Why You May Still Experience Knee Pain After Arthroscopic ACL Surgery



Arthroscopic ACL surgery has gained popularity over the past decade. If you have undergone an arthroscopic ACL surgery, there are many reasons that may cause you to continue experiencing knee pain and dysfunction despite the fact that your ACL has been repaired. In some cases, the pain may actually be worse, which can make recovery particularly frustrating for patients and their surgeons alike.

Fortunately,there are ways to minimize and manage knee pain following ACL surgery so that you can continue your recovery journey and enjoy pain-free living. Due to advances in medical technology, and orthopedic surgical techniques, most people who have undergone an arthroscopic ACL reconstruction (ACL reconstruction) are able to return to their pre-injury level of physical activity.

Here are some of the reasons why continued knee pain after arthroscopic ACL surgery may occur, as well as some tips on how to minimize it.

Table of Contents

1. Graft Harvesting Techniques

Ligament surgeons can use the bone-patellar tendon-bone graft or hamstring tendon graft to reconstruct the anterior cruciate ligament. There are differences in the anterior knee pain caused by these two grafts harvesting techniques. Bone-patellar tendon-bone graft (BPTB) causes more anterior knee pain than hamstring tendon graft. BPTB graft harvesting makes patient vulnerable anterior knee pain and pain when kneeling.

2. Meniscal Tear

A tear in the meniscus can be a cause of knee pain. Rarely after meniscus repair the torn part of the meniscus doesn’t heal back to its original position, or sometimes it can even tear more. If this happens, it can cause pain and discomfort, limiting your ability to move and walk normally. In many cases, doctors will recommend a repeat arthroscopy to deal with torn meniscus.

Sometimes meniscus tear can cause a sudden locking of the joint, often making it difficult for the person to bend their knee without experiencing pain. This locking episode may last for minutes or hours before subsiding. If this continues, it may be necessary to undergo a meniscal repair.

3. Cartilage Damage

Old ACL tear is usually not the cause of the ongoing pain. It is a result of other injuries in the joint that were caused because of trauma or repetitive wear and tear. If neglected, an ACL tear can lead to cartilage damage which can cause pain in that area. Neglecting ACL tear gradually leads to full thickness loss of cartilage will cause pain without any outside influence. Pain associated with the injury from before (e.g., old ACL tear) will persist due to damage to the articular cartilage. In some cases, it could be possible for new degenerative changes in the knee joint to develop secondary to prior injuries.

4. Arthritis

After an arthroscopic ACL reconstruction, it is possible to have arthritis in the knee joint. This can happen due to full thickness cartilage loss due to neglected chronic ACL tear. This results in joint space narrowing, and osteophytes formation. Eventually knee arthritis can develop when not enough cartilage remains to cushion the bones and absorb shock.
When there is a lack of synovial fluid between the joints that move, like the knees, this results in friction on these joints which can lead to pain and eventually arthritis. The knee suffers from wear-and-tear as well as damage caused by injury or excessive stress. Without proper rest and treatment, this damage will continue until there is no more cartilage left at all.

5. Quadriceps Weakness Following ACL Surgery

Postoperative extension deficit is a condition where the patient lacks full extension of the operated knee following arthroscopic ACL reconstruction. The deficit can be caused by quadriceps weakness and results in postoperative anterior knee pain, which can lead to long-term complications and functional limitations.
To prevent this from happening, focus on strengthening your quadriceps and always try to complete a full extension during activities. In addition, make sure to pay close attention to preoperative rehabilitation and activity restrictions as it will help avoid complications postoperatively.

6. Persistent Swelling Following ACL Surgery

Most common cause of persistent swelling following an ACL surgery is inflammation. This is a common complication of an ACL reconstruction and can be seen first few weeks and gradually reduces by few weeks. The extent of swelling varies from person to person and can be minimized by bracing, icing and adequate rest.
When these measures fail, exclude infection as a cause for the continued swelling. Absence of fever and localized temperature rise does not rule out the possibility of a post-operative infection. A diagnosis can be confirmed with a culture, MRI, or aspiration to identify the source.

7. Inadequate Rehabilitation Following ACL Surgery

Rehabilitation following knee surgery is important to address the pain and regain strength. Inadequate rehabilitation can lead to thigh muscle wasting, an inability to achieve complete range of motion in the knee joint, and continuous knee pain. It is important for patients to follow up with their surgeon about their rehabilitation plan in order to avoid these risks.
Patients should not feel like they are rushing back to work or normal daily activity too quickly. The key is not just exercising your knees but also exercising other parts of your body so that one injury does not cause another. Good stretching techniques are also essential as stiffness in the muscles contributes to pain and lack of range of motion in the knee joint.

The Cruciates is a team of highly experienced and skilled surgeons who are in the sports medicine field from a long time and have dealt with complicated sports injuries. Dr. Nagendra Prasad is one of the best arthroscopy surgeons in India leads the team. The Cruciates is committed to deliver high-quality services and would like to make sure that, you are satisfied with our work. The team Cruciates provides customized treatment and follow up to each patient to make sure that everyone will achieve desired level of recovery and rehabilitation to ensure early return to sports.

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