Q. I had knee surgery a year back and still getting swelling and pain with movement. Why?

Answered by
Dr. Lokesh
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 16, 2020

Hello doctor,

I have suffered a recent knee injury and had ACL replacement. The injury involved a sudden and complete closure of the knee. I will feel fine but with more use the knee gets sore with swollen veins. I can provide pictures. Please help.



Welcome to

The swelling can happen if there is a recent surgery. You are doing physiotherapy to get your range of knee motion back to its normal. As the ligament and the knee capsule stretches, it causes inflammation and swelling. However, if the surgery was done more than a year back, it is not normal, and associated factors need to be considered.

Is there instability of the knee joint on performing pivoting or rotatory movements? Is there any associated rheumatoid arthritis? Is there arthritis of the knee joint now or before surgery? Do you have any other medical co-morbidities? Is swelling your main problem, or is it associated with instability? Do you have ligamentous laxity? When you answer these questions, let me also know your date of surgery and exactly which graft was taken to do the ACL reconstruction?

Probable diagnosis:

Pain and swelling post ACL (anterior cruciate ligament) surgery.

Regarding follow up:

Follow up with answers.

Thank you doctor,

The ACL replacement was done before 20 years, and the knee was fine until the recent injury in which my foot slipped and caused the right knee to close forcibly. There has been no black and blue discoloration, but my knee has looseness and is popping and clicking since then. Is it possible I stretched some tendons? Could such an incident cause meniscus damage? The inside of the knee seems more swollen than the outside. When I stay off the knee, it starts feeling fine, but the pain returns if I start doing works. How long should I stay calm with the knee for complete healing? What can I do to accelerate the healing process? Should the knee be iced? What about the jacuzzi? Should the water be warm or cold? I have attached my photo a year after the knee surgery.



Welcome back to

So your ACL surgery was done a few years back, and the knee flexion injury is recent. Based on the mechanism of injury described, it is likely you can have a posterior horn meniscal injury of a cruciate ligament sprain or tear.

Take rest for a few days for about one to two weeks. Do icing and start physiotherapy with gentle quads exercises and knee ROM exercises.

Even after two weeks, if your knee does not get better, it will be justified to get another MRI (magnetic resonance imaging) scan done to see the damage. Painkillers like Codeine or Ibuprofen may help.

Probable diagnosis:

Meniscal or cruciate ligament tear.

Regarding follow up:

If required.

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