Knee rehabilitation

In knee surgery as with the shoulder, rehabilitation is inseparable from the surgical procedure in achieving the result. The knee is a weight-bearing joint, used with every step: after surgery, it must regain its range of motion, muscle strength, stability and ability to bear body weight. Well-conducted rehabilitation optimizes the result; neglected rehabilitation can compromise the benefit of an otherwise successful surgery. It is a partnership between the surgeon, the physiotherapist and the patient.

Dr Charousset applies an Enhanced Recovery After Surgery (ERAS) protocol, which anticipates recovery starting in the preoperative period. This protocol coordinates all those involved, surgeon, anesthesiologist, physiotherapist, nurses, primary care physician, around common goals: controlling pain, preventing complications, accelerating functional recovery and enabling outpatient surgery under the best conditions. Anticipated pain management is a pillar of this protocol.

Preparation begins before the procedure. This preoperative phase allows the patient to learn the exercises, strengthen their muscles (strong quadriceps before surgery recover faster afterward), and prepare range of motion. Dr Charousset provides a written protocol detailing the goals of each stage. A well-prepared knee and patient approach surgery under the best conditions.

Postoperative knee rehabilitation follows a logical progression. Regaining range of motion comes first (achieving full extension and flexion), essential since a stiff knee is a poor knee. Muscle strengthening comes next, particularly of the quadriceps, the driver of stability and walking. Return to weight-bearing and walking follows a schedule adapted to the procedure. Finally, for athletic patients, proprioceptive training and progressive retraining for the demands of sport. Each stage respects the healing timeframes specific to the procedure performed.

The protocol is tailored to each type of surgery. After meniscus trimming, recovery is quick (a few weeks). After meniscus repair, protection is longer to allow the meniscus to heal. After ACL reconstruction, rehabilitation is prolonged and progressive, protecting the graft then retraining the knee up to a return to sport around 6 to 9 months. After a knee replacement, it aims to quickly regain range of motion and walking independence. The physiotherapist follows the precise protocol provided by Dr Charousset.

After certain procedures, particularly knee replacement, rehabilitation uses a continuous passive motion machine (Kinetec): this device gently and passively mobilizes the knee to quickly regain flexion and extension without muscular effort. Cryotherapy (cold application) is widely used to combat pain and swelling. These tools, combined with the patient's active work, speed up recovery.

Knee rehabilitation relies heavily on patient involvement. Attendance at sessions, regularity in exercises and motivation directly determine the outcome. Instructions must be respected without rushing the stages (returning to weight-bearing or sport too early can compromise a repair or a graft), while also actively maintaining progress. This balance, guided by the surgeon and the physiotherapist, makes the difference.

In addition to supervised sessions, daily self-rehabilitation at home greatly increases the effectiveness of care. Mobilization, strengthening and stretching exercises done alone, regularly, are essential for good recovery. Dr Charousset provides materials and videos to support patients in this independent approach. A knee is rehabilitated as much at home as in the physiotherapist's office.