ACL Surgery Pain Timeline: Pain After ACL Reconstruction Surgery

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An ACL reconstruction surgery is a very common procedure, but it’s still difficult to find any information online about what to expect after the surgery in terms of pain and recovery.

In this blog, I am going to answer the question that many people are often left wondering after their surgery, which is how long will the pain in my knee last and when should I expect to feel better. We will discuss what to expect in the first year with respect to pain, ability to do everyday activities, and the overall quality of life that people experienced.

Before jumping into it, it’s important to understand how the information will be presented. Often people in healthcare use standardized tests to quickly understand a person’s condition. A standardized test is a questionnaire that takes a person’s experiences and turns them into numbers. The Knee Injury and Osteoarthritis Outcome Score, or KOOS for short, is one such test. It asks a lot of knee recovery related questions, and measures the answers on a scale of 0 to 100, where 0 = extreme knee problems and 100 = no knee problems at all. There is a free online tool that will allow you to obtain your KOOS score.

By reading the rest of this blog you will be able to understand what to expect before surgery, 3 months, 6 months and 12 months after surgery. Every person who has an ACL tear wants to know what to expect in terms of pain and their ability to do activities. This blog provides exactly that information! So read on.

Before Surgery

People had an average KOOS pain score of 76.6.^[3] Meaning the pain they had was noticeable and distracting, but it could be ignored.^[4]
Many studies reported patients actually experienced more pain the 1st day after their surgery, that drastically declined over the first two weeks.^[2]
People had an average KOOS ADL score of 84.8.^[3] ADL stands for activities of daily living, which measures people’s ability to do everyday things like getting out of a bed or chair, taking a shower, using the bathroom, among other things. This score is still relatively high, so people found their ability to do everyday things was impacted, but they were still able to do most things independently.
People had an average KOOS QOL score of 35.1.^[3] QOL stands for quality of life, which is a measure of a person’s overall health, comfort, and happiness. This score is very low, meaning their knee was preventing them from enjoying their lives most of the time.

3 Months After Surgery

People had an average KOOS pain score of 84.8.^[3] Meaning the pain was annoying, and occasionally hurt more than normal.^[4]
At this point, most people had less pain than they did before they had the surgery.
People had an average KOOS ADL score of 92.2,^[3] meaning people were able to do most everyday things, and be very independent.
People had an average KOOS QOL score of 57.2,^[3] meaning people felt that their lives were improved, but it was still highly negatively impacted by their knee about half the time.

6 Months After Surgery

People had an average KOOS pain score of 90.5.^[3] Pain is drastically reduced for many people by this point. Pain was perceived by many people to be mild and barely noticeable, to a point that most of the time it’s not on their mind.^[4]
People had an average KOOS ADL score of 96.5,^[3] meaning their ability to do everyday tasks was only minimally impacted by their knee.
People had an average KOOS QOL score of 72.1,^[3] meaning people had a much better quality of life than before the surgery and 3 months ago, but it was still impacting their ability to enjoy their lives.

12 Months After Surgery

People had an average KOOS pain score of 92.7.^[3] Some mild pain was still present, but pain was continuing to improve over time and may continue to improve beyond this point.
Another study did find that most KOOS scores seemed to plateau at the 12 month mark, and not much improvement was seen between the 12 month and 24 month period.^[1]
People had an average KOOS ADL score of 96.9,^[3] showing that people kept experiencing an improvement in their ability to do everyday tasks with time.
People had an average KOOS QOL score of 78.1,^[3] which is about the same as the 6 month mark.

Overall, most people saw gradual improvements in all aspects of their knee recovery and life, over the span of 1 year. We've also written a great blog about returning to sport after ACL injury or surgery here.

It’s important to note that the data for this blog was taken from a research article that looked at people who received a specific type of ACL reconstruction surgery called a single-bundle four strand hamstring graft technique .^[3] There is a limitless sea of research papers that compare every different surgical technique under the sun and what this can mean for a person’s recovery. A number of research articles seem to demonstrate that pain and rate of recovery follows a similar timeline, regardless of the technique used.^[2]

Conclusion

The most improvement occurs the first year after surgery. Most people had less pain than they did before the surgery after about 3 months. At the one year mark, people had a drastic reduction in the amount of pain they felt.

Rehabilitation after an ACL reconstruction surgery is important to ensure a timely and proper recovery journey. Curovate can help you if you have had an ACL reconstruction surgery, to reduce pain in your everyday life and help get you back to the activities you love. The app contains daily exercise plans created by an experienced licensed physiotherapist, along with precautionary notes and demonstrations. Download our ACL reconstruction recovery app below.

If you need further customized assistance during your surgery or injury recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

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