Post-Operative Instructions: Knee Arthroscopy

Pain Medications

  • In most cases local or regional nerve blocks will provide 8-12 hours of numbness. As soon as you start to feel the numbness wearing off, begin taking oral pain medication.

  • Take Tylenol 500mg one tab every 8 hours.

  • Take Aleve (Naproxen) 220mg two tabs (440mg total) every 12 hours with food.

  • If you still have pain after Tylenol and Aleve/Naproxen, take one Norco tab (5mg/325mg).

  • If you still have pain after all of the above, take a second Norco tab.

  • Keep in mind Norco has Tylenol in it (325mg). If you take an extra Norco, then skip a dose of Tylenol.DO NOT exceed 3500mg of Tylenol over 24 hours. 

  • It is illegal to drive or operate machinery with narcotic medications. 

  • Do not combine alcohol or other sedatives with narcotic medications.

  • You do not need to take pain medications once you no longer have pain. You should stop the Norco first (usually 2-3 days), then wean off the others over the next week or two.

Other Medications

  • Take Aspirin 325mg one tab once a day for the first 4 weeks to prevent blood clots.

  • Take Zofran as needed for nausea (usually associated with anesthesia/narcotic meds).

  • Take an over-the-counter stool softener (Docusate/Senna/Miralax) as needed for constipation.

Activity

  • Use both crutches to assist with ambulation. Do NOT use only one crutch.

  • You may progress to putting all of your weight on your operative leg as tolerated.

  • You can stop using the crutches once you are walking normally with no limp. 

  • Elevate your operative extremity above the heart as much as possible to decrease swelling.

  • Avoid prolonged periods standing to prevent excessive pain and swelling.

Recovery Equipment

  • Keep your ACE wrap on for compression to help with swelling during the first 3 days after surgery.

  • You typically will not need any knee braces unless otherwise instructed.

Cold Therapy

  • We recommend cold therapy use as much as possible in the first two weeks. 

  • Cold therapy units may be used continuously as instructed.

  • Ice packs should be applied 30 minutes at a time, with 30 minutes off between applications.

  • Do not apply ice directly to the skin to avoid burning.

Recovery Exercises

  • You may perform leg bridges, heel slides (0-90 degrees), quad sets, and ankle exercises as instructed in your preoperative packet.

  • Your motion goal should be to have 0-90 degrees of knee motion at your initial postoperative visit.

  • You may or may not need physical therapy depending on how you are doing two weeks postoperatively.

Diet: Please refer to your preoperative packet instructions.

Incision Care: Please refer to your preoperative packet instructions.

Emergencies: Please refer to your preoperative packet instructions.

Post-Operative Rehabilitation: Knee Arthroscopy

Therapy Plan: As needed - twice per week for 0-2 months, once per week for 2-4 months

ROM Progression

Progress ROM as tolerated with the goal of symmetric full motion at 6-8 weeks.

Weight Bearing Progression

Full weight bearing as tolerated utilizing crutches initially for assistance.

  • Progress weight bearing with the goal of removing crutches at 2-4 weeks

  • Do NOT progress to one crutch - gait must be pain free and non-compensatory to remove both crutches

Initial Post-Operative Physical Therapy Visit

  • Correctly perform weight bearing with crutches

  • Instruct on leg bridge for extension, heel slides for flexion, quad sets, ankle pumps

  • Isometric exercises for core, glutes, quadriceps, hamstrings

Phase 1 Physical Therapy (0-4 weeks): protect the joint, progress ambulation

  • NO open-chain exercises

  • Manual therapy 20+ minutes per session, stationary bike 20-60 minutes/day (NO resistance)

  • Initiate closed-chain strengthening and planks advancing as tolerated

  • Soft tissue mobilization, patellar mobilization, isometric exercises, core strengthening

  • Tactile and verbal cueing to enable non-compensatory gait patterning

Phase 2 Physical Therapy (4-8 weeks): progressive strengthening

  • Continue closed-chain strengthening and planks advancing as tolerated

  • Proprioceptive training

  • Soft tissue mobilization, patellar mobilization, isometric exercises, core strengthening

  • Plyometrics and agility drills as tolerated

  • Elliptical and pool running may start at 6 weeks

Phase 3 Physical Therapy (8-12 weeks): return to pre-injury level and sport

  • Focus on functional exercises in all planes, advance only when fully controlled

  • Advance closed-chain and core strengthening

  • Proprioceptive training

  • Straight treadmill running may start at 8 weeks

  • Sport-specific drills as tolerated

  • Full return may take a full 3-6 months or more depending on surgery and recovery