Scar Management Following ACL Arthroscopy

JOI knee anatomyImage of Knee Pain.

Having knee arthroscopic surgery can be traumatizing. Initially following the surgery, not only are you concerned about the pain, the possibility of moving your knee again, or even running again, but you may also be panicked at the first look of your scar. Don’t stress, the initial reaction to the scar is commonly overwhelming. Many patients are immediately concerned about what they can do to minimize the long term scar on the knee.

Initially, it is important to care for the wound itself by following the recommendations of the surgeon. Most surgeons recommend that the wound is kept clean and dry for at least the first 48-72 hours following arthroscopic knee surgery. This decreases the risk of infection, as well as giving the scar time to build tensile strength. Following this first stage, most surgeons will allow you to get the scar wet, depending on the type of closure used. It is still advised not to do any rigorous cleaning to the area, as the scar is still not strong, potentially adding increased tension on the wound. Protecting the wound from possible re-opening and limiting direct sunlight in the area will also help to decrease the appearance of the scar.

Scar Management Following ACL Arthroscopy

Immediately following ACL arthroscopy, it is important to get the knee moving. But, early movement can hinder scar healing. Allowing early motion creates wound tension. Wound tension decreases the growth factor which allows fibroblasts to create tensile proteins, thus contracting and pulling the wound tightly together. When wounds are placed under tension, the fibroblasts are unable to lay down in a “basket weave” formation, and ultimately lay down in one direction. This gives the scar a raised appearance. In this case, the pros of early movement must outweigh the cons. Early movement of the knee following ACL surgery has proven to be beneficial to overall success of the knee. With this being said, gradual increases in ROM and keeping the steri-strips over the wound for 7-10 days, can assist in decreasing too much tension on the wound.

Finally, over the counter creams and scar massage are simple things that can be done at home to decrease the prevalence of the scar. There are many different types of scar creams available. Use them with caution, knowing how your skin reacts to certain products. Scar massage alone, with massage cream or over the counter scar creams, also assists in reducing the amount of scar tissue that develops in and around the scar. Be careful not to massage directly over the scar, until it is well healed.  

If you have any questions following your surgery about managing the scar or if you have any questions about physical therapy you may contact us at JOI-2000 or click BOOK APPOINTMENT below with an Knee Orthopedic Specialist.

If you would like to learn more about ACL surgery, go to this video: ACL Surgery.


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By: Nikki Clayton, PT, DPT, ATC

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