My knee is still swollen weeks after arthroscopy. Is that normal?

Why the knee swells after keyhole surgery

During arthroscopy the joint is filled with sterile fluid and the lining of the knee, called the synovium, is handled by the instruments. The lining reacts by producing extra joint fluid for a while, a bit like a graze that weeps before it settles. Small amounts of blood in the joint add to this in the first days.

The swelling often follows a pattern: smaller in the morning, larger in the evening, and worse after long periods of standing, walking in a mall or driving. That pattern on its own usually means the knee is being asked to do a little more than it is ready for, not that something has gone wrong.

What helps it settle

• Raise the leg above the level of the heart for 20 to 30 minutes a few times a day
• Use ice or a cold pack wrapped in a cloth for 15 to 20 minutes after activity
• Keep doing the thigh-tightening and gentle bending exercises you were given, as the muscle pump moves fluid away
• Increase walking and standing in steps rather than all at once
• Wear a compression sleeve if your surgeon has suggested one

Swelling switches off the thigh muscle, and a weak thigh lets the knee swell more, so steady physiotherapy breaks the cycle.

When swelling is not normal

Contact the team at Aman Hospital the same day, or go to an emergency department, if you notice:

• Fever, chills, or a knee that is hot, red and increasingly painful
• Cloudy fluid or pus from an incision
• Pain and swelling in the calf, or sudden breathlessness or chest pain
• A knee that becomes suddenly very tense and painful after a twist

If the knee is still regularly swollen beyond about six to eight weeks, or swells after every exercise session, book a review. Dr. Gelber will examine the knee and may drain fluid, adjust your rehabilitation or arrange imaging to look for a cause such as a retear or a cartilage problem.