When will the swelling and protrusion at the anterior horn repair site, which resolves with rest, cease to occur in an adult patient after leg press or squat exercises?

Postoperative Swelling at Anterior Horn Repair Site

The localized swelling and protrusion at the anterior horn repair site that resolves with rest cessation should typically cease within 6-8 weeks postoperatively, as this represents the critical period for meniscal healing and tissue adaptation to loading stresses.

Expected Timeline for Resolution

The phenomenon you're describing follows a predictable pattern based on tissue healing phases:

• Weeks 0-2: Minor physiological swelling is normal and expected after any surgical repair, typically resolving within the first week with rest and elevation 1
• Weeks 2-6: Persistent localized swelling that appears with loading exercises (leg press, squats) and resolves with rest indicates ongoing tissue remodeling and incomplete healing adaptation 1
• Weeks 6-8: Most patients experience resolution of exercise-induced swelling by this timeframe as the repaired tissue matures and adapts to mechanical loads 1
• Beyond 8 weeks: Persistent swelling after this period warrants further evaluation for underlying pathology such as repair failure, inadequate fixation, or meniscal extrusion 2

Physiological Explanation

The transient swelling you're experiencing represents:

• Reactive synovitis from mechanical stress on healing tissue during loaded exercises like leg press and squats 1
• Incomplete tissue maturation where the repaired anterior horn has not yet fully adapted to compressive and shear forces 3
• Normal inflammatory response to loading that diminishes as collagen remodeling progresses and tissue tensile strength increases 1

Critical Monitoring Parameters

You should be concerned if any of the following develop:

• Persistent swelling beyond 8 weeks that does not resolve with rest, suggesting repair failure or meniscal subluxation 2
• Progressive worsening of swelling intensity or duration despite appropriate activity modification 1
• Associated mechanical symptoms such as clicking, locking, or giving way episodes, which may indicate anterior horn dislocation or repair dehiscence 4
• Anteromedial joint line tenderness persisting beyond 3 months, which could represent symptomatic anterior horn pathology 4

Activity Modification Strategy

During the healing phase (weeks 2-8):

• Continue closed kinetic chain exercises (leg press, squats) as these are appropriate for your postoperative timeline, but monitor swelling response 1, 5
• Reduce load or volume if swelling persists beyond 24 hours after exercise, as this indicates excessive mechanical stress on healing tissue 1
• Apply cryotherapy and compression immediately post-exercise to minimize reactive inflammation 6
• Avoid open kinetic chain exercises before 4 weeks postoperatively to reduce shear stress on the anterior horn repair 1

When to Seek Urgent Evaluation

Immediate assessment is warranted if:

• Swelling becomes constant rather than exercise-related, suggesting possible repair failure 1
• Mechanical symptoms develop (clicking, catching, locking) indicating potential anterior horn dislocation 4
• Pain intensity increases despite activity modification and anti-inflammatory measures 1
• Functional decline occurs with inability to perform previously tolerated activities 3

Common Pitfall to Avoid

Do not assume all postoperative swelling is benign—while transient exercise-induced swelling resolving with rest is expected in the first 6-8 weeks, persistent or progressive swelling requires diagnostic imaging (MRI) to exclude repair failure, meniscal extrusion, or anterior horn subluxation 2. The anterior horn position in the coronal plane is particularly critical, as displacement correlates strongly with meniscal extrusion and potential repair failure 2.