema in medical terms: it’s exactly the same thing.
Some individuals may not experience edema, or it may be so minimal that it is concealed by the dressing over the tiny incision.
However, in most cases, edema is present around the kneecap and sometimes in the thigh, calf, or even at the foot level.
The knee swelling usually subsides within a few days to a few weeks after arthroscopy. In rare cases, it may persist for several months, but this isolated sign is not necessarily a sign of complication.
Simply put, some people’s bodies take longer to naturally drain the edema. Some measures can be taken to reduce knee swelling, but time is the best and most natural treatment!
How long does the pain last after knee arthroscopy?
The pain after knee arthroscopy is milder and shorter-lasting compared to knee replacement surgery or other more invasive knee procedures.
It is due to:
- Inflammation (there it is again!)
- Minor tissue damage caused during the procedure
- The fact that you probably had pre-existing pain, and these sensations often don’t disappear overnight.
The level of pain varies greatly from person to person. Some individuals may feel the need to take pain-relieving medications in addition to implementing other measures to alleviate the pain (such as applying cold packs to the knee). Others may not feel the need to take pain relievers.
Pain after arthroscopy is most intense in the first few days and gradually decreases over time. It usually disappears within a few weeks.
📘 Hoofwijk 2015 Study: Out of 104 individuals who underwent knee arthroscopy and were followed after the procedure, 71% experienced moderate to severe pain during the week following the operation.
33% of them still had pain one year after the procedure:
- 17% had more pain than before arthroscopy
- 13% had the same level of pain
- 71% had less pain than before arthroscopy.
When to walk without crutches after knee arthroscopy?
In the vast majority of cases, you can start walking right away, on the same day of the arthroscopy.
You may still need crutches to:
- Relieve pressure on the operated leg due to pain, lack of strength, or a slight paralysis sensation in the thigh muscle.
- Be able to walk for slightly longer periods.
- Avoid limping.
Walking regularly while adapting your walking style, duration, and intensity of walking sessions is one of the best things you can do to recover well after knee arthroscopy.
Generally, you won’t need crutches for walking a few days after knee arthroscopy. In more rare cases, it may take a few weeks.
When can you drive after knee arthroscopy?
It is not advisable to resume driving immediately after leaving the hospital or outpatient clinic. It is highly likely that you won’t be able to bend your knee enough or be comfortable enough with your leg to drive.
In general, you can start driving your car in the days or at most weeks following knee arthroscopy.
Is it important for you to follow the law regarding this matter?
Here it is:
Law in France
Every driver must constantly maintain a position and be able to execute all maneuvers required of them comfortably and without delay. (…)The fact that any driver violates the provisions of II above shall be subject to the fine provided for offenses of the second class. (…)In case of violation of the provisions of II above, immobilization of the vehicle may be prescribed.Article R412-6 of the Highway Code
As you can see, it is somewhat vague. From a regulatory standpoint, the worst-case scenario is a class 2 fine. However, in the event of an accident, your insurance may not cover you depending on the clauses specified in your policy.
Statistically, the chances of that happening are quite low. It’s up to you to evaluate the benefits and risks of resuming driving sooner or later after knee arthroscopy based on your post-operative condition!
Law in United States
In the United States, the regulations regarding driving after knee arthroscopy may vary by state. Generally, there is no specific nationwide law or regulation that dictates the exact time frame for resuming driving after the procedure.
Instead, the decision is often left to the discretion of the patient or patient’s surgeon and their ability to safely operate a vehicle.
What is time off work after knee arthroscopy?
The duration of work leave is not determined by the specific health issue but rather by its impact on your professional activity.
If you have a desk job and work from home, you may only need to take one or two days off.
However, if you have a physically demanding job that involves walking, lifting, or standing for extended periods, you may require a few weeks of work leave following knee arthroscopy.
Generally, the initial work leave is prescribed by the surgeon, and then your primary care physician may extend it if necessary.
When to resume sports after knee arthroscopy?
Different factors will determine when and at what intensity you can resume sports activities:
- The reason for the knee arthroscopy (ACL tear, meniscal injury, etc.);
- Your previous intensity and level of physical activity before the operation;
- Any pain or discomfort in your knee;
- Your own assessment of the risk-benefit balance in resuming sports at different paces.
Physical therapists are essential partners in discussing the resumption of sports activities!
Generally, stationary biking or using a home-trainer can be resumed a few days after the operation. Running can be resumed after a few weeks. Other sports and sports involving pivoting or combat may be resumed after 1 to 3 months (longer in the case of ACL reconstruction surgery).
What can be done to minimize the recovery time?
Injuries to tissues take some time to heal, no matter what we do. So, there is no magic recipe to ensure the quickest and maximum recovery, or to significantly accelerate the natural healing process.
The best things you can do are:
- Be reassured that most people recover very well after this surgical procedure.
- Resume your daily activities, adapting them as needed.
- Change positions regularly throughout the day (extend and flex the knee).
- Avoid prolonged sitting with the knee bent or prolonged static standing.
- Take walks outdoors at least once a day, gradually increasing the duration of your walks.
💡 You can find more details in my eBook: The Road to Recovery: Maximizing Healing After Fractures, Injuries, and Surgery
What is the rehabilitation process after knee arthroscopy?
After knee arthroscopy, physiotherapy sessions are often prescribed, regardless of the reason for the procedure. Sometimes, the clinic or hospital will provide a rehabilitation protocol (a fact sheet or booklet).
These sessions are conducted in private practices or through home-based physiotherapy (especially in the first few days).
- Knee arthroscopy is not a reason to be admitted to a rehabilitation center, even in a day hospital setting.
- The Health Insurance sets a maximum number of physiotherapy sessions covered by insurance and health plans after knee arthroscopy:
- Isolated, total, or subtotal meniscectomy: a maximum of 15 physiotherapy sessions.
- Anterior cruciate ligament (ACL) reconstruction of the knee: a maximum of 40 physiotherapy sessions.
However, these durations can be extended by submitting a small file to the Health Insurance: the request for prior agreement. Your physiotherapist should take care of this.
The main objectives of the rehabilitation are:
- To reassure you about your recovery.
- To answer your questions.
- To provide personalized guidance on daily activities to improve knee flexion and extension, alleviate pain, reduce swelling, gradually resume daily activities, and eventually return to sports.
Is rehabilitation with physical therapist mandatory? No. If you feel comfortable and confident in knowing what to do during this recovery period, that’s great! Seek a physiotherapist only if you feel the need for it!
If you feel the need to learn more about the recovery period after a knee arthroscopy, I wrote this guide in eBook format:
Here’s what I wanted to tell you about this! I wish you a very good recovery! Do you have any comments or questions? Your comments are welcome 🙂 !
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Relevant academic publications regarding the issues raised in this article include:
Hoofwijk DMN, Fiddelers AAA, Emans PJ, Joosten EA, Gramke HF, Marcus MAE, Buhre WFFA. Prevalence and Predictive Factors of Chronic Postsurgical Pain and Global Surgical Recovery 1 Year After Outpatient Knee Arthroscopy: A Prospective Cohort Study. Medicine (Baltimore). 2015 Nov;94(45):e2017. doi: 10.1097/MD.0000000000002017. PMID: 26559300; PMCID: PMC4912294.
Bhattacharyya R, Davidson DJ, Sugand K, Akhbari P, Bartlett MJ, Bhattacharya R, Gupte CM. Knee Arthroscopy: A Simulation Demonstrating the Imperial Knee Arthroscopy Cognitive Task Analysis (IKACTA) Tool. JBJS Essent Surg Tech. 2018 Dec 26;8(4):e32. doi: 10.2106/JBJS.ST.18.00017. PMID: 30775137; PMCID: PMC6358334.
Yin, B., Goldsmith, L., & Gambardella, R. (2015). Web-Based Education Prior to Knee Arthroscopy Enhances Informed Consent and Patient Knowledge Recall. The Journal of Bone and Joint Surgery-American Volume, 97(12), 964–971. doi:10.2106/jbjs.n.01174
Article R412-6 legifrance.gouv.fr
Most of the information presented in this article is based on my own professional experience with individuals who have undergone knee arthroscopy since there are very few studies on the outcomes of this operation in general. However, more studies are available depending on the specific reason that led to the arthroscopy (for example, an ACL tear, meniscal injuries, etc.).
It is worth noting that many studies on this topic state that the benefits of knee arthroscopy (regardless of the reason) are controversial, and this will be the subject of a future article!
By Nelly Darbois
I love to write articles that are based on my experience as a physiotherapist and extensive research in the international scientific literature.
I live in the French Alps 🌞❄️ where I work as a physiotherapist and scientific editor for my own website, where you are.