{ "name": "Steady recovery data index", "description": "Week-by-week pain bands and recovery milestones for common orthopaedic surgeries, compiled from published cohort studies and rehabilitation protocols. Every value links to the source it was read from.", "url": "https://growsteady.me/recovery-data", "attribution": "Steady — https://growsteady.me/recovery-data. Free to quote and reuse with a link back.", "method": { "painScale": "0-10, where 0 is no pain. low / typical / high describe a cohort band, not a single patient.", "basis": "'measured' means the paper prints this value at this week. 'derived' means we worked it out from figures it does print — a starting value minus a reported fall, or the middle of two groups it reports separately — and `derivation` states the sum so you can redo it. Points we draw between two anchors are excluded from this file entirely.", "bandBasis": "Where the low-high band came from. 'printed' means both edges appear in the cited paper. 'estimated' means we built the band and the paper prints no range. 'comparison' means the edges are two different things the paper compared, named in bandNote — they are not the spread between people. 'absent' means no range we can source. Of 96 published bands, 16 are printed, 58 estimated and 22 comparison. Quote the typical value freely; quote the band only when this field says printed.", "converted": "true means the source reported another scale (for example VAS 0-100) and the value was normalised to 0-10." }, "disclaimer": "Published cohort data. Not medical advice, not a prediction for an individual, and not a substitute for a surgeon or clinician.", "lastReviewed": "2026-08-09", "totals": { "procedures": 15, "measuredPoints": 62, "derivedPoints": 8, "interpolatedPoints": 31, "milestones": 88, "weeklyCards": 316, "citedSources": 73, "firstWeek": 0, "lastWeek": 104, "lastReviewed": "2026-08-09" }, "procedures": [ { "procedure": "Hip arthroscopy for FAI", "timelineName": "Hip arthroscopy recovery", "bodyRegion": "hip", "url": "https://growsteady.me/hip-arthroscopy-recovery-timeline", "confidence": "medium", "lastReviewed": "2026-06-05", "painPoints": [ { "week": 0, "low": 4, "typical": 5, "high": 7.4, "converted": false, "scaleNote": "0-10 pre-op baseline; typical 5.2 from Cunningham (PMC5721367); low/high = pre-op rest 4.0 / activity 7.4 (PMC8530429)", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is pain at rest before surgery; the high edge is pain during activity before surgery — same patients, two different situations, not two different people.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5721367/" }, { "week": 2, "low": 1.8, "typical": 2.8, "high": 3.8, "converted": false, "scaleNote": "0-10 pain; Cunningham mean change from pre-op to 2 weeks", "basis": "derived", "derivation": "The paper reports pain fell 2.4 points from a starting 5.2, so 2.8.", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5721367/" }, { "week": 6, "low": 1, "typical": 2, "high": 3, "converted": false, "scaleNote": "0-10 pain; Cunningham mean change from pre-op to 6 weeks", "basis": "derived", "derivation": "The paper reports pain fell 3.1 points from a starting 5.2, so 2.1, shown as 2.", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5721367/" }, { "week": 52, "low": 1.7, "typical": 2.2, "high": 2.7, "converted": true, "scaleNote": "0-10 normalized from DHAR NRS rest/walk /100", "basis": "measured", "bandBasis": "comparison", "bandNote": "The high edge is pain after a 15-minute walk; the low edge approximates pain at rest — the same registry patients measured two ways, not two different groups of people.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5467416/" }, { "week": 104, "low": 1.7, "typical": 2, "high": 2.2, "converted": true, "scaleNote": "0-10 normalized from DHAR NRS rest/walk /100 at 2 years", "basis": "derived", "derivation": "The registry reports 17 at rest and 22 while walking on a 0-100 scale. Rescaled to 1.7 and 2.2, their midpoint is 2.", "bandBasis": "comparison", "bandNote": "The low edge is pain at rest; the high edge is pain after a 15-minute walk — the same registry patients measured two ways, not two different people.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5467416/" } ], "milestones": [ { "milestone": "Protected flat-foot weight bearing with crutches", "typicalWeek": 0, "range": "0-2 weeks; longer if microfracture or chondral repair was performed", "advisory": true, "source": "https://academic.oup.com/jhps/advance-article/doi/10.1093/jhps/hnaf055/8303980" }, { "milestone": "Off crutches / normalized gait", "typicalWeek": 4, "range": "About 2-6 weeks, protocol-dependent", "advisory": true, "source": "https://academic.oup.com/jhps/article/12/1/33/7922540" }, { "milestone": "Return to driving", "typicalWeek": 4, "range": "Around 4 weeks, also depends on opioids and right-vs-left side", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8689281/" }, { "milestone": "Start running", "typicalWeek": 14, "range": "8-18 weeks, criteria-based", "advisory": true, "source": "https://academic.oup.com/jhps/advance-article/doi/10.1093/jhps/hnaf055/8303980" }, { "milestone": "Return to sport", "typicalWeek": 30, "range": "About 6-9 months, sport-dependent", "advisory": true, "source": "https://pubmed.ncbi.nlm.nih.gov/29595996/" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5467416/", "title": "Danish Hip Arthroscopy Registry: outcome of patients with FAI", "tier": "registry", "declared": true, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 6 }, { "url": "https://academic.oup.com/jhps/advance-article/doi/10.1093/jhps/hnaf055/8303980", "title": "2024 ISHA physiotherapy agreement after hip arthroscopy for FAI", "tier": "expert consensus statement (Delphi-based agreement)", "declared": true, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 5 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5721367/", "title": "Early recovery after hip arthroscopy for FAI syndrome", "tier": "prospective cohort", "declared": true, "backsPainPoints": 4, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://academic.oup.com/jhps/article/12/1/33/7922540", "title": "academic.oup.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/29595996/", "title": "PMID 29595996", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 2 }, { "url": "https://academic.oup.com/jhps/article/4/1/60/3052240", "title": "academic.oup.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8530429/", "title": "PMC8530429", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8689281/", "title": "PMC8689281", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8949441/", "title": "PMC8949441", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32909823/", "title": "PMID 32909823", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/34494918/", "title": "PMID 34494918", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/35384746/", "title": "PMID 35384746", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://academic.oup.com/jhps/article/5/4/362/5259348", "title": "academic.oup.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://academic.oup.com/jhps/article/12/Supplement_2/ii109/8398285", "title": "academic.oup.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11395971/", "title": "PMC11395971", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11848980/", "title": "PMC11848980", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12014245/", "title": "PMC12014245", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12092996/", "title": "PMC12092996", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12795564/", "title": "PMC12795564", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5117082/", "title": "PMC5117082", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5467422/", "title": "PMC5467422", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6942269/", "title": "PMC6942269", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7148278/", "title": "PMC7148278", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8527320/", "title": "PMC8527320", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9331773/", "title": "PMC9331773", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9859857/", "title": "PMC9859857", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/26524553/", "title": "PMID 26524553", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/26671201/", "title": "PMID 26671201", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/27620622/", "title": "PMID 27620622", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/29119283/", "title": "PMID 29119283", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/29281560/", "title": "PMID 29281560", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/29373805/", "title": "PMID 29373805", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/29402586/", "title": "PMID 29402586", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/29893223/", "title": "PMID 29893223", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/30067064/", "title": "PMID 30067064", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/30612761/", "title": "PMID 30612761", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/30857899/", "title": "PMID 30857899", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/31765225/", "title": "PMID 31765225", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32093507/", "title": "PMID 32093507", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32704505/", "title": "PMID 32704505", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/33534611/", "title": "PMID 33534611", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/35833961/", "title": "PMID 35833961", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/36395964/", "title": "PMID 36395964", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/37547081/", "title": "PMID 37547081", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/39826664/", "title": "PMID 39826664", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 } ], "sources": [ { "title": "Danish Hip Arthroscopy Registry: outcome of patients with FAI", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5467416/", "tier": "registry", "reliabilityScore": 9 }, { "title": "Early recovery after hip arthroscopy for FAI syndrome", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5721367/", "tier": "prospective cohort", "reliabilityScore": 8.5 }, { "title": "2024 ISHA physiotherapy agreement after hip arthroscopy for FAI", "url": "https://academic.oup.com/jhps/advance-article/doi/10.1093/jhps/hnaf055/8303980", "tier": "expert consensus statement (Delphi-based agreement)", "reliabilityScore": 7.5 } ], "studies": [] }, { "procedure": "ACL reconstruction", "timelineName": "ACL recovery", "bodyRegion": "knee", "url": "https://growsteady.me/acl-recovery-timeline", "confidence": "high", "lastReviewed": "2026-06-05", "painPoints": [ { "week": 0, "low": 4.1, "typical": 5.2, "high": 5.5, "converted": false, "scaleNote": "VAS/NRS 0-10 acute post-op; typical 5.2 = 6h VAS (PMC4898387); low/high = day-1 day-case 4.1 / inpatient 5.5 (BJMP day-case series)", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is patients sent home the same day; the high edge is patients kept in hospital overnight — from a different study than the typical value, not two people who had identical care.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4898387/" } ], "milestones": [ { "milestone": "Full weight-bearing as tolerated", "typicalWeek": 0, "range": "Day 0 to 2 weeks, usually with crutches", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4482298/" }, { "milestone": "Off crutches / normal gait", "typicalWeek": 3, "range": "2-6 weeks; criteria include quad control and full extension", "advisory": true, "source": "https://med.virginia.edu/orthopaedic-surgery/wp-content/uploads/sites/242/2021/06/ACL-Reconstruction-1.pdf" }, { "milestone": "Pool or unweighted treadmill running", "typicalWeek": 8, "range": "7-8 weeks", "advisory": true, "source": "https://med.virginia.edu/orthopaedic-surgery/wp-content/uploads/sites/242/2021/06/ACL-Reconstruction-1.pdf" }, { "milestone": "Return to work", "typicalWeek": 11, "range": "About 46-84 days depending on graft and job demands", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11092533/" }, { "milestone": "Return to sport / pivoting clearance", "typicalWeek": 39, "range": "9-12 months, criteria-based", "advisory": true, "source": "https://www.sportsmed.org/membership/sports-medicine-update/winter-2025/return-to-play-after-acl-integrating-key-metrics" } ], "citedPapers": [ { "url": "https://med.virginia.edu/orthopaedic-surgery/wp-content/uploads/sites/242/2021/06/ACL-Reconstruction-1.pdf", "title": "med.virginia.edu", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 3 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6036619/", "title": "MOON longitudinal prospective ACL reconstruction cohort", "tier": "prospective cohort", "declared": true, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 4 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5542121/", "title": "PMC5542121", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 4 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11092533/", "title": "PMC11092533", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 3 }, { "url": "https://www.sportsmed.org/membership/sports-medicine-update/winter-2025/return-to-play-after-acl-integrating-key-metrics", "title": "sportsmed.org", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 3 }, { "url": "https://www.bjmp.org/content/daycase-anterior-cruciate-ligament-reconstruction-success-pitfalls-and-patient-pain-scores", "title": "bjmp.org", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 2, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4482298/", "title": "MOON ACL reconstruction rehabilitation guidelines", "tier": "society guideline", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4898387/", "title": "Immediate post-operative pain in ACL reconstruction", "tier": "RCT", "declared": true, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6299316/", "title": "PMC6299316", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.70020", "title": "esskajournals.onlinelibrary.wiley.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://ijspt.scholasticahq.com/article/32378-quadriceps-strength-following-anterior-cruciate-ligament-reconstruction-normative-values-based-on-sex-graft-type-and-meniscal-status-at-3-6-9-mon", "title": "ijspt.scholasticahq.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://journals.sagepub.com/doi/10.1177/19417381251395745", "title": "journals.sagepub.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10623603/", "title": "PMC10623603", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10748928/", "title": "PMC10748928", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10769975/", "title": "PMC10769975", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10982565/", "title": "PMC10982565", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11061071/", "title": "PMC11061071", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11569586/", "title": "PMC11569586", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11881120/", "title": "PMC11881120", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12661217/", "title": "PMC12661217", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4901658/", "title": "PMC4901658", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7405670/", "title": "PMC7405670", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7457408/", "title": "PMC7457408", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7745570/", "title": "PMC7745570", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7829529/", "title": "PMC7829529", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9322324/", "title": "PMC9322324", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9859849/", "title": "PMC9859849", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9947688/", "title": "PMC9947688", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/23906272/", "title": "PMID 23906272", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/25157180/", "title": "PMID 25157180", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/25201444/", "title": "PMID 25201444", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/26772611/", "title": "PMID 26772611", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/27522592/", "title": "PMID 27522592", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/28223305/", "title": "PMID 28223305", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/30505694/", "title": "PMID 30505694", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/36455966/", "title": "PMID 36455966", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/36656027/", "title": "PMID 36656027", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/37907079/", "title": "PMID 37907079", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/41655193/", "title": "PMID 41655193", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://www.sciencedirect.com/science/article/pii/S2059775425006418", "title": "sciencedirect.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 } ], "sources": [ { "title": "MOON longitudinal prospective ACL reconstruction cohort", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6036619/", "tier": "prospective cohort", "reliabilityScore": 10 }, { "title": "MOON ACL reconstruction rehabilitation guidelines", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4482298/", "tier": "society guideline", "reliabilityScore": 9 }, { "title": "Immediate post-operative pain in ACL reconstruction", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4898387/", "tier": "RCT", "reliabilityScore": 7 } ], "studies": [] }, { "procedure": "Knee arthroscopy / meniscus", "timelineName": "Meniscus surgery recovery", "bodyRegion": "knee", "url": "https://growsteady.me/meniscus-surgery-recovery-timeline", "confidence": "medium", "lastReviewed": "2026-06-05", "painPoints": [ { "week": 0, "low": 3, "typical": 6, "high": 6.1, "converted": false, "scaleNote": "VAS/NRS 0-10; heterogeneous baseline", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10393789/" }, { "week": 1, "low": 1, "typical": 2, "high": 3, "converted": false, "scaleNote": "NRS 0-10; POD7 knee arthroscopy subgroup", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7472168/" }, { "week": 6, "low": 0.4, "typical": 0.7, "high": 1, "converted": false, "scaleNote": "VAS 0-10; partial meniscectomy 6-week anchor", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is the needle-arthroscopy technique's mean pain; the typical is the standard-arthroscopy technique's mean pain — two different operations, not spread among people who had the same surgery.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10393789/" }, { "week": 12, "low": 0.5, "typical": 1.4, "high": 2.3, "converted": false, "scaleNote": "VAS 0-10; 3-month degenerative meniscus trial", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3513419/" } ], "milestones": [ { "milestone": "Off crutches / full weight-bearing after partial meniscectomy", "typicalWeek": 0.6, "range": "Immediate to about 1 week", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7146095/" }, { "milestone": "Return to light or sedentary work", "typicalWeek": 1.5, "range": "About 1-2 weeks; job-dependent", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8155825/" }, { "milestone": "Full weight-bearing after meniscus repair", "typicalWeek": 3.9, "range": "About 4 weeks; tear-pattern dependent", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7146095/" }, { "milestone": "Return to running after partial meniscectomy", "typicalWeek": 7, "range": "6-8 weeks, criteria-based", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7146095/" }, { "milestone": "Return to sport after partial meniscectomy", "typicalWeek": 9, "range": "Roughly 7-16 weeks, criteria-based", "advisory": true, "source": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-meniscectomy.pdf" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7146095/", "title": "Early Functional Rehabilitation after Meniscus Surgery: Are Currently Used Orthopedic Rehabilitation Standards Up to Date?", "tier": "cross-sectional survey", "declared": false, "backsPainPoints": 0, "backsMilestones": 3, "backsCards": 3 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10393789/", "title": "Partial meniscectomy using needle arthroscopy associated with significantly less pain and improved patient reported outcomes at two weeks after surgery: A comparison to standard knee arthroscopy", "tier": "retrospective cohort", "declared": false, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3513419/", "title": "Medical Exercise Therapy is Effective After Arthroscopic Surgery of Degenerative Meniscus of the Knee: A Randomized Controlled Trial", "tier": "randomized trial", "declared": false, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8155825/", "title": "Home-Based vs Supervised Inpatient and/or Outpatient Rehabilitation Following Knee Meniscectomy: A Systematic Review and Meta-analysis", "tier": "systematic review and meta-analysis", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7472168/", "title": "Pain after knee arthroscopy subgroup", "tier": "prospective cohort", "declared": true, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-meniscectomy.pdf", "title": "Rehabilitation Protocol for Arthroscopic Partial Meniscectomy", "tier": "clinical protocol", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11636631/", "title": "Arthroscopic meniscal surgery in Norway 2010-2020", "tier": "registry", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12310086/", "title": "EU-US Meniscus Rehabilitation 2024 Consensus", "tier": "society guideline", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 0 } ], "sources": [ { "title": "EU-US Meniscus Rehabilitation 2024 Consensus", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12310086/", "tier": "society guideline", "reliabilityScore": 9.5 }, { "title": "Arthroscopic meniscal surgery in Norway 2010-2020", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11636631/", "tier": "registry", "reliabilityScore": 9 }, { "title": "Pain after knee arthroscopy subgroup", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7472168/", "tier": "prospective cohort", "reliabilityScore": 7 } ], "studies": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11636631/", "identifier": "PMC11636631", "title": "Arthroscopic meniscal surgery in Norway from 2010 to 2020: A paradigmatic shift", "design": "registry", "participants": "n=119,528 knee arthroscopy procedures for meniscal injury, Norway 2010-2020 (107,117 arthroscopic partial resection (APR) / 12,411 arthroscopic repair (AR))", "technique": "Population-wide comparison of two arthroscopic techniques: arthroscopic partial resection (APR — trimming out the torn part of the meniscus) and arthroscopic repair (AR — stitching the tear back together).", "timepoints": "Annual procedure counts and rates, 2010-2020 (11-year national registry period).", "findings": [ "Between 2010 and 2020, Norway's national patient registry recorded 119,528 knee arthroscopy procedures for meniscal injury; 107,117 (89.6%) were arthroscopic partial resection (APR, trimming out the torn meniscus) and 12,411 were arthroscopic repair (AR, stitching the tear).", "The number of APR procedures performed nationally fell from 14,474 in 2010 to 4,423 in 2020 (Table 2); the authors describe this as a 72% decrease.", "The number of AR procedures performed nationally rose from 615 in 2010 to 1,709 in 2020 (Table 2); the authors describe this as a 178% increase.", "The national rate of APR fell from 298 to 82 procedures per 100,000 people per year (p < 0.001).", "The national rate of AR rose from 13 procedures per 100,000 people per year in 2010 to a peak of 32 per 100,000 in 2019 (p < 0.001).", "The ratio of APR procedures to AR procedures fell from 22-to-1 in 2010 to below 5-to-1 by 2020 at the national level; the APR/AR trend curves showed a statistically significant decrease (p < 0.001).", "Of all APR procedures, public hospitals performed 66.4% (71,182) and private clinics performed 33.6% (35,935); of all AR procedures, public hospitals performed 89.3% (11,091) and private clinics performed 10.7% (1,320).", "In private institutions specifically, the APR-to-AR ratio rose from 75 in 2010 to 110 in 2013, then dropped sharply between 2013 and 2014, ending close to the national and public-sector ratio by 2020.", "Every age group (0-19, 20-39, 40-59, 60+) showed a significant fall in APR rate and rise in AR rate (p < 0.001); the rise in AR was especially marked for patients aged 20-59, and patients aged 60+ had close to a 75% reduction in APR.", "Men were operated on more often than women (p < 0.001), and men aged 40-59 had more meniscal surgeries than any other age/gender group. Combining APR and AR together, both sexes showed a significant downward trend in overall surgery rate over the decade, except women aged 0-19, whose rate did not change significantly (p = 0.45).", "Public institutions performed about twice as many APR procedures as private institutions, and about nine times as many AR procedures (both p < 0.001).", "Comparing each region's own yearly trend to the national average yearly trend (Table 3): the yearly APR rate-of-change ratio (IRR/year — a value below 1 means the rate fell that year) was 0.848 for Southern-Eastern Norway (95% CI 0.845-0.851, p<0.001), 0.912 for Western Norway (95% CI 0.907-0.917, p<0.001), 0.864 for Central Norway (95% CI 0.858-0.869, p=0.463, not significant), 0.874 for Northern Norway (95% CI 0.866-0.881, p=0.026), and 0.866 nationally (95% CI 0.864-0.868). For AR, the yearly rate-of-change ratio was 1.122 for Southern-Eastern Norway (95% CI 1.113-1.131, p<0.001), 1.120 for Western Norway (95% CI 1.105-1.135, p=0.004), 1.050 for Central Norway (95% CI 1.032-1.069, p<0.001), 1.011 for Northern Norway (95% CI 0.981-1.043, p<0.001), and 1.100 nationally (95% CI 1.094-1.108).", "Separately in the text (not the Table 3 comparison above), the authors state that Northern Norway 'failed to demonstrate a statistically significant increase of AR' in its own regional trend (p = 0.47) — this is a different statistical test, looking at whether that region's own AR rate changed significantly over time, rather than comparing its yearly change to the national average." ], "notMeasured": [ "This is a national registry study of procedure counts and rates, not of individual patients: it reports no pain scores, function scores, complication rates, or revision/reoperation rates.", "It does not report return to sport, return to work, driving, or recovery time for individual patients.", "It does not distinguish degenerative from traumatic meniscal tears in its counts, and does not classify tear type (e.g. root tears, ramp lesions) — the authors state this explicitly as a limitation.", "It does not track individual patients over time; each arthroscopy is counted once as an annual national/regional total, not as a followed case." ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7146095/", "identifier": "PMC7146095", "title": "Early Functional Rehabilitation after Meniscus Surgery: Are Currently Used Orthopedic Rehabilitation Standards Up to Date?", "design": "cross-sectional survey", "participants": "n=62 orthopedic institutions surveyed (Germany, Austria, Switzerland); protocols analyzed by procedure: partial meniscectomy n=15, meniscus repair n=54, meniscus replacement n=7 (some institutions supplied protocols for more than one procedure, so these three counts add to more than 62)", "technique": "Survey of written rehabilitation protocols covering three procedures: partial meniscectomy, meniscus repair, and meniscus replacement (meniscus transplant/implant)", "timepoints": "protocols were scored at postop day 3, postop day 7, then weekly until full weight bearing and full range of motion were reached; the surveyed protocols cover the early rehab period up to 12 weeks", "findings": [ "This study compared the written rehab instructions used by 62 orthopedic clinics in Germany, Austria, and Switzerland after meniscus surgery, across three operations: trimming a torn meniscus (partial meniscectomy, 15 protocols), stitching a tear back together (meniscus repair, 54 protocols), and meniscus replacement or transplant (7 protocols).", "After partial meniscectomy, protocols allowed full weight on the leg at a mean of 0.6 weeks after surgery (about 4 days), with every protocol allowing full weight bearing within the first two postoperative weeks.", "After partial meniscectomy, every protocol reviewed allowed full knee bending and straightening (range of motion) immediately after surgery, with no restriction.", "No protocol recommended a knee brace after partial meniscectomy.", "After partial meniscectomy, most protocols recommended a motion machine (continuous active or passive motion, CAM/CPM) for a mean of 3.8 weeks (SD 1.9 weeks).", "After partial meniscectomy, basic rehab exercises such as stationary cycling, pool walking, or general strength work were recommended to start at a mean of 3.2 weeks (SD 1.0 weeks).", "After partial meniscectomy, 'specific training' — defined by the paper as roadwork, coordination, and proprioception work, plus sport-specific drills — was recommended to start at a mean of 7.3 weeks (SD 2.6 weeks). The paper does not use the word 'running.'", "After meniscus repair, full weight bearing was recommended at a mean of 3.9 weeks (SD 2.1 weeks), with all 54 protocols agreeing on full weight bearing by 6 weeks.", "After meniscus repair, free range of motion was recommended at a mean of 5.0 weeks (SD 1.6 weeks), with all protocols agreeing on free motion by 6 weeks.", "After meniscus repair, just under half of protocols (48.1%) used a knee brace, for a mean of 5.9 weeks (SD 0.7 weeks).", "After meniscus repair, only 4 of 54 protocols (7.4%) used a passive motion machine (CPM), and only in the first week; most instead used an active/passive motion machine (CAM/CPM) for a mean of 6.4 weeks (SD 1.9 weeks).", "After meniscus repair, basic rehab exercises started at a mean of 5.6 weeks (SD 1.5 weeks), and sport-specific training started much later, at a mean of 14.6 weeks (SD 5.4 weeks).", "After meniscus replacement, full weight bearing was recommended at a mean of 6.3 weeks (SD 2.1 weeks), with all 7 protocols agreeing on full weight bearing by 10 weeks.", "After meniscus replacement, full range of motion was recommended at a mean of 7.1 weeks (SD 1.1 weeks), with all protocols agreeing by 9 weeks.", "After meniscus replacement, all 7 protocols recommended a knee brace, and every one specified exactly 8 weeks of use (SD 0.00 — no variation across protocols).", "After meniscus replacement, 3 of 7 protocols (42.9%) used a passive motion machine (CPM), limited to the first week; most protocols used an active/passive motion machine (CAM/CPM) for a mean of 7.1 weeks (SD 1.1 weeks).", "After meniscus replacement, sport-specific training was not recommended to start before 6 months after surgery.", "Across every measure, recovery milestones came earliest after partial meniscectomy, later after repair, and latest after meniscus replacement — differences the paper reports as statistically significant (p<0.001 for most comparisons; p=0.009 for free range of motion, repair vs. replacement)." ], "notMeasured": [ "Actual patient outcomes (pain, function, satisfaction, complication or failure rates) — this paper reports what protocols recommend, not what happened to patients.", "A definitive return-to-running date. The closest reported figure, 'specific training,' is defined as roadwork, coordination, and proprioception work plus sport-specific drills — not running specifically.", "A distinct 'full sport return' timepoint, for any of the three procedures — the paper reports only when sport-specific training starts, not when it's judged complete.", "Return to work, driving, or sleep.", "A response rate, or how many institutions were contacted versus how many of the 62 responded.", "Any minimum-maximum range for a timing figure — only means and standard deviations are reported throughout.", "Any validated pain or function outcome scale (e.g. VAS, KOOS, IKDC, Lysholm) — none is used in this protocol survey." ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7472168/", "identifier": "PMC7472168", "title": "Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery", "design": "prospective cohort", "participants": "n=191 total across four day-surgery types (50 hemorrhoid surgery / 47 inguinal hernia repair / 49 knee arthroscopy / 50 shoulder arthroscopy); knee arthroscopy subgroup n=49 enrolled, n=48 with complete pain data (analyzed in Table 2)", "scales": [ { "name": "Numeric Rating Scale (NRS) — average pain, pain at rest, pain at movement", "range": "0-10", "direction": "higher_worse" }, { "name": "Numeric Rating Scale (NRS) — patient satisfaction", "range": "0-10", "direction": "higher_better" } ], "timepoints": "before discharge, POD1, POD2, POD3, POD4, POD7, POD14, POD28 (pain); POD7 (satisfaction, whole-cohort only)", "followUp": "28 days", "findings": [ "This paper followed 191 people who had one of four kinds of day surgery — hemorrhoid surgery, inguinal hernia repair, knee arthroscopy, or shoulder arthroscopy — and reported pain separately for each group; 49 people had knee arthroscopy, and 48 of them have complete pain-score data.", "Right before leaving hospital after knee arthroscopy, typical pain was 3 out of 10, with the middle half of patients scoring between 1 and 4.", "One day after knee arthroscopy, typical pain was 2 out of 10, with the middle half of patients between 1 and 4.", "Two days after knee arthroscopy, typical pain was 2 out of 10, with the middle half between 1 and 3.", "Three days after knee arthroscopy, typical pain was 2 out of 10, with the middle half between 1 and 2.5.", "Four days after knee arthroscopy, typical pain was 1 out of 10, with the middle half between 0.75 and 3.25.", "One week after knee arthroscopy (day 7), typical pain was 2 out of 10, with the middle half of patients scoring between 1 and 4.", "Two weeks after knee arthroscopy, typical pain was 1 out of 10, with the middle half between 1 and 2.", "Four weeks after knee arthroscopy, typical pain was 1 out of 10, with the middle half between 0 and 2.", "Pain rated above 3 out of 10 (called 'moderate' in the paper) was reported by 27.0% of knee arthroscopy patients before discharge, 14.5% on day 1, 12.5% on day 2, 8.3% on day 3, 16.6% on day 4, 16.6% on day 7, and 4.1% on both day 14 and day 28.", "Pain rated above 5 out of 10 (called 'severe' in the paper) was reported by 10.4% of knee arthroscopy patients before discharge, 6.2% on day 1, 2.0% on day 2, 0% on day 3, 4.1% on day 4, 6.2% on day 7, 0% on day 14, and 4.1% on day 28.", "Across the whole study (all 191 patients, not broken out by surgery type), 24.61% of people did not take their prescribed pain medication exactly as instructed over the first 4 days; the most common reasons given were side effects like nausea or tiredness, or simply not having enough pain to need it.", "Also across the whole study, patients who took their pain medication as prescribed rated their day-7 satisfaction higher (typical score 9 out of 10) than patients who skipped or changed the schedule (typical score 8 out of 10)." ], "notMeasured": [ "Return to work", "Return to sport or driving after surgery", "Any pain or recovery data beyond the 28-day follow-up window" ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8155825/", "identifier": "PMC8155825", "title": "Home-Based vs Supervised Inpatient and/or Outpatient Rehabilitation Following Knee Meniscectomy: A Systematic Review and Meta-analysis", "design": "systematic review and meta-analysis", "participants": "n=434 pooled from 8 RCTs (209 home-based program [HBP] / 225 inpatient and/or outpatient supervised [IOP]); studies published 1982-2019; age range 21-74 years; 332 men / 104 women", "technique": "Arthroscopic isolated meniscectomy (partial or complete meniscus removal). The paper does not compare surgical variants — it compares two POST-OP REHAB approaches after that surgery: a home-based exercise program (HBP) vs standard inpatient and/or outpatient supervised physical therapy (IOP).", "scales": [ { "name": "Lysholm score", "range": "0-100", "direction": "higher_better" }, { "name": "Subjective IKDC score (International Knee Documentation Committee)", "range": "0-100", "direction": "higher_better" }, { "name": "Knee flexion", "range": "degrees", "direction": "higher_better" }, { "name": "Knee extension", "range": "degrees", "direction": "higher_better" }, { "name": "Thigh girth", "range": "centimeters", "direction": "higher_better" }, { "name": "Single-leg (horizontal) hop test", "range": "centimeters", "direction": "higher_better" }, { "name": "Vertical hop test", "range": "centimeters", "direction": "higher_better" }, { "name": "Time to return to work", "range": "days", "direction": "higher_worse" } ], "timepoints": "short-term (28 days to 3 months; individual studies picked the timepoint closest to 6 weeks), midterm (6 months, Lysholm score only)", "followUp": "Follow-up length across the 8 pooled trials ranged from 28 days to 6 months.", "findings": [ "This review pooled 8 randomized trials with 434 people total (209 given a home-based exercise program, 225 given supervised in-person physical therapy) after arthroscopic isolated meniscectomy, published between 1982 and 2019. Ages ranged 21 to 74; 332 were men and 104 were women.", "Pooling 5 studies, knee function (Lysholm score, 0-100, higher is better) was 8.64 points better in the supervised in-person group than the home-program group in the short term (28 days to 3 months): mean difference -8.64 points (95% CI, -15.14 to -2.13; P = .02). The largest difference in any single pooled study was 15.8 points.", "That short-term Lysholm result did not hold up: when the analysis was repeated leaving out one study that only reported data as a published abstract in tabular form, the difference disappeared (no statistically significant difference).", "At 6 months, pooling 2 studies, there was no significant difference in Lysholm score between the two rehab approaches: mean difference -4.78 points (95% CI, -9.98 to 0.42; P = .07). The largest difference in either pooled study was 5.67 points.", "Subjective IKDC score (0-100, higher is better), pooled from 5 studies at short term (1 month to 6 weeks), showed no significant difference between groups: mean difference -6.73 points (95% CI, -38.15 to 24.69; P = .22). The largest difference in any single pooled study was 9.6 points.", "Knee bending range (flexion), pooled from 4 studies at short term, showed no significant difference between groups: mean difference -7.40 degrees (95% CI, -15.12 to 0.32; P = .055). The largest difference in any single pooled study was 12.2 degrees.", "Knee straightening range (extension), pooled from 2 studies at short term, showed no significant difference between groups: mean difference 0.55 degrees (95% CI, -0.07 to 1.18; P = .08). The largest difference in either pooled study was 0.9 degrees.", "Thigh muscle girth (a proxy for muscle wasting), pooled from 3 studies at short term, was larger in the home-program group: mean difference 1.38 cm (95% CI, 0.27 to 2.48; P = .01). The largest difference in any single pooled study was 1.9 cm.", "A single-leg hop distance test, pooled from 2 studies at short term (28 to 50 days), showed no significant difference between groups: mean difference -13.88 cm (95% CI, -30.23 to 2.47; P = .10). The largest difference in either pooled study was 19.1 cm.", "A vertical hop test, pooled from 2 studies at short term (28 to 50 days), was better in the supervised in-person group: mean difference -3.25 cm (95% CI, -6.20 to -0.29; P = .03). The largest difference in either pooled study was 3.47 cm.", "Time to return to work, pooled from 2 studies, showed no significant difference between the two rehab approaches: mean difference 4.53 days (95% CI, -0.39 to 9.44; P = .07). The largest difference in either pooled study was 12.6 days.", "Two individual trials inside the review reported their own return-to-work gap between groups (not pooled, and the paper's table does not print an absolute number of days for either group on its own, only the gap between the two rehab arms): Forster and Frost (1982) found a 4-day gap favoring the home program; Goodwin et al (2003) found a 12.6-day gap favoring the home program.", "Risk-of-bias review found 'some concerns' in 4 of the 8 included studies and 'high risk of bias' in the other 4. Certainty of the evidence (GRADE) was rated low to very low across all reported outcomes." ], "notMeasured": [ "A pain scale (e.g. VAS or NRS) — the paper reports only composite knee-function/symptom scores (Lysholm, IKDC), not a standalone pain score.", "Absolute (non-comparative) average scores or days for either rehab group on its own — nearly every figure reported is the DIFFERENCE between the home-based and supervised groups, not what either group's actual average score or return-to-work day count was.", "Driving — mentioned only once, in the Discussion, as a general rationale for why home-based rehab helps people without easy transport to a clinic. No driving outcome was measured or reported as a result.", "Return to sport as a measured outcome — mentioned only in the Discussion as background context (citing other work), not as data this review collected or pooled.", "Sleep — not mentioned anywhere in the paper.", "Weekly pain or function values over time — the paper reports only two fixed windows (short-term and midterm/6-month), not week-by-week tracking." ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3513419/", "identifier": "PMC3513419", "title": "Medical Exercise Therapy is Effective After Arthroscopic Surgery of Degenerative Meniscus of the Knee: A Randomized Controlled Trial", "design": "randomized trial", "participants": "n=70 randomized (36 exercise group / 34 control group); 5 (7%) dropped out during the treatment period", "technique": "Standard arthroscopic partial meniscectomy (procedure code NGD 11) for degenerative medial meniscus tear, done at St Olav University Hospital and Teres Rosenborg Clinic, Trondheim, Norway. After surgery, patients were randomized to high-repetition medical exercise therapy (3x/week for 12 weeks) or no formal rehabilitation.", "scales": [ { "name": "VAS (pain, at rest)", "range": "paper's Methods section states 0-100 mm; the numbers printed in its results table are on an unlabeled ~0-10 range with no unit given — see note below", "direction": "higher_worse" }, { "name": "KOOS (Knee Injury and Osteoarthritis Outcome Score, composite of pain/symptoms/ADL/sport-recreation/QOL)", "range": "0-100, paper states 100 = no knee-related problems. Note: the paper's own Methods section defines higher KOOS as better, but its Results describe a score DECREASE as the favorable outcome for the exercise group — a contradiction inside the paper itself, not resolved here.", "direction": "higher_better" }, { "name": "Five repetition maximum (5RM) quadriceps strength test, leg extension bench", "range": "no fixed range or unit given in the text", "direction": "higher_better" } ], "timepoints": "preop (pretest), 1 month postop, 3 months postop (12 weeks, post-test)", "followUp": "3 months (12 weeks) postoperatively — trial does not follow patients past this point", "findings": [ "Before surgery, pain (VAS) measured 3.3 (SD 2.1) in the exercise group and 2.9 (SD 1.5) in the control group.", "By 3 months after surgery, pain had fallen to 1.4 (SD 1.4) in the exercise group and 2.3 (SD 1.3) in the control group — a within-group drop of 1.9 in the exercise group versus 0.6 in the control group, with an adjusted between-group difference of -1.1 (95% CI -1.5 to -0.6, p<0.01) favoring the exercise group.", "Quadriceps strength (5RM test) rose from 11.6 (SD 4.3) to 20.2 (SD 5.4) in the exercise group and from 12.5 (SD 5.2) to 14.5 (SD 5.2) in the control group by 3 months — a gain of 8.6 versus 2.0, adjusted difference 6.5 (95% CI 5.0 to 8.0, p<0.01) favoring the exercise group.", "Knee function/symptom score (KOOS) moved from 48.0 (SD 21.7) to 30.0 (SD 17.7) in the exercise group and from 43.4 (SD 22.9) to 36.9 (SD 23.1) in the control group by 3 months — a within-group change of -18.0 versus -6.5, adjusted difference -10.7 (95% CI -14.7 to -6.7, p<0.01). The paper's own Discussion calls the larger drop in the exercise group 'both a statistically and a clinical difference' in that group's favor, even though its Methods section defines a higher KOOS score (100) as fewer problems — the paper does not reconcile this itself.", "5 of 70 participants (7%) dropped out during the treatment period.", "The exercise group completed 82% of the prescribed rehabilitation program on average.", "At both 1 month and 3 months after surgery, the exercise group had significantly less pain and significantly better knee function than the control group (p<0.05); by 3 months the difference reached p<0.01 for pain, strength, and knee function.", "Twelve weeks after surgery, both groups scored significantly better on pain and knee function than they had at 1 month (p<0.05), but the paper does not print the numeric 1-month VAS or KOOS values, only this comparison.", "Study group: average age 46.3 years (SD 8.6), 23 of 70 (33%) women, average symptom duration before surgery 2.1 years (SD 2.0).", "During the same surgery, 25 of 70 patients also had chondral (cartilage) lesions; 12 (48%) of those were unstable flaps treated by shaver debridement, and 92% of those debridements were on the medial (inner) side of the knee." ], "notMeasured": [ "Return to work, employment status, or job type — not mentioned anywhere in the paper's text.", "Driving.", "Sleep.", "Sport/recreation as a standalone result — it is only one of five components folded into the single composite KOOS number; no separate sport-and-recreation subscore is printed.", "Weekly or day-by-day pain values — only baseline (pretest) and 3-month (post-test) numbers appear in the results table; 1-month values were collected but not printed.", "Anything beyond 3 months postoperatively — the trial's follow-up ends at 12 weeks." ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10393789/", "identifier": "PMC10393789", "title": "Partial meniscectomy using needle arthroscopy associated with significantly less pain and improved patient reported outcomes at two weeks after surgery: A comparison to standard knee arthroscopy", "design": "retrospective cohort", "participants": "n=38 (19 needle arthroscopy / 19 standard arthroscopy)", "technique": "Partial meniscectomy by knee arthroscopy, comparing a needle-arthroscopy technique (1.9 mm NanoScope, no skin incisions) against standard arthroscopy (anterolateral/anteromedial portal incisions). Meniscus repairs, root repairs, and cases with associated ligament injuries were excluded. 17 of 19 patients in each group (89%) had a medial meniscus tear of the posterior horn.", "scales": [ { "name": "VAS pain", "range": "0-10 (paper reports VAS pain values consistent with this convention; the numeric endpoints are not spelled out in the text itself)", "direction": "higher_worse" }, { "name": "KOOS (Knee injury and Osteoarthritis Outcome Score) — Pain, Symptoms/Stiffness, Activities of Daily Living, Sport/Recreation, Quality of Life subscales", "range": "0-100% (standard KOOS convention; the paper reports scores as percentages but does not itself state that 100 = best)", "direction": "higher_better" } ], "timepoints": "preop, 24 hr post-op (opioid use only), 2 wk, 6 wk", "followUp": "6 weeks. All 38 patients had data at 2 weeks; at 6 weeks, 15 of 19 (79%) needle-arthroscopy patients and 14 of 19 (74%) standard-arthroscopy patients had data available.", "findings": [ "Before surgery, pain averaged 6.1 out of 10 in both groups (needle arthroscopy 6.1 ± 1.7, standard arthroscopy 6.1 ± 1.8, 19 patients each) — the two groups started with the same amount of pain.", "At 2 weeks after surgery, pain was lower in the needle-arthroscopy group: 1.0 out of 10, versus 2.6 out of 10 in the standard-arthroscopy group.", "By 6 weeks after surgery, pain was about the same in both groups: 0.4 out of 10 with needle arthroscopy versus 0.7 out of 10 with standard arthroscopy.", "In the first 24 hours after surgery, needle-arthroscopy patients used less opioid pain medicine than standard-arthroscopy patients (1.2 vs 2.4 morphine milligram equivalents).", "At 2 weeks, function and quality-of-life scores (KOOS) were higher in the needle-arthroscopy group across every subscale measured — for example KOOS pain 79% vs 58%, and quality of life 70% vs 43%.", "By 6 weeks, KOOS scores had converged and were similar between groups (for example KOOS pain 82% vs 78%, quality of life 72% vs 68%).", "One patient in the standard-arthroscopy group (1 of 19, about 5%) developed a deep vein thrombosis (a blood clot) two weeks after surgery. No other complications were recorded in either group.", "The amount of fluid used during surgery was much higher with standard arthroscopy than needle arthroscopy (1.4 vs 0.5 liters), though the tourniquet time on the leg was about the same (20 vs 16 minutes)." ], "notMeasured": [ "Return to work timing.", "Return to sport timing.", "Driving.", "Sleep.", "Any outcome beyond 6 weeks after surgery — the study did not follow patients past that point." ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-meniscectomy.pdf", "title": "Rehabilitation Protocol for Arthroscopic Partial Meniscectomy", "design": "clinical protocol", "technique": "arthroscopic partial meniscectomy", "scales": [ { "name": "KOOS-sports (Knee injury and Osteoarthritis Outcome Score, Sport and Recreation subscale)", "range": "0-100%", "direction": "higher_better" }, { "name": "Quadriceps strength index (hand-held dynamometer or isokinetic testing, % of uninjured leg)", "range": "0-100%", "direction": "higher_better" }, { "name": "Hamstring / glute med / glute max strength index (% of uninjured leg)", "range": "0-100%", "direction": "higher_better" }, { "name": "Single leg hop test (% of uninjured leg)", "range": "0-100%", "direction": "higher_better" } ], "timepoints": "Phase I: day 0-7. Phase II: day 8 - week 2. Phase III: week 2-8. Phase IV: week 9-12.", "followUp": "Protocol runs from post-op day 0 to unrestricted return to sport at 9-12 weeks. Phase IV is described as the last stage with no further discharge criteria, so the protocol does not track anything past that point.", "findings": [ "In the first week after surgery (Phase I), the goals are to reduce swelling and pain, restore knee range of motion, and get the quad muscle firing again; walking is allowed with crutches, bearing as much weight as tolerated.", "Crutches can be stopped within the first few days once swelling has gone down, the patient can do a straight leg raise with good quad control, and their walking pattern looks right, at the physical therapist's judgment.", "To move on from Phase I, the knee needs to bend from 0 to 90 degrees, and the patient needs to be able to do a straight leg raise with good quad activation.", "Phase II runs from day 8 to week 2. Goals are full pain-free motion, better strength and endurance, a gradual return to normal activities, walking normally without crutches, and better balance.", "To move on from Phase II, the knee needs full pain-free motion, no swelling (checked with the Modified Stroke Test), and a normal, non-limping walk without any walking aid.", "Phase III runs from 2 to 8 weeks after surgery, with full weight bearing throughout. Goals are to keep full pain-free motion, build strength and endurance, avoid pain or swelling after exercise, and move with good form.", "From 4 to 6 weeks after surgery, cardio work such as the elliptical, stair climber, flutter-kick swimming, or pool jogging is added, as tolerated.", "Once the surgical leg's quad strength reaches more than 80% of the other leg's (by hand-held or isokinetic dynamometer), the patient can start an interval running program and progress to jump and agility training.", "Before returning to any impact activity, the protocol asks for: 10 single-leg squats with good form through at least 60 degrees of knee bend, a controlled single-leg drop jump, finishing the jog/run program pain- and swelling-free, quad strength over 80% of the other leg, hamstring/glute strength at least 80% of the other leg, and a single-leg hop test at least 75% of the other leg.", "Phase IV, unrestricted return to sport, runs from 9 to 12 weeks after surgery.", "To be cleared for unrestricted return to sport, the protocol requires quad strength over 95% of the other leg, hamstring/glute strength at least 95%, a single-leg hop test at least 95% of the other leg with good landing control, and a KOOS-sports questionnaire score above 90% (or another patient-reported outcome measure).", "The protocol lists no discharge criteria beyond Phase IV; it is described as the last stage." ], "notMeasured": [ "Actual pain scores over time on any numeric scale (e.g. 0-10) — the protocol names 'minimize pain' as a goal but never reports a measured pain value at any point.", "Return to work timing.", "Return to driving timing.", "Sleep.", "A single fixed return-to-sport date — the protocol gives a 9-12 week window gated by strength/hop-test criteria, not a fixed day.", "Any measured outcome data from an actual patient cohort — this is a treatment protocol for clinicians, not a study reporting results from treated patients, so there is no sample, no measured before/after values, and no statistics." ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12310086/", "identifier": "PMC12310086", "title": "The formal EU-US Meniscus Rehabilitation 2024 Consensus: An ESSKA-AOSSM-AASPT initiative. Part I—Rehabilitation management after meniscus surgery (meniscectomy, repair and reconstruction)", "design": "consensus statement", "technique": "Arthroscopic partial meniscectomy, meniscus repair (stable vertical tears, complex vertical tears, complete oblique/radial tears, horizontal lesions, ramp lesions, root tears), and meniscus reconstruction (allograft transplantation or scaffold)", "timepoints": "meniscectomy: 4-12 wk; meniscus repair: minimum 4 mo (vertical tears) up to 6-9 mo (complex, radial, root and horizontal tears); meniscus reconstruction: 6 wk non-weight-bearing, full weight-bearing progression after 8 wk, at least 9 mo total rehab, return to sport at least 12 mo", "findings": [ "This is not a study of patients - it is a formal consensus of 67 experts (26 in a steering group, 41 in a rating group: orthopaedic surgeons, sports medicine doctors and physiotherapists) from the US and 13 European countries, agreeing on how rehab after meniscus surgery should be run.", "The panel screened 395 papers and produced 29 recommendations across 19 questions, but graded the underlying evidence weak: only 1 recommendation got the top evidence grade (A), 2 got grade B, 9 got grade C, and 17 - the majority - got the lowest grade, D.", "Despite the weak evidence, the panel agreed strongly with the recommendations themselves: on a 1-to-9 scale, the mean of the median ratings across all 19 questions was 8.2/9, and the global mean rating across all statements was 8.4 +/- 0.2.", "After meniscectomy (partial removal of torn meniscus), rehab should be guided by milestones the person hits - swelling down, motion back, strength returned - rather than a fixed calendar, and typically runs 4 to 12 weeks.", "After a meniscus repair for a stable vertical tear, deep squatting and jumping should be avoided for a minimum of 4 months.", "After repair of a complex, radial, root, or horizontal tear, recovery runs longer - 6 to 9 months - with knee bending kept under 30 degrees for weeks 4 to 8, under 45 degrees through week 12, and progressed up to 60-90 degrees by weeks 13 to 16.", "After meniscus reconstruction (transplant or scaffold), the leg is kept non-weight-bearing for 6 weeks, weight is added gradually after 8 weeks, total rehab takes at least 9 months, and return to sport takes at least 12 months.", "Before returning to activity, quadriceps (thigh muscle) strength should reach at least 80% of the strength in the uninjured leg.", "The panel found no good evidence on whether to use a knee brace after meniscus reconstruction, so it made no recommendation either way." ], "notMeasured": [ "Pain scores (VAS/NRS) are not reported anywhere in this document.", "Return to sport data is explicitly deferred to a planned Part II article, not covered here: \"return to sports... will be presented in a part II article.\"", "Patient-reported outcome measures (e.g. Lysholm, KOOS, IKDC) are likewise deferred to Part II, not reported as results here.", "Return to work, driving, and sleep are not addressed in this document.", "Prevention programmes and non-operative treatment of tears are deferred to Part II, not covered here." ], "access": "full_text", "lastChecked": "2026-08-10" } ] }, { "procedure": "Arthroscopic rotator cuff repair", "timelineName": "Rotator cuff surgery recovery", "bodyRegion": "shoulder", "url": "https://growsteady.me/rotator-cuff-surgery-recovery-timeline", "confidence": "high", "lastReviewed": "2026-06-05", "painPoints": [ { "week": 0, "low": 2.6, "typical": 4.4, "high": 6.4, "converted": false, "scaleNote": "VAS 0-10; POD0-POD1 block rebound", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is the average for patients who got a nerve block; the high edge is a different day's figure for patients who got no block — two different treatments on two different days, not the spread among people managed the same way.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9310229/" }, { "week": 6, "low": 2.3, "typical": 4, "high": 5.8, "converted": false, "scaleNote": "VAS 0-10; mean 4.04 +/- 1.78", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4233217/" }, { "week": 12, "low": 1.2, "typical": 3, "high": 4.8, "converted": false, "scaleNote": "VAS 0-10; 3-month anchor", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4233217/" }, { "week": 52, "low": 0, "typical": 0.9, "high": 1.4, "converted": false, "scaleNote": "VAS 0-10; 12-month anchor", "basis": "measured", "bandBasis": "estimated", "bandNote": "The paper's own printed mean and SD put the top of a one-SD band at about 1.7, not 1.4 shown here — the high edge doesn't reconstruct from the paper's own numbers.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4233217/" } ], "milestones": [ { "milestone": "Passive ROM begins", "typicalWeek": 1, "range": "Within 7 days to about 3 weeks, protocol-dependent", "advisory": true, "source": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-rotator-cuff-repair.pdf" }, { "milestone": "Deskwork / sedentary work", "typicalWeek": 2, "range": "When comfortable in the sling (protocol gives no fixed week; commonly ~1-2 weeks)", "advisory": true, "source": "https://orthopedics.medicine.uiowa.edu/sites/orthopedics.medicine.uiowa.edu/files/2024-08/MOON%20Post-Operative%20Rotator%20Cuff%20Repair%20Immediate%20Therapy%20Protocol.pdf" }, { "milestone": "Sling discontinued", "typicalWeek": 6, "range": "About 6 weeks; some protocols extend to 7-8 weeks", "advisory": true, "source": "https://orthopedics.medicine.uiowa.edu/sites/orthopedics.medicine.uiowa.edu/files/2024-08/MOON%20Post-Operative%20Rotator%20Cuff%20Repair%20Immediate%20Therapy%20Protocol.pdf" }, { "milestone": "Return to driving", "typicalWeek": 6, "range": "Often around sling discontinuation; observed timing varies", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12002080/" }, { "milestone": "Overhead reaching", "typicalWeek": 12, "range": "Around 12 weeks by protocol gate", "advisory": true, "source": "https://orthopedics.medicine.uiowa.edu/sites/orthopedics.medicine.uiowa.edu/files/2024-08/MOON%20Post-Operative%20Rotator%20Cuff%20Repair%20Immediate%20Therapy%20Protocol.pdf" } ], "citedPapers": [ { "url": "https://orthopedics.medicine.uiowa.edu/sites/orthopedics.medicine.uiowa.edu/files/2024-08/MOON%20Post-Operative%20Rotator%20Cuff%20Repair%20Immediate%20Therapy%20Protocol.pdf", "title": "orthopedics.medicine.uiowa.edu", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 3, "backsCards": 4 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4233217/", "title": "The Factors Affecting Pain Pattern after Arthroscopic Rotator Cuff Repair (Kim CW, Kim JH, Kim DG, Clin Orthop Surg, 2014)", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 4, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12002080/", "title": "PMC12002080", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9310229/", "title": "PMC9310229", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-rotator-cuff-repair.pdf", "title": "massgeneral.org", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12255946/", "title": "Pain catastrophizing and early pain after rotator cuff repair (phone follow-up, n=32)", "tier": "prospective case series", "declared": true, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9983088/", "title": "Return to activities after arthroscopic rotator cuff repair", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 } ], "sources": [ { "title": "Pain catastrophizing and early pain after rotator cuff repair (phone follow-up, n=32)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12255946/", "tier": "prospective case series", "reliabilityScore": 6 }, { "title": "The Factors Affecting Pain Pattern after Arthroscopic Rotator Cuff Repair (Kim CW, Kim JH, Kim DG, Clin Orthop Surg, 2014)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4233217/", "tier": "retrospective cohort", "reliabilityScore": 7 }, { "title": "Return to activities after arthroscopic rotator cuff repair", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9983088/", "tier": "meta-analysis", "reliabilityScore": 8 } ], "studies": [] }, { "procedure": "Total knee replacement", "timelineName": "Knee replacement recovery", "bodyRegion": "knee", "url": "https://growsteady.me/knee-replacement-recovery-timeline", "confidence": "high", "lastReviewed": "2026-06-05", "painPoints": [ { "week": 0, "low": 4, "typical": 6, "high": 8, "converted": false, "scaleNote": "VAS/NRS 0-10; POD0", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10399043/" }, { "week": 1, "low": 3.5, "typical": 4.7, "high": 6.5, "converted": false, "scaleNote": "NRS 0-10; typical = day 8-9 mean ~4.7; band estimated (daily SDs not reported)", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9741301/" }, { "week": 2, "low": 3, "typical": 5.4, "high": 7, "converted": false, "scaleNote": "VAS 0-10; among people still reporting pain", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10399043/" }, { "week": 26, "low": 0, "typical": 1, "high": 3.8, "converted": false, "scaleNote": "VAS 0-10 at 6 months; ~86% report little/no pain (median ~0-1); among the ~14% still symptomatic the mean is 3.8 +/- 2.7, which drives the high band", "basis": "measured", "bandBasis": "comparison", "bandNote": "The high edge is the average pain of the roughly 1-in-7 patients who had NOT recovered by 6 months — not the top of normal variation among people who did recover.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10399043/" } ], "milestones": [ { "milestone": "Hospital discharge", "typicalWeek": 0.3, "range": "Usually 1-3 days", "advisory": true, "source": "https://www.nhs.uk/tests-and-treatments/knee-replacement/recovery/" }, { "milestone": "Off crutches or cane / walking unaided", "typicalWeek": 6, "range": "Around 6 weeks", "advisory": true, "source": "https://www.nhs.uk/tests-and-treatments/knee-replacement/recovery/" }, { "milestone": "Driving resumed", "typicalWeek": 6, "range": "About 6 weeks for total knee", "advisory": true, "source": "https://www.nhs.uk/tests-and-treatments/knee-replacement/recovery/" }, { "milestone": "Strength gate >=80% of non-operative limb", "typicalWeek": 10, "range": "8-12 weeks", "advisory": true, "source": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-total-knee-arthroplasty.pdf" }, { "milestone": "Return to work", "typicalWeek": 11, "range": "6-12 weeks sedentary; 3-6 months for physical labor", "advisory": true, "source": "https://pubmed.ncbi.nlm.nih.gov/37499045/" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10399043/", "title": "Mapping the course to recovery after TKA", "tier": "prospective cohort", "declared": true, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 5 }, { "url": "https://www.nhs.uk/tests-and-treatments/knee-replacement/recovery/", "title": "nhs.uk", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 3, "backsCards": 3 }, { "url": "https://boneandjoint.org.uk/Article/10.1302/0301-620X.106B6.BJJ-2023-0889.R1", "title": "boneandjoint.org.uk", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-total-knee-arthroplasty.pdf", "title": "massgeneral.org", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6746267/", "title": "PMC6746267", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6858006/", "title": "PMC6858006", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8487473/", "title": "PMC8487473", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9741301/", "title": "PMC9741301", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/39271495/", "title": "PMID 39271495", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/37499045/", "title": "Return to sports and work after TKA", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://boneandjoint.org.uk/Article/10.1302/0301-620X.104B2.BJJ-2021-0890.R1", "title": "boneandjoint.org.uk", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6902788/", "title": "Early postoperative pain trajectories after TKA", "tier": "prospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0148193", "title": "journals.plos.org", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10733550/", "title": "PMC10733550", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12096998/", "title": "PMC12096998", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4140618/", "title": "PMC4140618", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4647493/", "title": "PMC4647493", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4835733/", "title": "PMC4835733", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6381229/", "title": "PMC6381229", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7814195/", "title": "PMC7814195", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8635544/", "title": "PMC8635544", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9039409/", "title": "PMC9039409", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/20798443/", "title": "PMID 20798443", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/23090437/", "title": "PMID 23090437", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/25737387/", "title": "PMID 25737387", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/29897271/", "title": "PMID 29897271", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/30773356/", "title": "PMID 30773356", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/34564735/", "title": "PMID 34564735", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/35227816/", "title": "PMID 35227816", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/36252743/", "title": "PMID 36252743", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/37100814/", "title": "PMID 37100814", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/38777908/", "title": "PMID 38777908", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/39952303/", "title": "PMID 39952303", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://www.sciencedirect.com/science/article/abs/pii/S088354032100334X", "title": "sciencedirect.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 } ], "sources": [ { "title": "Early postoperative pain trajectories after TKA", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6902788/", "tier": "prospective cohort", "reliabilityScore": 9 }, { "title": "Return to sports and work after TKA", "url": "https://pubmed.ncbi.nlm.nih.gov/37499045/", "tier": "meta-analysis", "reliabilityScore": 9 }, { "title": "Mapping the course to recovery after TKA", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10399043/", "tier": "prospective cohort", "reliabilityScore": 8 } ], "studies": [] }, { "procedure": "Total hip replacement", "timelineName": "Hip replacement recovery", "bodyRegion": "hip", "url": "https://growsteady.me/hip-replacement-recovery-timeline", "confidence": "high", "lastReviewed": "2026-06-08", "painPoints": [ { "week": 0, "low": 1, "typical": 3, "high": 5, "converted": false, "scaleNote": "0-10 NRS POD1; rest ~1 / on-motion ~5 (PMC9522754); median ~3 from fast-track diary cohort (PMC5385107)", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge approximates pain at rest and the high edge approximates pain during movement, averaged loosely across three different surgical approaches this paper never itself averaged — not variation between individual patients.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9522754/" }, { "week": 6, "low": 0, "typical": 0, "high": 3, "converted": false, "scaleNote": "0-10 NRS; diary cohort week-6 median 0 (range 0-8)", "basis": "measured", "bandBasis": "estimated", "bandNote": "The paper's own printed range at 6 weeks is 0 to 8, not 0 to 3 shown here — this band understates how much people varied in the source study.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5385107/" } ], "milestones": [ { "milestone": "Stand and walk with an aid", "typicalWeek": 0, "range": "Day 0 to day 1 (ERAS: mobilize as soon as possible)", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7006728/" }, { "milestone": "Hospital discharge", "typicalWeek": 0.3, "range": "1-3 days; some centers same-day", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7006728/" }, { "milestone": "Return to driving", "typicalWeek": 4, "range": "Left hip ~3-4 weeks, right hip ~4-6 weeks; off narcotics", "advisory": true, "source": "https://www.uhhospitals.org/-/media/files/services/rehabilitation/total-hip-arthroplasty-rehabilitation-post-operative-guidelines.pdf" }, { "milestone": "Off assistive devices / walking unaided", "typicalWeek": 6, "range": "About 3-6 weeks, once gait is normal", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5385107/" }, { "milestone": "Return to work", "typicalWeek": 10, "range": "Desk ~4 weeks; manual labor 3-6 months (wide, job-dependent)", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9926652/" }, { "milestone": "Return to sport / recreation", "typicalWeek": 22, "range": "About 16-28 weeks, per clearance", "advisory": true, "source": "https://pubmed.ncbi.nlm.nih.gov/29691754/" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5385107/", "title": "PMC5385107", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 3, "backsMilestones": 1, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10914419/", "title": "Postoperative pain trajectories in THA (PROMIS, n=1,249)", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7006728/", "title": "PMC7006728", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 1 }, { "url": "https://www.sciencedirect.com/science/article/pii/S0883540325012495", "title": "sciencedirect.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 3 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9522754/", "title": "PMC9522754", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9612671/", "title": "PMC9612671", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/22427017/", "title": "PMID 22427017", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/29691754/", "title": "PMID 29691754", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9926652/", "title": "Return to work following primary THA: systematic review and meta-analysis", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://www.uhhospitals.org/-/media/files/services/rehabilitation/total-hip-arthroplasty-rehabilitation-post-operative-guidelines.pdf", "title": "uhhospitals.org", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://boneandjoint.org.uk/Article/10.1302/2633-1462.36.BJO-2022-0023", "title": "boneandjoint.org.uk", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://boneandjoint.org.uk/Article/10.1302/0301-620X.98B4.37201", "title": "boneandjoint.org.uk", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0149306", "title": "journals.plos.org", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10957851/", "title": "National PROM registry after primary hip replacement (AOANJRR/ACORN)", "tier": "registry", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10607190/", "title": "PMC10607190", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12471251/", "title": "PMC12471251", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3204273/", "title": "PMC3204273", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3628341/", "title": "PMC3628341", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3825899/", "title": "PMC3825899", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5522532/", "title": "PMC5522532", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5785289/", "title": "PMC5785289", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7268999/", "title": "PMC7268999", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7648978/", "title": "PMC7648978", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8023959/", "title": "PMC8023959", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8474772/", "title": "PMC8474772", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8944083/", "title": "PMC8944083", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/21388906/", "title": "PMID 21388906", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/29195847/", "title": "PMID 29195847", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32778414/", "title": "PMID 32778414", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/33347013/", "title": "PMID 33347013", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/33812717/", "title": "PMID 33812717", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/40541851/", "title": "PMID 40541851", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/41763743/", "title": "PMID 41763743", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 } ], "sources": [ { "title": "National PROM registry after primary hip replacement (AOANJRR/ACORN)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10957851/", "tier": "registry", "reliabilityScore": 9.5 }, { "title": "Postoperative pain trajectories in THA (PROMIS, n=1,249)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10914419/", "tier": "retrospective cohort", "reliabilityScore": 8 }, { "title": "Return to work following primary THA: systematic review and meta-analysis", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9926652/", "tier": "meta-analysis", "reliabilityScore": 8.5 } ], "studies": [] }, { "procedure": "Lumbar microdiscectomy", "timelineName": "Microdiscectomy recovery", "bodyRegion": "lower_back", "url": "https://growsteady.me/microdiscectomy-recovery-timeline", "confidence": "high", "lastReviewed": "2026-06-08", "painPoints": [ { "week": 0, "low": 6, "typical": 6.7, "high": 7.5, "converted": true, "scaleNote": "Leg (radicular) pain; VAS 0-100 normalized to 0-10 (Peul baseline ~67)", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2427077/" }, { "week": 8, "low": 0.5, "typical": 1, "high": 2.3, "converted": true, "scaleNote": "Leg pain; VAS/100 -> 0-10 (Peul week 8, 10.2/100)", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2427077/" }, { "week": 26, "low": 0.6, "typical": 0.8, "high": 1.8, "converted": true, "scaleNote": "Leg pain; VAS/100 -> 0-10 (Peul week 26, 8.4/100)", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2427077/" }, { "week": 52, "low": 0.2, "typical": 1.1, "high": 6.4, "converted": true, "scaleNote": "Leg pain; VAS/100 -> 0-10 (Peul 11/100; wide high band reflects the ~25% poor-responder tail, CSORN NRS ~6.4)", "basis": "measured", "bandBasis": "estimated", "bandNote": "The high edge blends a poor-responder subgroup within this trial with a pain score from a different registry (CSORN) — not the range within this trial's own patients.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2427077/" } ], "milestones": [ { "milestone": "Return to driving", "typicalWeek": 1.5, "range": "1-2 weeks; off narcotics, can tolerate sitting", "advisory": true, "source": "https://www.axisspinecenter.com/wp-content/uploads/2021/04/LUMBAR-MICRODISCECTOMY-PHYSICAL-THERAPY-POST-OP-PROTOCOL.pdf" }, { "milestone": "Walking program (build to 20-30 min)", "typicalWeek": 2, "range": "0-6 weeks, progressive", "advisory": true, "source": "https://www.axisspinecenter.com/wp-content/uploads/2021/04/LUMBAR-MICRODISCECTOMY-PHYSICAL-THERAPY-POST-OP-PROTOCOL.pdf" }, { "milestone": "Return to work (any role, pooled)", "typicalWeek": 5, "range": "About 3.9-5.7 weeks; job-dependent", "advisory": true, "source": "https://pubmed.ncbi.nlm.nih.gov/39831367/" }, { "milestone": "Lifting restrictions lifted", "typicalWeek": 6, "range": "6-8 weeks", "advisory": true, "source": "https://www.axisspinecenter.com/wp-content/uploads/2021/04/LUMBAR-MICRODISCECTOMY-PHYSICAL-THERAPY-POST-OP-PROTOCOL.pdf" }, { "milestone": "Return to running / sport", "typicalWeek": 10, "range": "8-12 weeks, criteria-based", "advisory": true, "source": "https://www.axisspinecenter.com/wp-content/uploads/2021/04/LUMBAR-MICRODISCECTOMY-PHYSICAL-THERAPY-POST-OP-PROTOCOL.pdf" }, { "milestone": "Full return to original-role work", "typicalWeek": 16, "range": "Median 14-16 weeks; 85% by 26 weeks", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12594137/" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2427077/", "title": "Prolonged conservative care vs early surgery in sciatica: 2-year RCT (Peul, BMJ 2008)", "tier": "RCT", "declared": true, "backsPainPoints": 7, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://www.axisspinecenter.com/wp-content/uploads/2021/04/LUMBAR-MICRODISCECTOMY-PHYSICAL-THERAPY-POST-OP-PROTOCOL.pdf", "title": "Lumbar Microdiscectomy Physical Therapy Post Op Protocol", "tier": "clinical protocol", "declared": false, "backsPainPoints": 0, "backsMilestones": 4, "backsCards": 3 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/39831367/", "title": "Return to work after lumbar microdiskectomy: systematic review and meta-analysis", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12594137/", "title": "Timelines and Associated Factors for Return-to-Work of Patients With Painful Lumbar Radiculopathy Who Undergo Lumbar Microdiscectomy Followed by Physiotherapy: A Prospective Cohort Study", "tier": "prospective cohort", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9249755/", "title": "Postoperative recovery patterns following discectomy (CSORN registry)", "tier": "registry", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 } ], "sources": [ { "title": "Prolonged conservative care vs early surgery in sciatica: 2-year RCT (Peul, BMJ 2008)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2427077/", "tier": "RCT", "reliabilityScore": 9 }, { "title": "Postoperative recovery patterns following discectomy (CSORN registry)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9249755/", "tier": "registry", "reliabilityScore": 9 }, { "title": "Return to work after lumbar microdiskectomy: systematic review and meta-analysis", "url": "https://pubmed.ncbi.nlm.nih.gov/39831367/", "tier": "meta-analysis", "reliabilityScore": 8 } ], "studies": [ { "url": "https://www.axisspinecenter.com/wp-content/uploads/2021/04/LUMBAR-MICRODISCECTOMY-PHYSICAL-THERAPY-POST-OP-PROTOCOL.pdf", "title": "Lumbar Microdiscectomy Physical Therapy Post Op Protocol", "design": "clinical protocol", "technique": "Microdiscectomy — removal of a herniated or bulging disc at a single lumbar level, often combined with a hemilaminectomy to decompress the affected nerve root. One midline or para-midline incision, closed with Dermabond.", "timepoints": "0-2 wk (Phase 1, wound healing/protection), 2-6 wk (Phase 2, initial strength), 6-8 wk (Phase 3, advanced strength), 8-12 wk (return to running/sport)", "findings": [ "The protocol restricts lifting to under 15 lb for the first 2 weeks after surgery.", "The protocol limits sitting, including in the car, to no more than 30 minutes at a time during weeks 0-2, with standing and walking breaks, and tells patients to avoid bending, twisting, pushing, and pulling in that window.", "The protocol allows driving once the patient is off narcotic pain medication and can tolerate sitting for more than 15 minutes at a time, which it places at 1-2 weeks.", "The protocol prescribes a walking program starting at 10 minutes, 1-2 times a day, gradually increasing to 20 minutes at a time during weeks 0-2.", "From 2 to 6 weeks, the protocol allows walking as cardio up to 30 minutes at a time.", "The protocol starts a recumbent stationary bike at 2 weeks, an upright stationary bike without resistance at 4 weeks, and adds resistance on the upright bike at 6 weeks.", "The protocol allows aquatic physical therapy starting at 2 weeks, once the incision has healed with no scabs, avoiding rotation and using walking and multi-directional arm movements in the water.", "From 2 to 6 weeks, the protocol begins lifting at 15 lb and progresses it until there are no lifting restrictions at week 6, while keeping the lumbar spine neutral and avoiding bending and twisting below the knees.", "The protocol typically releases patients to full activity without restrictions at 6 to 8 weeks, once they are independent in their home exercise program.", "The protocol allows swimming, elliptical, and outdoor cycling at 6 weeks, and skiing, yoga, or Pilates at 8 weeks.", "The protocol places running, soccer, golf, and basketball, along with plyometrics and return to sport, at 8 to 12 weeks, criteria dependent on progress through the program.", "The Silverlon wound dressing can be removed after 5 days; the incision can get wet but should not be submerged, and no lotions, balms, ointments, or oils should be applied to it." ], "access": "full_text", "lastChecked": "2026-08-09" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9249755/", "identifier": "PMC9249755", "title": "Postoperative recovery patterns following discectomy surgery in patients with lumbar radiculopathy", "design": "registry", "participants": "n=524 (57 surgeons, 13 institutions); leg pain trajectory model n=517, back pain model n=469, disability model n=502", "technique": "open or minimally invasive lumbar discectomy surgery with a posterior midline or paracentral approach, for degenerative pathology", "scales": [ { "name": "leg pain NRS", "range": "0-10", "direction": "higher_worse" }, { "name": "back pain NRS", "range": "0-10", "direction": "higher_worse" }, { "name": "Oswestry Disability Index (ODI, modified)", "range": "0-100", "direction": "higher_worse" } ], "timepoints": "preop, 3 mo, 12 mo, 24 mo", "followUp": "24 months", "findings": [ "Among 517 patients tracked for leg pain, three recovery patterns emerged. 18.4% recovered to almost no leg pain: average leg pain fell from 7.5 out of 10 before surgery to 0.8 by 3 months, 0.2 by 12 months, and 0.0 by 24 months.", "55.4% of the leg-pain cohort improved but landed low and plateaued: average leg pain fell from 7.5 out of 10 before surgery to 2.3 by 3 months, and stayed at 2.3 through 12 and 24 months.", "26.3% of the leg-pain cohort improved little: average leg pain fell from 8.1 out of 10 before surgery to 6.1 by 3 months, 6.4 by 12 months, and 6.4 by 24 months.", "At 12 months, in the leg-pain 'excellent' group all patients (100%) reached the minimal important pain reduction and 90.6-91.8% counted as a clinical success (50% improvement or an ODI score of 22 or below); in the 'good' group 88.0% reached the minimal important reduction and 62.5-64.8% counted as a clinical success; in the 'poor' group 35.2% reached the minimal important reduction and 18.2-22.4% counted as a clinical success.", "For back pain, among 469 patients, three groups emerged: 13.0% recovered to almost no back pain (falling from 6.2 to 0.8 by 3 months, 0.3 by 12 months, 0.1 by 24 months, all out of 10); 56.4% improved and plateaued (falling from 6.5 to 2.6 by 3 months, 2.4 by 12 months, 2.4 by 24 months); 30.6% improved little (falling from 7.6 to 5.5 by 3 months, then rising slightly to 6.4 by 12 months and 6.2 by 24 months).", "For disability, measured with the Oswestry Disability Index (0-100, higher is worse), among 502 patients: 59.7% had an 'excellent' recovery, falling from 46.3 before surgery to 16.5 by 3 months, 10.3 by 12 months, 9.6 by 24 months; 35.6% had a 'fair' recovery, falling from 55.1 to 39.9 by 3 months, 38.3 by 12 months, 37.8 by 24 months; 4.7% had a 'poor' recovery, starting at 68.4 and staying between about 63 and 67 through 24 months.", "The paper describes a disconnect between pain and disability recovery: 95.3% of patients showed good-to-excellent disability recovery, but 26.3-30.6% of patients still reported persistent leg or back pain after surgery." ], "notMeasured": [ "return to work", "driving", "sleep", "return to sport or athletic activity" ], "access": "full_text", "lastChecked": "2026-08-09" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2427077/", "identifier": "PMC2427077", "title": "Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial", "design": "randomized trial", "participants": "n=283 (141 assigned early surgery / 142 assigned prolonged conservative care); 125 of 141 (89%) in the early-surgery group actually had microdiscectomy, and 62 of 142 (44%) in the conservative group eventually had surgery too", "technique": "microdiscectomy — unilateral transflaval approach with magnification, annular fenestration and nerve root decompression, loose degenerated disc material removed with curette and rongeur (no attempt at subtotal discectomy)", "scales": [ { "name": "Roland Disability Questionnaire for Sciatica", "range": "0-23", "direction": "higher_worse" }, { "name": "Leg pain, visual analogue scale (VAS)", "range": "0-100 mm", "direction": "higher_worse" }, { "name": "Back pain, visual analogue scale (VAS)", "range": "0-100 mm", "direction": "higher_worse" }, { "name": "Global perceived recovery (7-point Likert)", "range": "1-7 (dichotomised to satisfactory/unsatisfactory)", "direction": "higher_worse" }, { "name": "SF-36 Bodily Pain subscale", "range": "0-100", "direction": "higher_better" }, { "name": "SF-36 Physical Functioning subscale", "range": "0-100", "direction": "higher_better" } ], "timepoints": "baseline, 2 wk, 4 wk, 8 wk, 12 wk, 26 wk, 38 wk, 52 wk, 78 wk, 104 wk (headline results tables report baseline, 8, 26, 52, and 104 weeks)", "followUp": "2 years (104 weeks)", "findings": [ "This trial randomly assigned 283 people who had had sciatica (leg pain from a herniated disc) for 6 to 12 weeks to either early surgery (141 people) or prolonged conservative care with surgery only if needed later (142 people).", "In the end, 125 of the 141 people assigned to early surgery (89%) actually had microdiscectomy; 16 of 141 (11%) recovered on their own before their scheduled surgery happened. Median time from randomisation to surgery was 1.9 weeks.", "In the conservative-care group, 62 of 142 people (44%) eventually needed surgery — 55 of them within the first year, a median of 14.6 weeks after randomisation, and 7 more in the second year.", "Leg pain (VAS, 0-100, higher is worse) in the early-surgery group fell from 67.2 at the start to 10.2 by 8 weeks, 8.4 by 26 weeks, 11.0 by 52 weeks (1 year), and 11.0 by 104 weeks (2 years).", "Leg pain in the conservative-care group fell more slowly at first: from 64.4 at the start to 27.9 by 8 weeks and 14.5 by 26 weeks, then caught up to the surgery group at 11.0 by 52 weeks and 9.0 by 104 weeks.", "Back pain (VAS, 0-100) in the early-surgery group went from 33.8 at the start to 14.4 at 8 weeks, 15.5 at 26 weeks, 14.2 at 52 weeks, and 15.9 at 104 weeks; back pain fell less sharply than leg pain and did not keep improving after 8 weeks.", "Back pain in the conservative-care group went from 30.8 at the start to 25.7 at 8 weeks, 17.8 at 26 weeks, 16.5 at 52 weeks, and 17.3 at 104 weeks.", "Disability (Roland Sciatica scale, 0-23, higher is worse) in the early-surgery group fell from 16.5 at the start to 6.1 at 8 weeks, 4.0 at 26 weeks, 3.3 at 52 weeks, and 3.1 at 104 weeks.", "Disability in the conservative-care group fell from 16.3 at the start to 9.2 at 8 weeks, 4.8 at 26 weeks, 3.7 at 52 weeks, and 2.6 at 104 weeks.", "By 8 weeks, 81.2% of the early-surgery group rated their recovery as satisfactory or nearly complete, versus 36.5% of the conservative group. The gap narrowed over time: 77.4% vs 70.8% at 26 weeks, 85.7% vs 82.5% at 52 weeks, and 81.3% vs 78.9% at 104 weeks.", "By the end of year one, 95% of people in both groups had reported a satisfactory recovery at some point, though the early-surgery group got there faster (their pace of recovery in year one was about twice as fast, hazard ratio 1.97, 95% CI 1.72 to 2.22).", "At two years, 20% of all patients (56 of 281 with data) still rated their outcome unsatisfactory, with no significant difference between the two groups (81.3% vs 78.9% satisfactory, P=0.66) — early surgery sped up relief but did not lower the overall chance of a poor long-term outcome.", "6% of people who had surgery in either group needed a second operation for recurrent sciatica within two years — 7 people in the early-surgery group and 4 in the conservative group.", "Surgical complications occurred in 1.6% of all operated patients: two dural tears (a small tear in the membrane around the nerves) and one wound haematoma (a pocket of blood at the incision), none needing further treatment. No one developed a new neurological deficit from surgery or from conservative care.", "SF-36 bodily pain score (0-100, higher is better) in the early-surgery group rose from 21.9 at the start to 62.8 at 8 weeks, 76.1 at 26 weeks, 81.2 at 52 weeks, and 78.4 at 104 weeks; the conservative group rose from 23.9 to 54.4, 72.8, 78.5, and 80.7 at the same timepoints." ], "notMeasured": [ "Return to work rate or timing as an outcome. The paper only reports baseline sick-leave status (76% of the surgery group and 82% of the conservative group had taken sick leave before enrolling, average about 5.3 weeks each) and a general note that patients were advised to resume work from six weeks onward — it does not report what fraction of either group had actually returned to work by any given week.", "Driving, sleep, or sport/return-to-activity outcomes — none of these are reported.", "Week-by-week pain values between the reported checkpoints. The methods list assessments at 2, 4, 12, 38, and 78 weeks in addition to the headline 8/26/52/104-week timepoints, but the results tables in the fetched text only give numeric leg pain, back pain, disability, and SF-36 scores at baseline, 8, 26, 52, and 104 weeks — values at 2, 4, 12, 38, and 78 weeks are not printed as numbers in the text reviewed." ], "access": "full_text", "lastChecked": "2026-08-09" }, { "url": "https://pubmed.ncbi.nlm.nih.gov/39831367/", "identifier": "PMID 39831367", "title": "Return to Work After Lumbar Microdiskectomy: A Systematic Review and Meta-analysis", "design": "meta-analysis", "participants": "31 studies pooled overall (2285 records screened); 21 studies pooled for the return-to-work rate, 13 studies pooled for return-to-work timing; individual patient counts not given in the abstract", "technique": "lumbar microdiskectomy for degenerative disc herniation (excludes spinal stenosis, percutaneous diskectomy, artificial disk/arthroplasty, laminectomy, fusion, and cauda equina symptoms)", "timepoints": "not reported as discrete timepoints; pooled averages are reported, with a meta-regression against duration of follow-up across studies", "followUp": "varies by pooled study; not stated as a single value in the abstract", "findings": [ "This review pooled 31 studies on return to work after lumbar microdiscectomy, screened from 2285 records; most of the studies had a low risk of bias.", "Pooling 21 of those studies, on average 78 out of 100 people had returned to work after surgery (95% CI 71%-83%).", "Pooling 13 of those studies, the average time to return to work was 4.79 weeks (95% CI 3.88-5.70 weeks).", "People followed for longer after surgery were slightly more likely to have returned to work by the time they were checked, but the effect was small (meta-regression coefficient 0.02, 95% CI 0.01-0.03, p=0.006).", "How long someone had symptoms before surgery did not significantly change whether they returned to work.", "The review's conclusion: about 70% to 80% of people return to work within the first month and a half after surgery, and returning after that point is uncommon." ], "notVisible": [ "Full methods detail: exact search dates, study-selection process, and QUIPS bias-assessment specifics.", "The list and characteristics of the 31 individual studies (countries, sample sizes, follow-up lengths, patient demographics).", "How 'return to work' was defined in each study (full duty vs. modified duty, same job vs. any job).", "Any breakdown of return-to-work timing or rate by job type, physical demand, age, or other subgroup.", "Heterogeneity statistics (I²), sensitivity analyses, funnel plots, or publication-bias assessment.", "Discussion and limitations sections.", "Total or per-study patient counts." ], "access": "abstract_only", "lastChecked": "2026-08-09" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12594137/", "identifier": "PMC12594137", "title": "Timelines and Associated Factors for Return-to-Work of Patients With Painful Lumbar Radiculopathy Who Undergo Lumbar Microdiscectomy Followed by Physiotherapy: A Prospective Cohort Study", "design": "prospective cohort", "participants": "n=257 (of 333 enrolled; 68 excluded for not being in paid employment, 8 excluded for missing return-to-work data); mean age 43.3 (SD 10.1); 157 male (61.1%)", "technique": "lumbar microdiscectomy — relieving pressure on the affected lumbar nerve root by removing part of the intervertebral disc and ligamentum flavum, using a surgical microscope — followed by physiotherapy (median start 14 wk postop, IQR 8–26 wk)", "scales": [ { "name": "VAS leg pain", "range": "0-100mm", "direction": "higher_worse" }, { "name": "VAS back pain", "range": "0-100mm", "direction": "higher_worse" }, { "name": "Roland Disability Questionnaire (RDQ)", "range": "0-24", "direction": "higher_worse" } ], "timepoints": "preop (baseline VAS/RDQ only); return-to-work status tracked continuously to 52 wk postop", "followUp": "52 weeks", "findings": [ "178 of 257 patients (69.3%) had fully returned to their original job, with no changes to tasks or hours, by 52 weeks after surgery.", "Among those who fully returned, the median time to full return to work was 16.0 weeks (IQR 14.0-16.0 weeks).", "There was an 85% probability of having returned to work within the first 26 weeks after surgery.", "Separately from full return, 23 patients (9.0%) had moved to a less physically demanding role, 30 patients (11.7%) stayed in their original role but with modified tasks, 17 patients (6.6%) took a different job with similar physical demands, and 9 patients (3.4%) had a work status that could not be classified — the paper does not give a median time for these partial/modified returns.", "Before surgery, leg pain (VAS, 0-100mm) was a median of 75.0 (IQR 55.4-87.1).", "Before surgery, back pain (VAS, 0-100mm) was a median of 49.8 (IQR 20.0-74.0).", "Before surgery, disability (Roland Disability Questionnaire, 0-24) was a median of 17.0 (IQR 14.0-20.0).", "People with a higher education level returned to work faster: adjusted hazard ratio 2.01 (95% CI 1.37-2.95, p<0.001), after adjusting for age, sex and leg pain.", "Self-employed people returned to work faster: adjusted hazard ratio 1.73 (95% CI 1.08-2.78, p=0.01).", "People without predominantly physical jobs returned to work faster: adjusted hazard ratio 1.49 (95% CI 1.49-2.81, p=0.01) — the paper prints the lower confidence bound as equal to the hazard ratio itself; copied as printed.", "People with a high preoperative disability score (RDQ) returned to work more slowly: adjusted hazard ratio 0.50 (95% CI 0.35-0.71, p<0.001)." ], "notMeasured": [ "Pain (VAS) or disability (RDQ) scores at any postoperative timepoint — only preoperative baseline values are reported.", "Surgical complication rates — not reported; the paper only notes postoperative imaging was not routine.", "Driving, sleep, or return to sport — not mentioned anywhere in the paper.", "A median or range specifically for time to partial/modified return to work (only full-return timing is given a median)." ], "access": "full_text", "lastChecked": "2026-08-09" } ] }, { "procedure": "Total shoulder replacement", "timelineName": "Shoulder replacement recovery", "bodyRegion": "shoulder", "url": "https://growsteady.me/shoulder-replacement-recovery-timeline", "confidence": "high", "lastReviewed": "2026-06-08", "painPoints": [ { "week": 0, "low": 4, "typical": 6, "high": 7.6, "converted": true, "scaleNote": "VAS 0-100 -> 0-10; pre-op baseline median 60 (IQR 40-76), n=755 (77% reverse, 23% anatomic)", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10871746/" }, { "week": 2, "low": 1, "typical": 2, "high": 4.1, "converted": true, "scaleNote": "VAS 0-100 -> 0-10; 2-week median 20 (IQR 10-41), n=755", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10871746/" }, { "week": 6, "low": 0, "typical": 1.1, "high": 3, "converted": true, "scaleNote": "VAS 0-100 -> 0-10; 6-week median 11 (IQR 0-30), n=755", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10871746/" }, { "week": 13, "low": 0, "typical": 1, "high": 2.6, "converted": true, "scaleNote": "VAS 0-100 -> 0-10; 3-month median 10 (IQR 0-22); corroborated by cohort 1.8 anatomic / 2.6 reverse", "basis": "measured", "bandBasis": "estimated", "bandNote": "The paper's own printed IQR at 3 months is 0 to 2.2, not 0 to 2.6 shown here. The anatomic/reverse subgroup numbers this was built from do not appear anywhere in the paper.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10871746/" }, { "week": 52, "low": 0, "typical": 0, "high": 1.2, "converted": true, "scaleNote": "VAS 0-100 -> 0-10; 1-year median 0 (IQR 0-10); cohort 12mo 1.2 anatomic / 1.5 reverse for high end", "basis": "measured", "bandBasis": "estimated", "bandNote": "The paper's own printed IQR at 12 months is 0 to 1.0, not 0 to 1.2 shown here. The anatomic/reverse subgroup numbers this was built from do not appear anywhere in the paper.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10871746/" } ], "milestones": [ { "milestone": "Sling worn continuously (elbow/wrist/hand movement allowed)", "typicalWeek": 0, "range": "First 4-6 weeks; up to 6+ weeks for reverse TSA or with a tendon transfer / subscapularis repair", "advisory": true, "source": "https://www.brighamandwomens.org/assets/bwh/patients-and-families/rehabilitation-services/pdfs/shoulder-reverse-total-shoulder-arthroplasty-protocol.pdf" }, { "milestone": "Active-assisted range of motion / sling weaning starts", "typicalWeek": 5, "range": "About 4-6 weeks; sling weaned during the day over ~2 weeks", "advisory": true, "source": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-total-shoulder-arthroplasty-and-hemi.pdf" }, { "milestone": "Sling discontinued / sleep without sling", "typicalWeek": 6, "range": "About 6 weeks; reverse TSA may extend with poor tissue quality or tendon transfer", "advisory": true, "source": "https://www.summitortho.com/wp-content/uploads/2022/08/6573_SURGICAL-Reverse-Total-Shoulder-Replacement-Protocol_6.22_MB.pdf" }, { "milestone": "Return to light activity / household & light work", "typicalWeek": 9, "range": "About 9-12 weeks; no lifting heavier than ~10 lb until strengthening; manual labor much later", "advisory": true, "source": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-total-shoulder-arthroplasty-and-hemi.pdf" }, { "milestone": "Strengthening / overhead reach phase begins", "typicalWeek": 12, "range": "Around 12 weeks; full ROM and strengthening expected by week 12", "advisory": true, "source": "https://www.brighamandwomens.org/assets/bwh/patients-and-families/rehabilitation-services/pdfs/shoulder-reverse-total-shoulder-arthroplasty-protocol.pdf" }, { "milestone": "Return to recreational activity / sport (physician-cleared)", "typicalWeek": 26, "range": "About 4-6+ months, individualized; full recovery generally 9-12 months", "advisory": true, "source": "https://www.summitortho.com/wp-content/uploads/2022/08/6573_SURGICAL-Reverse-Total-Shoulder-Replacement-Protocol_6.22_MB.pdf" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10871746/", "title": "Variations in 1-year trajectories of pain and capability after shoulder arthroplasty (n=755)", "tier": "registry study / retrospective cohort", "declared": true, "backsPainPoints": 5, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-total-shoulder-arthroplasty-and-hemi.pdf", "title": "MGH rehabilitation protocol for total shoulder arthroplasty and hemiarthroplasty", "tier": "clinical protocol", "declared": true, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 2 }, { "url": "https://www.brighamandwomens.org/assets/bwh/patients-and-families/rehabilitation-services/pdfs/shoulder-reverse-total-shoulder-arthroplasty-protocol.pdf", "title": "brighamandwomens.org", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 1 }, { "url": "https://www.summitortho.com/wp-content/uploads/2022/08/6573_SURGICAL-Reverse-Total-Shoulder-Replacement-Protocol_6.22_MB.pdf", "title": "summitortho.com", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11965055/", "title": "PMC11965055", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/40769237/", "title": "PMID 40769237", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11276123/", "title": "Trajectory of recovery after the Big 3 shoulder surgeries (anatomic vs reverse VAS 3/6/12mo)", "tier": "prospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 0 } ], "sources": [ { "title": "Variations in 1-year trajectories of pain and capability after shoulder arthroplasty (n=755)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10871746/", "tier": "registry study / retrospective cohort", "reliabilityScore": 7.5 }, { "title": "Trajectory of recovery after the Big 3 shoulder surgeries (anatomic vs reverse VAS 3/6/12mo)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11276123/", "tier": "prospective cohort", "reliabilityScore": 7.5 }, { "title": "MGH rehabilitation protocol for total shoulder arthroplasty and hemiarthroplasty", "url": "https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-total-shoulder-arthroplasty-and-hemi.pdf", "tier": "clinical protocol", "reliabilityScore": 7 } ], "studies": [] }, { "procedure": "Shoulder labral / Bankart repair", "timelineName": "Shoulder labral repair recovery", "bodyRegion": "shoulder", "url": "https://growsteady.me/shoulder-labral-repair-recovery-timeline", "confidence": "medium", "lastReviewed": "2026-06-08", "painPoints": [ { "week": 0, "low": 3.1, "typical": 5.6, "high": 8, "converted": false, "scaleNote": "VAS 0-10; 24h post-op, arthroscopic Bankart RCT (high = mean+SD, block wear-off rebound)", "basis": "derived", "derivation": "The trial reports its two pain-control groups separately, 5.8 and 5.4. Their midpoint is 5.6.", "bandBasis": "estimated", "bandNote": "The paper reports no range for pain at this point. This band is built from an SD-based estimate averaged across two drug-regimen arms that scored statistically identically (p=.47).", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7879172/" }, { "week": 0.6, "low": 1.7, "typical": 3.9, "high": 6.2, "converted": false, "scaleNote": "VAS 0-10; ~day 4 post-op, arthroscopic Bankart RCT", "basis": "derived", "derivation": "The trial reports its two pain-control groups separately, 4.0 and 3.8. Their midpoint is 3.9.", "bandBasis": "estimated", "bandNote": "The paper reports no range for pain at this point. This band is built from an SD-based estimate averaged across two drug-regimen arms that scored statistically identically.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7879172/" }, { "week": 1, "low": 1, "typical": 2.7, "high": 4.5, "converted": false, "scaleNote": "VAS 0-10; 1 week post-op, arthroscopic Bankart RCT", "basis": "measured", "bandBasis": "estimated", "bandNote": "The paper reports no range for pain at this point — only mean and SD, with both treatment arms scoring identically. This band is an SD-based estimate, not a printed range.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7879172/" } ], "milestones": [ { "milestone": "Return to light / sedentary (desk) work", "typicalWeek": 2.5, "range": "Office workers around 2.5 weeks (range 1-17); often once off narcotic pain medication", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10532194/" }, { "milestone": "Sling discontinued", "typicalWeek": 4.8, "range": "Mean 4.8 weeks across 30 protocols; many use 6 weeks", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5958453/" }, { "milestone": "External-rotation restriction phase ends (full passive ER)", "typicalWeek": 9.1, "range": "Guarded ER from ~3.6 weeks; full passive ER by ~9 weeks; no forced ER for ~3 months", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5958453/" }, { "milestone": "Return to physical / heavy-labor work", "typicalWeek": 12, "range": "Median 12 weeks for physical jobs (range 4-20); overall RTW median 7 weeks", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10532194/" }, { "milestone": "Full active range of motion / overhead reaching restored", "typicalWeek": 12.2, "range": "Full active ROM by ~12 weeks; full passive ROM ~9 weeks", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5958453/" }, { "milestone": "Return to contact / overhead sport", "typicalWeek": 32, "range": "Return to sport mean ~32 weeks (~7.5 months); return to competitive play ~39 weeks; criteria-based, contact later", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5958453/" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5958453/", "title": "Physical therapy protocols for arthroscopic Bankart repair (30 protocols)", "tier": "protocol review", "declared": true, "backsPainPoints": 0, "backsMilestones": 4, "backsCards": 4 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7879172/", "title": "NSAIDs vs opioids after arthroscopic Bankart repair: RCT (n=80, VAS trajectory)", "tier": "RCT", "declared": true, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10532194/", "title": "Return to work after arthroscopic Bankart repair (prospective cohort)", "tier": "prospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/35665856/", "title": "Postoperative recovery comparisons of arthroscopic Bankart to open Latarjet for the treatment of anterior glenohumeral instability", "tier": "retrospective cohort", "declared": false, "backsPainPoints": 2, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9872416/", "title": "Return to sports after arthroscopic Bankart repair in teenage athletes: a retrospective cohort study", "tier": "retrospective cohort", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 } ], "sources": [ { "title": "NSAIDs vs opioids after arthroscopic Bankart repair: RCT (n=80, VAS trajectory)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7879172/", "tier": "RCT", "reliabilityScore": 7 }, { "title": "Physical therapy protocols for arthroscopic Bankart repair (30 protocols)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5958453/", "tier": "protocol review", "reliabilityScore": 7.5 }, { "title": "Return to work after arthroscopic Bankart repair (prospective cohort)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10532194/", "tier": "prospective cohort", "reliabilityScore": 7 } ], "studies": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7879172/", "identifier": "PMC7879172", "title": "Opioid Use Is Reduced in Patients Treated with NSAIDs After Arthroscopic Bankart Repair: A Randomized Controlled Study", "design": "randomized trial", "participants": "n=80 (40 NSAID+opioid / 40 opioid-only)", "technique": "arthroscopic shoulder capsulolabral (Bankart) repair for recurrent anterior shoulder instability", "scales": [ { "name": "VAS pain", "range": "0-10", "direction": "higher_worse" }, { "name": "patient satisfaction", "range": "1-10", "direction": "higher_better" } ], "timepoints": "24 h, 96 h, 1 wk", "followUp": "1 week", "findings": [ "This trial randomized 80 patients recovering from arthroscopic Bankart (shoulder labral) repair into two groups: 40 got ibuprofen 600 mg plus a small supply of oxycodone/acetaminophen for breakthrough pain, and 40 got oxycodone/acetaminophen alone.", "24 hours after surgery, pain averaged 5.8 out of 10 (SD 2.3) in the ibuprofen-plus-opioid group and 5.4 out of 10 (SD 2.8) in the opioid-only group — the paper found this difference not statistically meaningful (p=.47).", "By 96 hours (about day 4), pain had eased to 4.0 out of 10 (SD 2.3) in the ibuprofen group and 3.8 out of 10 (SD 2.3) in the opioid-only group (p=.72).", "At 1 week, pain was 2.7 out of 10 in both groups (SD 1.7 ibuprofen group, SD 1.9 opioid-only group; p=1.00).", "Over the full week, the opioid-only group took more opioid pills on average: 11.7 tablets (SD 10.8) versus 7.9 tablets (SD 6.9) in the group that also had ibuprofen (p=.05).", "The ibuprofen group also took more NSAID tablets overall, 15.4 (SD 10.4) versus 7.8 (SD 11.8) in the opioid-only group (p=.001) — because 20 of the 40 opioid-only patients (50%) chose to buy their own over-the-counter NSAID anyway, mainly to cut back on narcotics.", "Side effects (nausea, vomiting, or constipation) in the week after surgery hit 35% of the opioid-only group versus 17.5% of the ibuprofen-plus-opioid group.", "Satisfaction with pain control at 1 week was high in both groups and not significantly different: 9.0 out of 10 with ibuprofen added (SD 1.0), 8.6 out of 10 with opioid alone (SD 1.8, p=.26).", "No patient in either group asked for a refill of pain medication, and no patients dropped out of the study." ], "notMeasured": [ "Pain or medication use beyond 1 week post-op.", "Return to work.", "Return to sport.", "Driving.", "Sleep.", "Range of motion or any shoulder function score (e.g. ASES, SANE).", "Recurrence of instability or other longer-term surgical outcomes." ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5958453/", "identifier": "PMC5958453", "title": "Physical Therapy Protocols for Arthroscopic Bankart Repair", "design": "protocol review", "participants": "n=30 published rehab protocols from 27 ACGME-accredited orthopaedic surgery programs (16.4% of 164 eligible programs) - no patient cohort, this paper reviews written protocols, not patient outcomes", "technique": "arthroscopic Bankart repair; open Bankart repair protocols were excluded from the review", "timepoints": "0 to 39+ weeks post-op (protocol-recommended milestones, from sling removal through return to game competition)", "findings": [ "Across the 30 protocols, the sling was worn for an average of 4.8 weeks (range not given by the paper as a whole distribution, only mean ± 1.8 weeks). 24 of 30 protocols (80%) recommended a sling alone, and 9 of 30 (30%) also called for a period of no arm movement at all, averaging 2.8 weeks (± 1.6).", "Guided passive external rotation to about 20-30 degrees typically began at 3.6 weeks (± 1.6). Full passive external rotation was targeted by a mean of 9.1 weeks (± 2.6) in the paper's results text - though the same paper's abstract and summary table list this same milestone as 9.2 weeks (± 2.8), an inconsistency within the paper itself.", "Full passive range of motion in all directions was targeted by a mean of 9.2 weeks (± 2.8).", "Active-motion exercises typically started at 5.4 weeks (± 1.8), with full active range of motion targeted by a mean of 12.2 weeks (± 2.8).", "Non-overhead sport-specific activity was recommended starting at a mean of 15 weeks (± 4.2). A throwing progression (where specified) started around 19.3 weeks.", "Only 10 of 30 protocols (33.3%) gave any timeline for return to sport at all; among those, the mean was 32.4 weeks (± 9.3). Only 3 of 30 (10%) gave an estimate for return to full game competition; among those, the mean was 39.3 weeks (± 7.6).", "Strength milestones varied widely across protocols: resistance-band work at a mean of 5.6 weeks (± 2.1), push-ups at 11.1 weeks (± 2.2), and bench press at a mean of 18 weeks (± 8.5).", "The paper's overall conclusion: rehab protocols after arthroscopic Bankart repair were 'highly variable,' including when compared against a published consensus protocol (the ASSET guideline)." ], "notMeasured": [ "No pain scores of any kind - this paper never tracks patients, it only reviews written protocol documents.", "No actual patient recovery outcomes - every figure above is what a protocol targets or recommends, not what real patients achieved.", "No data on repair failure, re-tear, or surgical success/complication rates.", "Driving and sleep are not addressed anywhere in the paper.", "Return to work (non-sport) is not addressed.", "No comparison of return-to-sport timing by contact vs. non-contact or overhead vs. non-overhead athletes - the paper notes only that one of the 30 protocols was written specifically for throwers." ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://pubmed.ncbi.nlm.nih.gov/35665856/", "identifier": "PMID 35665856", "title": "Postoperative recovery comparisons of arthroscopic Bankart to open Latarjet for the treatment of anterior glenohumeral instability", "design": "retrospective cohort", "participants": "n=787 primary arthroscopic Bankart / n=36 revision arthroscopic Bankart / n=75 open Latarjet", "technique": "Primary arthroscopic Bankart repair and revision arthroscopic Bankart repair, compared against open Latarjet reconstruction, for recurrent anterior glenohumeral (shoulder) instability", "scales": [ { "name": "VAS (pain)", "range": "0-10", "direction": "higher_worse" }, { "name": "ASES (American Shoulder and Elbow Surgeons score)", "range": "0-100", "direction": "higher_better" }, { "name": "SANE (Single Assessment Numeric Evaluation)", "range": "0-100", "direction": "higher_better" }, { "name": "VR-12 (Veterans RAND 12-item health survey)", "range": "not stated in the visible abstract", "direction": "higher_better" } ], "timepoints": "6 wk, 3 mo, 1 yr, 2 yr", "followUp": "up to 2 years postoperative (mean follow-up not stated in the abstract)", "findings": [ "This study used a multicenter registry to compare recovery after three shoulder-instability surgeries: primary arthroscopic Bankart repair (787 people), revision arthroscopic Bankart repair done because a first repair had failed (36 people), and open Latarjet surgery (75 people).", "People who had open Latarjet surgery reported significantly less pain (VAS) than people who had a first-time arthroscopic Bankart repair, at 6 weeks (p=0.03), 3 months (p=0.01), and 2 years (p<0.05) after surgery. The abstract states these differences were statistically significant but does not print the actual pain scores at these timepoints.", "Looking at the first two years overall, primary arthroscopic Bankart repair and open Latarjet gave nearly equal improvements in pain (VAS) and shoulder function (ASES, SANE, VR-12 scores).", "People who needed a revision (second) arthroscopic Bankart repair had worse outcomes at 1 and 2 years after surgery than people having their first Bankart repair." ], "notVisible": [ "The actual VAS pain values (means/SDs) for each group at 6 weeks, 3 months, 1 year, and 2 years — the abstract gives only the statistical comparison (p-values) between primary Bankart and Latarjet, not the numbers themselves.", "The actual ASES, SANE, and VR-12 scores at each timepoint.", "Patient demographics (age, sex, sport/activity level).", "Surgical technique details (anchor count/type, graft fixation for Latarjet, rehab protocol).", "Complication and re-revision/redislocation rates.", "Statistical methods, tables, and figures.", "Discussion and limitations sections." ], "access": "abstract_only", "lastChecked": "2026-08-10" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9872416/", "identifier": "PMC9872416", "title": "Return to sports after arthroscopic Bankart repair in teenage athletes: a retrospective cohort study", "design": "retrospective cohort", "participants": "n=50 (35 male / 15 female); mean age 16.8 ± 1.7 yr (range 13–19); 17 contact athletes / 22 dominant-hand overhead athletes / 11 noncontact-nonoverhead athletes", "technique": "Arthroscopic Bankart repair (ABR) with suture anchors, 4–7 anchors per patient (mean 5.9 ± 0.7); double-row technique for large bony Bankart lesions; concomitant bony Bankart repair in 15, SLAP repair in 12, HAGL repair in 6", "scales": [ { "name": "Rowe score", "range": "0-100", "direction": "higher_better" }, { "name": "Japan Shoulder Society Shoulder Instability Score (JSS-SIS)", "range": "0-100", "direction": "higher_better" }, { "name": "JSS Shoulder Sports Score (JSS-SSS)", "range": "0-100", "direction": "higher_better" }, { "name": "Oxford Shoulder Instability Score (OSIS)", "range": "0-48", "direction": "higher_better" }, { "name": "American Shoulder and Elbow Surgeons score (ASES)", "range": "0-100", "direction": "higher_better" }, { "name": "Athletic Shoulder Outcome Scoring System (ASOSS)", "range": "0-90", "direction": "higher_better" } ], "timepoints": "preop, final follow-up (in-person exam for range of motion; telephone survey for subjective scores) — single follow-up assessment, not serial", "followUp": "mean 44.5 ± 19.6 months (range 24–85 months)", "findings": [ "Rowe instability score rose from 40.7 out of 100 before surgery to 96.6 out of 100 at final follow-up, on average, across 50 patients.", "The Japan Shoulder Society Shoulder Instability Score rose from 56.3 to 96.7 out of 100.", "The Japan Shoulder Society Shoulder Sports Score rose from 50.0 to 93.7 out of 100.", "47 of 50 patients (94%) reached the minimum clinically important improvement on these scores.", "At final follow-up the Oxford Shoulder Instability Score averaged 47.5 out of 48, the ASES score averaged 99.4 out of 100, and the ASOSS score averaged 86.4 out of 90.", "2 of 50 patients (4.0%) had a repeat dislocation or subluxation after surgery — 1 contact athlete and 1 noncontact-nonoverhead athlete.", "All 50 patients (100%) returned to sport in some form.", "38 of 50 patients (76%) returned to sport at the same level or higher than before their injury, with no shoulder complaints.", "2 patients could only return to practice, not competition.", "Average time to return to play was 6.6 months (SD 2.7, range 3–18 months).", "Average time to return to competition was 9.3 months (SD 4.0, range 6–24 months).", "Average time to a complete return to pre-injury level was 10.6 months (SD 4.3, range 8–24 months).", "Complete return rate differed by sport type: 82.3% of contact athletes (14 of 17), 59.1% of dominant-hand overhead athletes (13 of 22), and 100% of noncontact-nonoverhead athletes (11 of 11) — a statistically significant difference (p=0.026).", "Time to complete return also differed by sport type: 8.3 months for contact athletes, 13.0 months for overhead athletes, 10.8 months for noncontact athletes (p=0.021).", "Among patients who did not fully return, the reasons given were: instability complaints (2), anxiety about full ability (2), slight pain (2), motion restriction (2), and indefinite/vague complaints (4)." ], "notMeasured": [ "No numeric pain scale (e.g. VAS or NRS out of 10) is reported anywhere in the paper.", "No week-by-week or serial outcome data — only a single preop measurement and a single final follow-up measurement (mean 44.5 months later).", "No return-to-work, return-to-school, return-to-driving, or sleep-quality data of any kind.", "No comparison to non-surgical (conservative) treatment or to other surgical techniques (open Bankart, Latarjet)." ], "access": "full_text", "lastChecked": "2026-08-10" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10532194/", "identifier": "PMC10532194", "title": "Time of Return to Work (RTW) May Not Correlate with Patient-Reported Outcomes Measurements (PROM) at Minimum One Year Post Arthroscopic Bankart Repair", "design": "retrospective cohort", "participants": "n=17 (9 office workers / 7 physical workers) of 31 identified in the hospital database, 17 reachable by phone; 4 female, 13 male; mean age 30 (range 17-57)", "technique": "Arthroscopic Bankart repair, by a fellowship-trained shoulder surgeon (open Bankart and bony procedures such as Latarjet were excluded)", "scales": [ { "name": "SANE (Single Assessment Numeric Evaluation)", "range": "0-100", "direction": "higher_better" }, { "name": "GRoC (Global Rating of Change)", "range": "-7 to +7", "direction": "higher_better" }, { "name": "SST (Simple Shoulder Test)", "range": "0-12", "direction": "higher_better" } ], "timepoints": "single retrospective survey at minimum 12 months post-op; RTW and return-to-activity times were patient-recalled at that survey", "followUp": "12 to 49 months (range on day of survey; no mean given)", "findings": [ "31 patients who had an arthroscopic Bankart repair were identified in the hospital's database; 17 could be reached by phone at least 12 months later (follow-up ranged from 12 to 49 months) and answered a survey about their recovery.", "16 of the 17 patients (94%) had returned to work by the time of the survey.", "Across all 17 patients, the median time to return to work was 7 weeks (range 1 to 20 weeks).", "The 9 office workers returned to work in a median of 2.5 weeks (range 1 to 17 weeks).", "The 7 physical/manual-labor workers returned to work in a median of 12 weeks (range 4 to 20 weeks). The paper's Results section calls this office-vs-physical gap statistically significant, p = 0.0239.", "Return to physical activity (exercise/sport) took longer than return to work: a median of 5 months overall (range 2 to 12 months) — 4.5 months (range 2-10) for office workers and 5.5 months (range 3-12) for physical workers.", "At final follow-up, shoulder function scored a median SANE (0-100 scale) of 90 (range 80-100).", "Global Rating of Change (GRoC, -7 to +7 scale) was a median of 6 (range 0-7).", "Simple Shoulder Test (SST, 0-12 scale) scored a median of 12 (range 7-12) — every patient answered yes to all 12 items, so this score could not be used to test for a correlation with RTW time.", "How good patients said they felt did not line up with how fast they returned to work: RTW time versus SANE showed r=-0.41 (p=0.1164), and RTW time versus GRoC showed r=-0.16 (p=0.5643) — neither reached statistical significance.", "Office workers and physical workers scored the same on SANE, GRoC and SST — the paper states job type changed how fast people got back to work, not how good they felt about their shoulder." ], "notMeasured": [ "Weekly or repeated pain scores (no VAS/NRS reported anywhere in the paper).", "Complication rates or re-dislocation / recurrent instability rates.", "Range of motion or strength measurements.", "Return to driving.", "Return to sport specifically (only the broader 'return to physical activity' is reported).", "Sleep quality.", "A sample-size or power calculation." ], "access": "full_text", "lastChecked": "2026-08-10" } ] }, { "procedure": "Ankle ligament repair (Broström)", "timelineName": "Ankle ligament surgery recovery", "bodyRegion": "ankle", "url": "https://growsteady.me/ankle-ligament-surgery-recovery-timeline", "confidence": "medium", "lastReviewed": "2026-06-08", "painPoints": [ { "week": 0, "low": 5.9, "typical": 6.5, "high": 7.8, "converted": false, "scaleNote": "VAS 0-10; pre-op baseline pooled across Broström cohorts", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10799830/" }, { "week": 12, "low": 1, "typical": 1.4, "high": 3.1, "converted": false, "scaleNote": "VAS 0-10; 3-month: arthroscopic 1.23 / open 1.45 (n=51); high reflects SD", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10799830/" }, { "week": 26, "low": 0.7, "typical": 1.1, "high": 1.8, "converted": false, "scaleNote": "VAS 0-10; 6-month: arthroscopic 1.03 / open 1.23 (n=51)", "basis": "derived", "derivation": "The paper reports the two operations separately, 1.03 and 1.23. Their midpoint is 1.1.", "bandBasis": "comparison", "bandNote": "The low edge is close to the arthroscopic-repair group's mean minus one SD; the high edge is close to the open-repair group's mean plus one SD — one edge from each operation, not the spread within either group. The typical value is an average of both groups that the paper never prints.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10799830/" }, { "week": 52, "low": 0.7, "typical": 1, "high": 1.4, "converted": false, "scaleNote": "VAS 0-10; 12-month: arthroscopic 1.01 +/- 0.28 / open 1.04 +/- 0.37 (n=51); high ~ open-repair mean + 1 SD", "basis": "derived", "derivation": "The paper reports the two operations separately, 1.01 and 1.04. Their midpoint is 1.", "bandBasis": "comparison", "bandNote": "The high edge is close to the open-repair group's mean plus one SD; the typical value is an average of both surgical groups, not a printed pooled figure — the operations are being compared, not natural spread among people who had the same surgery.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10799830/" } ], "milestones": [ { "milestone": "Immobilization / non-weight-bearing in splint", "typicalWeek": 1, "range": "0-2 weeks; splint in slight dorsiflexion/eversion, NWB with crutches", "advisory": true, "source": "https://www.massgeneral.org/assets/MGH/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-brostrom-repair.pdf" }, { "milestone": "Protected weight-bearing in walking boot", "typicalWeek": 4, "range": "About 2-6 weeks, weight-bearing as tolerated in a CAM boot (accelerated protocols sooner)", "advisory": true, "source": "https://www.massgeneral.org/assets/MGH/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-brostrom-repair.pdf" }, { "milestone": "Out of boot into shoe with brace / return to normal walking", "typicalWeek": 7, "range": "About 6-8 weeks; mean time to normal activity ~8 weeks", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8298351/" }, { "milestone": "Return to running", "typicalWeek": 12, "range": "About 10-12 weeks, criteria-based (gait normalized, strength/hop symmetry)", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10356182/" }, { "milestone": "Return to sport", "typicalWeek": 20, "range": "Sport training ~3-4 months; unrestricted ~5-6 months (accelerated protocols as early as 8 weeks)", "advisory": true, "source": "https://www.massgeneral.org/assets/MGH/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-brostrom-repair.pdf" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10799830/", "title": "Modified Broström procedure, open vs arthroscopic: VAS at preop/3/6/12 months (n=51)", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 6, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://www.massgeneral.org/assets/MGH/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-brostrom-repair.pdf", "title": "MGH rehabilitation protocol for Broström lateral ankle ligament repair", "tier": "clinical protocol", "declared": true, "backsPainPoints": 0, "backsMilestones": 3, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8298351/", "title": "All-inside arthroscopic modified Broström-Gould: 2-year outcomes + rehab protocol", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 1, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10356182/", "title": "PMC10356182", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/30838117/", "title": "PMID 30838117", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 } ], "sources": [ { "title": "Modified Broström procedure, open vs arthroscopic: VAS at preop/3/6/12 months (n=51)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10799830/", "tier": "retrospective cohort", "reliabilityScore": 7 }, { "title": "All-inside arthroscopic modified Broström-Gould: 2-year outcomes + rehab protocol", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8298351/", "tier": "retrospective cohort", "reliabilityScore": 7.5 }, { "title": "MGH rehabilitation protocol for Broström lateral ankle ligament repair", "url": "https://www.massgeneral.org/assets/MGH/pdf/orthopaedics/sports-medicine/physical-therapy/rehabilitation-protocol-for-brostrom-repair.pdf", "tier": "clinical protocol", "reliabilityScore": 7.5 } ], "studies": [] }, { "procedure": "Achilles tendon repair", "timelineName": "Achilles surgery recovery", "bodyRegion": "achilles", "url": "https://growsteady.me/achilles-surgery-recovery-timeline", "confidence": "high", "lastReviewed": "2026-06-08", "painPoints": [ { "week": 0, "low": 2.4, "typical": 4.1, "high": 4.8, "converted": false, "scaleNote": "VAS 0-10; immediate post-op (low = minimally-invasive arms, typical/high = open repair)", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is a minimally-invasive-surgery group's mean pain; the typical and high edges are from open-repair groups — different operations, not spread among people who had the same surgery.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12255024/" }, { "week": 1, "low": 0.7, "typical": 2, "high": 3, "converted": false, "scaleNote": "VAS 0-10; week 1 across open vs MIS and immobilization sub-groups", "basis": "derived", "derivation": "The paper reports its open-repair groups separately. This is their average.", "bandBasis": "comparison", "bandNote": "The low edge is one minimally-invasive-surgery arm's mean; the high edge is one open-repair arm's mean — different operations and immobilization lengths, not variation among the same patients.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12255024/" }, { "week": 2, "low": 0.3, "typical": 0.9, "high": 1.8, "converted": false, "scaleNote": "VAS 0-10; week-2 group means span 0.3 (favourable MIS arm) to 1.8 (open repair) across the open-vs-MIS and immobilization sub-groups", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is a minimally-invasive arm's mean; the high edge is an open-repair arm's mean; the typical is a third arm's mean — different operations and immobilization protocols, not the spread among people who had the same surgery.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12255024/" }, { "week": 4, "low": 0.8, "typical": 1.9, "high": 2.6, "converted": false, "scaleNote": "VAS 0-10; week-4 immobilization cohort bracketed against percutaneous 1-month 2.63", "basis": "measured", "bandBasis": "estimated", "bandNote": "The high edge is not from this paper — it's a different paper's percutaneous-repair result, imported to fill in a ceiling this paper's own patients don't establish. The low edge is this cohort's least-immobilized arm.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11337624/" }, { "week": 6, "low": 0.2, "typical": 0.4, "high": 1, "converted": false, "scaleNote": "VAS 0-10; week-6 immobilization cohort means 0.2-0.4", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11337624/" }, { "week": 8, "low": 0, "typical": 0.1, "high": 0.2, "converted": false, "scaleNote": "VAS 0-10; week-8 immobilization cohort means 0-0.2", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low and high edges are different casting-duration groups' mean pain (from no immobilization up to 6 weeks of immobilization) — not variation among patients who had identical care.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11337624/" }, { "week": 13, "low": 0.6, "typical": 1.8, "high": 3, "converted": false, "scaleNote": "VAS 0-10; percutaneous 3-month 1.79 (residual-load uptick as activity resumes)", "basis": "measured", "bandBasis": "printed", "source": "https://pubmed.ncbi.nlm.nih.gov/35809780/" }, { "week": 26, "low": 0, "typical": 0.7, "high": 1.8, "converted": false, "scaleNote": "VAS 0-10; percutaneous 6-month 0.69", "basis": "measured", "bandBasis": "printed", "source": "https://pubmed.ncbi.nlm.nih.gov/35809780/" }, { "week": 52, "low": 0, "typical": 0.1, "high": 0.5, "converted": false, "scaleNote": "VAS 0-10; percutaneous 12-month 0.08; ATRS 94/100", "basis": "measured", "bandBasis": "printed", "source": "https://pubmed.ncbi.nlm.nih.gov/35809780/" } ], "milestones": [ { "milestone": "Weight-bearing in boot with heel wedges", "typicalWeek": 0, "range": "Day 0-2 weeks; immediate partial-to-full weight-bearing in a CAM boot under accelerated protocols", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11379499/" }, { "milestone": "Full weight-bearing in boot", "typicalWeek": 5, "range": "About 4-6 weeks in a CAM boot, protocol-dependent", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11379499/" }, { "milestone": "Return to work", "typicalWeek": 8, "range": "Desk ~2-4 weeks (from the boot); on-feet ~8 weeks; manual labour ~12-16 weeks", "advisory": true, "source": "https://www.cuh.nhs.uk/patient-information/achilles-tendon-rupture-management-and-rehabilitation/" }, { "milestone": "Out of boot into supportive shoe with heel lift", "typicalWeek": 9, "range": "About 8-9 weeks; some accelerated MIS protocols at ~6 weeks", "advisory": true, "source": "https://www.cuh.nhs.uk/patient-information/achilles-tendon-rupture-management-and-rehabilitation/" }, { "milestone": "Return to normal walking (out of boot, no limp)", "typicalWeek": 13, "range": "About 11-16 weeks in supportive footwear", "advisory": true, "source": "https://www.cuh.nhs.uk/patient-information/achilles-tendon-rupture-management-and-rehabilitation/" }, { "milestone": "Return to running / sport", "typicalWeek": 26, "range": "Running ~12-16 weeks; criteria-based return to sport at a pooled mean ~6 months (RTS rate ~80%)", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5136353/" } ], "citedPapers": [ { "url": "https://www.cuh.nhs.uk/patient-information/achilles-tendon-rupture-management-and-rehabilitation/", "title": "cuh.nhs.uk", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 3, "backsCards": 3 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/35809780/", "title": "PMID 35809780", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11379499/", "title": "PMC11379499", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11337624/", "title": "Immobilisation duration after open Achilles repair (prospective cohort, n=1088)", "tier": "prospective cohort", "declared": true, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12255024/", "title": "Open vs minimally invasive Achilles repair, stratified by immobilization duration", "tier": "prospective cohort", "declared": true, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5136353/", "title": "Return to play after Achilles rupture: systematic review and meta-analysis (108 studies)", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 } ], "sources": [ { "title": "Open vs minimally invasive Achilles repair, stratified by immobilization duration", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12255024/", "tier": "prospective cohort", "reliabilityScore": 8 }, { "title": "Immobilisation duration after open Achilles repair (prospective cohort, n=1088)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11337624/", "tier": "prospective cohort", "reliabilityScore": 8 }, { "title": "Return to play after Achilles rupture: systematic review and meta-analysis (108 studies)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5136353/", "tier": "meta-analysis", "reliabilityScore": 8.5 } ], "studies": [] }, { "procedure": "Periacetabular osteotomy (PAO)", "timelineName": "PAO recovery", "bodyRegion": "hip", "url": "https://growsteady.me/pao-recovery-timeline", "confidence": "medium", "lastReviewed": "2026-06-11", "painPoints": [ { "week": 0, "low": 4, "typical": 5.9, "high": 7.8, "converted": false, "scaleNote": "NRS 0-10 POD1 5.9 +/- 1.9 (mobile-messaging diary, n=29); band ~ mean +/- 1 SD", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7742655/" }, { "week": 1, "low": 2, "typical": 4.7, "high": 7.4, "converted": false, "scaleNote": "NRS 0-10; POD7 4.7 +/- 2.7 (same diary cohort)", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7742655/" }, { "week": 2, "low": 0.8, "typical": 4.1, "high": 7.4, "converted": false, "scaleNote": "NRS 0-10; POD14 4.1 +/- 3.3", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7742655/" }, { "week": 3, "low": 0, "typical": 2, "high": 4.6, "converted": false, "scaleNote": "NRS 0-10; days 20-21 2.0 +/- 2.6 — plateau begins", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7742655/" }, { "week": 6, "low": 0, "typical": 2.9, "high": 6.5, "converted": false, "scaleNote": "NRS 0-10; days 27-42 fluctuate 2.6-3.0 (band from +/- 1 SD)", "basis": "measured", "bandBasis": "estimated", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7742655/" }, { "week": 26, "low": 1.4, "typical": 2.1, "high": 4.1, "converted": true, "scaleNote": "VAS 0-100 -> 0-10: rest 14 / activity 41 at 6mo (Aarhus pain cohort n=299); typical = HOOS-Pain 79 inverted (100-HOOS)/10 — burden proxy, not momentary intensity", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is pain at rest; the high edge is pain during activity — the same patients measured two different ways, six months after surgery, not two different people.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6206701/" }, { "week": 104, "low": 1.4, "typical": 1.6, "high": 4.1, "converted": true, "scaleNote": "VAS rest 14/100, activity 41/100 unchanged at 24mo (Aarhus); typical = ANCHOR HOOS-Pain 84.3 inverted (n=391, mean f/u 2.6yr)", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is pain at rest and the high edge is pain during activity at 2 years — the same patients measured two different ways, not two different people.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5198872/" } ], "milestones": [ { "milestone": "Protected partial weight-bearing with crutches (~20-25% body weight, foot-flat)", "typicalWeek": 0, "range": "From POD 1 through 6-8 weeks; 6 wk in ~21% of protocols, 8 wk in ~18%, full published span 2-16 wk", "advisory": false, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12573821/" }, { "milestone": "Full weight-bearing established", "typicalWeek": 10, "range": "8-12 weeks, gated by x-ray consolidation; protocol-dependent", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12573821/" }, { "milestone": "Off crutches / normalized gait", "typicalWeek": 11, "range": "Criterion-based during weeks 6-12 (symmetric gait, no Trendelenburg), not a fixed week", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9528724/" }, { "milestone": "Return to driving (brake reaction time normalized)", "typicalWeek": 12, "range": "Most not yet safe at 6 weeks; normalized by 12 weeks (single n=26 study)", "advisory": true, "source": "https://pubmed.ncbi.nlm.nih.gov/33829912/" }, { "milestone": "Return to work", "typicalWeek": 16, "range": "Median 16 weeks, IQR 12-22 (n=242); 38.6% back by 12 wk, 85.7% by 24 wk (occupation split not reported)", "advisory": false, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12226093/" }, { "milestone": "Start running / impact loading", "typicalWeek": 23, "range": "20-26 weeks, gated on normalized hip strength + functional tasks (the >80% abductor ratio is the later return-to-sport gate)", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9528724/" }, { "milestone": "Return to sport", "typicalWeek": 38, "range": "Mean ~8.9-9 months; RTS rate 63-91%; measured shift toward lower-impact sport", "advisory": false, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11272631/" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7742655/", "title": "Daily postoperative pain and opioid use after PAO via automated mobile messaging (Bryan et al. 2020, n=29)", "tier": "prospective cohort", "declared": true, "backsPainPoints": 5, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9528724/", "title": "Rehabilitation guidelines following PAO: North American Delphi consensus (Disantis et al., IJSPT 2022)", "tier": "society guideline", "declared": true, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 4 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6206701/", "title": "Pain reduction up to two years after PAO, rest vs activity (Jakobsen et al., Aarhus, pain cohort n=299)", "tier": "prospective cohort", "declared": true, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12226093/", "title": "Anticipating time taken off work after Bernese PAO (2025, n=242)", "tier": "prospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/33829912/", "title": "Driving reaction time following periacetabular osteotomy", "tier": "prospective cohort", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11272631/", "title": "PAO activity levels and return to sport: systematic review (J Hip Preserv Surg 2024)", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5198872/", "title": "Patient-reported outcomes of PAO: prospective ANCHOR cohort (Clohisy et al., JBJS 2017, n=391)", "tier": "prospective cohort", "declared": true, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12573821/", "title": "Postoperative weight-bearing restrictions and rehabilitation after PAO: systematic review (63 studies)", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 0 } ], "sources": [ { "title": "Postoperative weight-bearing restrictions and rehabilitation after PAO: systematic review (63 studies)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12573821/", "tier": "meta-analysis", "reliabilityScore": 9 }, { "title": "Rehabilitation guidelines following PAO: North American Delphi consensus (Disantis et al., IJSPT 2022)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9528724/", "tier": "society guideline", "reliabilityScore": 9 }, { "title": "Patient-reported outcomes of PAO: prospective ANCHOR cohort (Clohisy et al., JBJS 2017, n=391)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5198872/", "tier": "prospective cohort", "reliabilityScore": 9 }, { "title": "Pain reduction up to two years after PAO, rest vs activity (Jakobsen et al., Aarhus, pain cohort n=299)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6206701/", "tier": "prospective cohort", "reliabilityScore": 8 }, { "title": "Daily postoperative pain and opioid use after PAO via automated mobile messaging (Bryan et al. 2020, n=29)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7742655/", "tier": "prospective cohort", "reliabilityScore": 8 }, { "title": "PAO activity levels and return to sport: systematic review (J Hip Preserv Surg 2024)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11272631/", "tier": "meta-analysis", "reliabilityScore": 8 }, { "title": "Anticipating time taken off work after Bernese PAO (2025, n=242)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12226093/", "tier": "prospective cohort", "reliabilityScore": 8 } ], "studies": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12226093/", "identifier": "PMC12226093", "title": "Anticipating Time Taken off Work After Bernese Periacetabular Osteotomy: A Single-Surgeon Experience of 282 Cases", "design": "retrospective cohort", "participants": "n=242 patients (282 PAO procedures, 40 bilateral); 250 procedures were in patients working before surgery; of those, 189 (75.6%) reported how many weeks they took off", "technique": "Bernese periacetabular osteotomy — bikini-line incision (5-7 cm), ischial, pubic, and iliac cuts, acetabular fragment fixed with 3-4 screws (4.5 mm). Rehab: partial weight-bearing (10-15 kg) for 6 weeks, then protected weight-bearing with crutches for a further 6 weeks", "scales": [ { "name": "EQ-5D VAS (self-rated overall health)", "range": "0-100", "direction": "higher_better" }, { "name": "EQ-5D Index (health-related quality of life)", "range": "0-1", "direction": "higher_better" }, { "name": "UCLA Activity Score", "range": "1-10", "direction": "higher_better" }, { "name": "NAHS (Non-Arthroplasty Hip Score)", "range": "1-100", "direction": "higher_better" }, { "name": "iHOT-12 (International Hip Outcome Tool-12)", "range": "1-100", "direction": "higher_better" }, { "name": "Satisfaction Score", "range": "1-5", "direction": "higher_better" } ], "timepoints": "preop, 6 mo, 1 yr (minimum follow-up)", "followUp": "minimum 1 year; registry data collected 2013-2023", "findings": [ "Among 189 people (of 250 who were working before surgery) who reported how much time they took off, the median time off work after Bernese periacetabular osteotomy was 16 weeks, with the middle half of people away between 12 and 22 weeks.", "Counting everyone including extreme outliers, the average time off work was 19.0 weeks (SD 19.3). Excluding statistical outliers, the average was 16.5 weeks (SD 9.3).", "Time off work ranged from 0 to 208 weeks across the group.", "11.6% (22 of 189) were back to work by 6 weeks.", "38.6% (73 of 189) were back to work by 12 weeks.", "62% (118 of 189) were back to work by 18 weeks.", "85.7% (162 of 189) were back to work by 24 weeks (6 months).", "97.4% (184 of 189) were back to work within 1 year.", "5 people were still off work after 1 year, and 2 of those were still off after 2 years.", "3 people had extended time off work (over a year), linked to delayed bone healing, infection, or ongoing pain at the side of the hip (greater trochanteric pain syndrome).", "A higher BMI was weakly linked to more time off work (r=0.216, p=.012, n=134). Age, smoking status, and gender showed no clear link to time off work.", "Worse hip and quality-of-life scores, both before surgery and at 1 year, were weakly linked to more time off work — for example the 1-year EQ-5D Index (r=-0.250, p=.008) and the 1-year NAHS function score (r=-0.260, p=.006).", "Among 25 people who had both hips operated on and reported timing for both surgeries: 10 took the same time off both times, 6 took less time the second time (7.3 weeks less on average), and 9 took more time the second time (8.1 weeks more on average).", "The authors note that some people reported returning to work at week 0, and suggest these are likely people with non-manual jobs who could work remotely." ], "notMeasured": [ "Occupation or job type — not collected, so the paper could not say whether manual vs. desk jobs changed how long people were off work.", "Driving return timing — not reported.", "Sport return timing — not reported.", "Week-by-week pain or function scores — only preop, 6-month, and 1-year points are given, not a weekly curve." ], "access": "full_text", "lastChecked": "2026-08-09" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7742655/", "identifier": "PMC7742655", "title": "Detailing postoperative pain and opioid utilization after periacetabular osteotomy with automated mobile messaging", "design": "prospective cohort", "participants": "n=29 (32 enrolled; 3 excluded — 2 had their operative plan changed to exclude PAO, 1 gave zero postoperative responses); 25 female / 4 male, mean age 22.4 ± 7.6 years; 21 of 29 also had concurrent hip arthroscopy", "technique": "periacetabular osteotomy (PAO), a procedure that reorients the hip socket; 21 of 29 patients also had hip arthroscopy done at the same time", "scales": [ { "name": "NRS Pain (Numeric Rating Scale for Pain)", "range": "0-10 (0 = no pain, 10 = worst pain imaginable)", "direction": "higher_worse" }, { "name": "Opioid pain-pill use, patient-reported tablets per 24 hours", "range": "0 and up, no fixed ceiling", "direction": "higher_worse" }, { "name": "Percent of prescribed opioid dose actually taken", "range": "0% and up (can exceed 100% if a refill was used)", "direction": "higher_worse" }, { "name": "Morphine milliequivalents (MME) consumed — a standard way to compare different opioid drugs on one scale", "range": "0 and up, no fixed ceiling", "direction": "higher_worse" } ], "timepoints": "preop (at enrollment, before surgery), then day of surgery (POD0) through day 14 daily, then day 15 through day 42 in 2-3 day blocks sent 3x/week (postop weeks 3-6)", "followUp": "6 weeks (42 days) after surgery", "findings": [ "This cohort of 29 people who had a periacetabular osteotomy (PAO) — a hip operation that repositions the socket — reported pain on a 0-10 scale (0 = no pain, 10 = worst pain imaginable) by automated text message daily for the first 2 weeks, then 3 times a week through week 6.", "Day-by-day pain in the first 2 weeks: 6.9/10 the day of surgery (n=8 responses), 5.9/10 on day 1 (n=15), 5.6/10 on day 2 (n=16), 4.4/10 on day 3 (n=14), 4.3/10 on day 4 (n=24), 4.4/10 on day 5 (n=20), 5.0/10 on day 6 (n=22), 4.7/10 on day 7 (n=19), 4.3/10 on day 8 (n=17), 4.1/10 on day 9 (n=24), 4.2/10 on day 10 (n=26), 3.4/10 on day 11 (n=19), 3.9/10 on day 12 (n=23), 3.8/10 on day 13 (n=18), and 4.1/10 on day 14 (n=9).", "From week 3 through week 6, pain averaged 2.9/10 (days 15-17), 3.5/10 (days 18-19), 2.0/10 (days 20-21 — the lowest point recorded in the whole 6 weeks, n=6), 2.5/10 (days 22-24), 2.3/10 (days 25-26), 2.6/10 (days 27-28), 2.5/10 (days 29-31), 2.1/10 (days 32-33), 2.8/10 (days 34-35), 2.5/10 (days 36-38), 2.7/10 (days 39-40), and 3.0/10 on the final block, days 41-42 (n=6).", "Before surgery, people's average pain (converted from a 0-10 visual scale used at enrollment) was 5.7/10 (± 1.9). It took an average of 5.2 days (± 5.8) after surgery for a person's pain to fall back to, or below, that pre-surgery level.", "Opioid pain-pill use (patient-reported tablets per 24 hours) started at 1.0 tablet the day of surgery (n=5), then rose: 5.0 on day 1 (n=10), 6.5 on day 2, 8.7 on day 3, 9.5 on day 4, 7.2 on day 5, 8.9 on day 6, 8.1 on day 7, peaking at 10.1 tablets on day 8 (n=16) — then fell: 6.6 on day 9, 5.5 on day 10, 3.7 on day 11, 5.0 on day 12, 4.5 on day 13, and 2.2 tablets on day 14 (n=8).", "From week 3 on, opioid use kept falling: 2.6 tablets (days 15-17), 2.6 (days 18-19), 2.5 (days 20-21), 1.7 (days 22-24), 1.1 (days 25-26), 0.81 (days 27-28), 0.9 (days 29-31), 1.0 (days 32-33), 0.8 (days 34-35), 0.4 (days 36-38), 0.7 (days 39-40), and 0.0 tablets — none at all — on the final block, days 41-42.", "People used 59.7% (± 44.7%) of their prescribed opioid dose in the first 2 weeks, 24.7% (± 45.0%) in weeks 3-6, and 44.1% (± 42.3%) — under half — over the full 6 weeks.", "People consumed 465.5 morphine milliequivalents (MME) on average over the 6 weeks: 419.3 (± 377.6) in the first 2 weeks and 63.4 (± 87.9) in weeks 3-6.", "At discharge, people were sent home with 77.3 tablets (± 14.7) on average, at a prescribed dose of 11.4 tablets (± 2.4) per 24 hours. 52 opioid prescriptions were written in total across the 29-person cohort.", "People were discharged from hospital 3 to 4 days after surgery on average (mean day 3.45 ± 0.9, range day 2 to day 7).", "People answered the automated text check-ins 84.1% of the time over the full 6 weeks: 79.6% during the first 2 weeks of daily messages, and 90.8% during the 3-times-a-week messages of weeks 3-6." ], "notMeasured": [ "Return to work.", "Return to driving.", "Return to sport or athletic activity.", "Sleep quality or disturbance.", "Any hip function or quality-of-life score (e.g. Harris Hip Score, iHOT) — none was used in this study.", "Patient satisfaction.", "Complications or adverse events — not reported as a quantified outcome in this paper; the limitations section does not mention any." ], "access": "full_text", "lastChecked": "2026-08-09" }, { "url": "https://pubmed.ncbi.nlm.nih.gov/33829912/", "identifier": "PMID 33829912", "title": "Driving reaction time following periacetabular osteotomy", "design": "prospective cohort", "participants": "n=26 (24 female, 2 male); mean age 32 (range 19-50)", "technique": "periacetabular osteotomy (PAO)", "scales": [ { "name": "Thinking time (driving simulator, braking at 30 mph)", "range": "seconds, no fixed range", "direction": "higher_worse" }, { "name": "Action time (driving simulator, braking at 30 mph)", "range": "seconds, no fixed range", "direction": "higher_worse" }, { "name": "Total brake reaction time (thinking time + action time)", "range": "seconds, no fixed range", "direction": "higher_worse" } ], "timepoints": "preop, 6 wk, 12 wk", "followUp": "12 weeks (last assessment point)", "findings": [ "The study tested 26 patients (24 women, 2 men) having periacetabular osteotomy, average age 32 (range 19-50), all of whom were driving with a valid license before surgery.", "A driving simulator measured how fast each patient could brake at 30 mph, before surgery and again at 6 and 12 weeks after.", "Before surgery, average reaction time was 0.69 seconds in total, made up of 0.48 seconds thinking time and 0.21 seconds action time.", "At 6 weeks after surgery, action time slowed to 0.26 seconds and total reaction time slowed to 0.78 seconds — both statistically significant increases from before surgery.", "By 12 weeks after surgery, reaction times were no longer significantly different from before surgery.", "The paper's stated conclusion: most patients are likely not safe to drive at 6 weeks after PAO but should be safe to drive by 12 weeks, with individual patient factors still needing consideration." ], "notVisible": [ "Full methods section (exact simulator protocol, how thinking/action time were separated and validated).", "Full statistical methods and any adjustment for covariates.", "Discussion and limitations section.", "Any tables or figures with per-patient or per-timepoint data beyond the means reported in the abstract.", "Whether thinking time alone (as opposed to action time and total time) reached statistical significance at 6 weeks — the abstract reports p-values only for action time and total time.", "Complication data, laterality (left/right hip), or any subgroup breakdown." ], "access": "abstract_only", "lastChecked": "2026-08-09" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5198872/", "identifier": "PMC5198872", "title": "Patient-Reported Outcomes of Periacetabular Osteotomy from the Prospective ANCHOR Cohort Study", "design": "prospective cohort", "participants": "n=391 hips (391 patients) analyzed; 371 of the 391 eligible hips (95%) had data at the minimum 2-year follow-up point used in this analysis", "technique": "Bernese periacetabular osteotomy (Ganz method). 303 of 391 hips also had a concomitant procedure: open arthrotomy (300), arthroscopy (70), femoral head/neck reshaping (230), partial labral trim (27), labral repair (22)", "scales": [ { "name": "modified Harris Hip Score (mHHS)", "range": "0-100", "direction": "higher_better" }, { "name": "HOOS Pain", "range": "0-100", "direction": "higher_better" }, { "name": "HOOS Activities of Daily Living", "range": "0-100", "direction": "higher_better" }, { "name": "HOOS Sports and Recreation", "range": "0-100", "direction": "higher_better" }, { "name": "HOOS Quality of Life", "range": "0-100", "direction": "higher_better" }, { "name": "HOOS Total Symptoms", "range": "0-100", "direction": "higher_better" }, { "name": "UCLA Activity Score", "range": "1-10", "direction": "higher_better" }, { "name": "SF-12 Physical Component", "range": "0-100", "direction": "higher_better" }, { "name": "SF-12 Mental Component", "range": "0-100", "direction": "higher_better" } ], "timepoints": "preop, minimum 2-year follow-up (mean 2.6 yr, range 2.0-5.4 yr)", "followUp": "mean 2.6 years, range 2.0 to 5.4 years", "findings": [ "In 391 hips followed for a mean of 2.6 years (range 2.0 to 5.4 years) after periacetabular osteotomy, the HOOS pain score (0-100, higher is better) improved from 55.8 before surgery to 84.3 after.", "Hip function (modified Harris Hip Score, 0-100, higher is better) improved from 61.2 before surgery to 85.1 after.", "Ability to do daily activities (HOOS Activities of Daily Living) improved from 67.6 to 89.7.", "Sports and recreation ability (HOOS Sports and Recreation) improved from 45.8 to 77.0.", "Quality of life (HOOS Quality of Life) improved from 35.1 to 69.8.", "General physical health (SF-12 Physical Component) improved from 39.4 to 49.0.", "General mental health (SF-12 Mental Component) improved from 51.2 to 52.8.", "Self-rated activity level (UCLA Activity Score, 1-10) improved from 6.8 to 7.2.", "364 of 391 patients (93%) were satisfied with their outcome: 55% extremely satisfied, 26% very satisfied, and 12% satisfied.", "3 of the 391 hips (0.8%) had converted to total hip replacement by final follow-up.", "12 hips (3%) needed a second operation, not counting hardware removal; most often (8 cases) this was a hip arthroscopy for ongoing pain.", "26 hips (7%) had a major complication (Dindo-Clavien grade III-IV): transient nerve palsy in 9 hips (2%, fully resolved in 6), pulmonary embolism in 2 (0.5%), deep vein thrombosis in 1 (0.3%), deep infection in 2 (0.5%), a fracture in 6 (1.5%), dislocation in 1 (0.3%), heterotopic bone needing removal in 4 (1%), and loss of fixation in 1 (0.3%)." ], "notMeasured": [ "Weekly or monthly pain values over the recovery period — only preop and final follow-up (mean 2.6 yr) are reported, with no 6-week, 3-month, or 6-month timepoints.", "Timing of return to work.", "Timing of return to driving.", "Timing of return to sport — only an overall sports/recreation score at final follow-up, not time-to-return.", "Sleep quality." ], "access": "full_text", "lastChecked": "2026-08-09" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11272631/", "identifier": "PMC11272631", "title": "Periacetabular osteotomy with and without concomitant arthroscopy: a systematic review of evidence on post-operative activity levels and return to sport", "design": "systematic review", "participants": "n=1,878 (1,904 hips) across 26 studies — PAO alone: n=1,523 (1,544 hips) across 15 studies; PAO + hip arthroscopy (HA): n=355 (360 hips) across 10 studies", "technique": "periacetabular osteotomy (PAO), alone or combined with concomitant hip arthroscopy (HA)", "scales": [ { "name": "UCLA Activity Score", "range": "1-10", "direction": "higher_better" }, { "name": "HOOS-SR (Hip disability and Osteoarthritis Outcome Score, Sport/Recreation subscale)", "range": "0-100", "direction": "higher_better" }, { "name": "HOS-SSS (Hip Outcome Score, Sport-Specific Subscale)", "range": "0-100", "direction": "higher_better" }, { "name": "Tegner and Lysholm scores", "range": "study-reported, not standardized in this paper", "direction": "higher_better" }, { "name": "iHOT (International Hip Outcome Tool)", "range": "0-100", "direction": "higher_better" } ], "timepoints": "pre-op, plus study-specific post-op checks (commonly 6 mo, 1 yr, 2 yr; some studies followed to 5-18 yr)", "followUp": "average 3.52 years across the 26 studies (range 1-18 years); PAO-alone studies ranged 1-18 years, PAO+HA studies ranged 2.83-6.5 years", "findings": [ "This review pooled 26 studies covering 1,878 people (1,904 hips) who had PAO: 1,523 people in 15 studies with PAO alone, and 355 people in 10 studies where PAO was combined with hip arthroscopy (HA).", "Average age at surgery was 27.7, and 82.3% of participants were female.", "Average follow-up across the 26 studies was 3.52 years, with individual studies ranging from 1 to 18 years.", "Only 3 of the 26 studies (all PAO-alone) reported a return-to-sport rate. Across those 3 studies, the rate ranged from 63% to 90.8%, averaging 77.93%, with an average time to return to sport of 8.9 months.", "In one of those 3 studies (Heyworth et al.), 80% of people had returned to sport by a median of 9 months. Returning to the same level of sport was less common in competitive athletes (11 of 19 people, 58%) than in recreational athletes (16 of 18 people, 89%).", "Only 1 PAO+HA study reported return-to-sport data: 81% of people returned to sport at an average follow-up of 2.83 years, with a higher rate in recreational athletes (85.6%) than competitive athletes (77.8%).", "One study of 111 people who had PAO alone (Leopold et al., 5.25-year follow-up) found low-impact sport participation rose from 31.7% to 52% after surgery, a statistically meaningful change (P = 0.001), while high-impact sport participation dropped slightly from 42.3% to 36.6%, which was not statistically meaningful (P = 0.361).", "In that same 111-person study, 58.1% said surgery improved their sports ability, 18.8% said it got worse, and 23.1% said no change.", "UCLA activity scores (a 1-10 activity-level scale) rose after PAO alone in most studies that measured it: for example from 4.7 to 5.5 in a 161-person study, from 5.3 to 6.6 in a 67-person study followed 5 years, and from 5.08 to 6.95 in the 111-person Leopold et al. study followed 5.25 years.", "HOOS-SR (a 0-100 hip and sport function score) rose from 44 before surgery to 71 at 2 years in a 146-person study, and from 42.76 to 69.49 at 2 years in a 321-person study, both PAO alone.", "HOS-SSS (a 0-100 sport-specific hip score) rose from 31 to 81 at 1 year in a 33-person PAO-alone study, and from 43.3 to 80.2 at 2.83 years in a 29-person PAO+HA study.", "The authors state a meta-analysis was not feasible because of differences between the included studies, so this paper reports a narrative systematic review, not a pooled statistical analysis.", "In 11 of the 12 PAO-alone studies that reported UCLA, HOOS-SR, or HOS-SSS, scores improved significantly after surgery (P < 0.05)." ], "notMeasured": [ "Return-to-work timing.", "Driving resumption.", "Week-by-week pain or symptom tracking.", "Sleep.", "Sport-specific injury rates after surgery.", "The paper notes 6 of the 26 studies reported iHOT scores but excludes them from the sport-outcome analysis because iHOT has no sport-specific subscore." ], "access": "full_text", "lastChecked": "2026-08-09" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12573821/", "identifier": "PMC12573821", "title": "Postoperative weight-bearing restrictions and rehabilitation after periacetabular osteotomy: a systematic review", "design": "systematic review", "technique": "periacetabular osteotomy (PAO) — a hip operation that repositions the socket. The review pools 63 separate studies rather than one cohort; most used the Bernese/Ganz PAO technique, with a few using curved or minimally invasive variants. It is not limited to one technique.", "scales": [ { "name": "HHS (Harris Hip Score)", "range": "0-100", "direction": "higher_better" }, { "name": "mHHS (Modified Harris Hip Score)", "range": "0-100", "direction": "higher_better" }, { "name": "Merle d'Aubigné (and Postel) score", "range": "0-18", "direction": "higher_better" }, { "name": "SHV (Subjective Hip Value)", "range": "0-100 (%)", "direction": "higher_better" } ], "timepoints": "Pooled across 63 studies with different protocols, not one shared timeline. Weight-bearing status is tracked from the day of surgery / postoperative day 1 through the point full weight-bearing is reached (8-16 weeks depending on study); hip-function scores are compared preop to final follow-up; return to sport is assessed from about 4 months to over a year post-op depending on the study.", "followUp": "Not pooled into one figure. Each of the 63 studies reports its own follow-up length and these vary widely (individual studies in the paper's table range from under 4 months to over a decade); the review does not state an overall mean or range across all 63.", "findings": [ "This review pooled 63 studies reporting postoperative weight-bearing protocols after PAO, drawn from 1,018 studies found in the initial literature search (449 duplicates removed, 569 screened by title/abstract, 164 checked in full text).", "18 of the 63 studies (29%) stated exactly when people were first allowed to move after surgery. Of those, most — 11 studies (18% of the full 63) — had people start moving on postoperative day one. Others started on day two (4 studies, 6%), day three (1 study, 2%), day four (1 study, 2%), or the day of surgery itself (1 study, 2%).", "Partial weight-bearing (putting some, but not full, weight through the operated leg — usually with crutches) was the most common early strategy, used in 41 of 63 studies (65%).", "How 'partial' weight-bearing was described varied a lot: toe-touch in 7 studies (11%), tip-touch in 3 studies (5%), touch-down in 2 studies (3%), flat-foot in 2 studies (3%), protected in 2 studies (3%), and restricted in 1 study (2%).", "The most common length for partial weight-bearing was 6 weeks, used in 14 of 63 studies (21%), followed by 8 weeks in 12 studies (18%). Other lengths reported: 6-8 weeks in 6 studies (9%), 4-6 weeks in 4 studies (6%), 10-12 weeks in 3 studies (5%), 12 weeks in 4 studies, and 2-4 weeks in 3 studies. Less common still: 5-8 weeks (2 studies, 3%), 8-10 weeks (1 study, 2%), 8-12 weeks (1 study, 2%), 12-16 weeks (1 study, 2%), and 4-12 weeks (1 study, 2%).", "So across all 63 studies, the shortest partial weight-bearing period reported was in the 2-4 week bucket and the longest was in the 12-16 week bucket — a full published span of roughly 2 to 16 weeks depending on the protocol.", "Full weight-bearing (no more restrictions) was typically allowed between 8 and 12 weeks after surgery. The review states duration and progression to full weight-bearing 'vary considerably' and there is 'no consensus on the optimal timing of weight-bearing.'", "One specific protocol in the review's table (Disantis et al., 2022) used 'foot-flat-wb 25% + crutches' for 6-8 weeks. Another (Novais et al., 2016) used '20-30% + crutches' for the first 8-12 weeks.", "A separate expert panel of physiotherapists (cited within the review, from Disantis et al. 2022) reached consensus recommending 25% foot-flat weight-bearing for six to eight weeks — but the review is explicit this is 'expert opinion rather than an evidence-based recommendation,' noting 'no studies currently exist supporting specific weight-bearing and range of motion precautions.'", "Crutches were recommended in 30 of 63 studies (48%).", "A brace was used in only 3 of 63 studies (5%), and none of those three gave any detail on what type of brace.", "Hip Harris Score (HHS) improved from 70 to 90 in 13 studies (21%).", "Modified Harris Hip Score (mHHS) improved from 60 to 90 in 9 studies (14%).", "Merle d'Aubigné score rose from 14 to 16.5 in 2 studies (3%).", "Subjective Hip Value (SHV) improved from 40 to 80 in 1 study (2%).", "Return to sport was reported in 9 of 63 studies (14%). The most common recommendation was 6 months, given in 4 studies (6%); 2 studies (3%) said 6-12 months depending on how intense the activity was.", "One study cited within the review compared people who bore full weight immediately after surgery against people who delayed full weight-bearing until about two months post-op: the immediate group had a 10.5% pelvic fracture rate versus 1.25% in the delayed group.", "The review's own conclusion: PAO rehab protocols vary substantially and use inconsistent terminology; there is still no standardized, evidence-based approach to weight-bearing timing, and no prospective comparative studies directly testing different mobilization strategies exist yet." ], "notMeasured": [ "Return to driving — not mentioned anywhere in the paper.", "Sleep — not mentioned anywhere in the paper.", "Week-by-week or day-by-day pain scores (e.g. VAS/NRS) — the paper reports only preop-to-final-follow-up hip-function scores (HHS, mHHS, Merle d'Aubigné, SHV), not a pain timeline.", "A pooled/aggregate total patient count across the 63 studies — the paper explicitly does not sum this; only individual study cohort sizes appear in its table.", "Any randomized controlled trial data — the review states none exist comparing different weight-bearing strategies after PAO.", "Specific brace type or design — the 3 studies that mentioned bracing gave no details on brand, model, or design." ], "access": "full_text", "lastChecked": "2026-08-09" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9528724/", "identifier": "PMC9528724", "title": "Rehabilitation Guidelines for Use Following a Periacetabular Osteotomy (PAO): A North American Based Delphi Consensus", "design": "consensus statement", "participants": "n=16 physiotherapists (Delphi expert panel, US and Canada; no patient cohort — this paper reports expert opinion, not measured patient outcomes)", "technique": "periacetabular osteotomy (PAO), general post-operative protocol — no specific PAO surgical variant named", "scales": [ { "name": "Hip Outcome Score - Activities of Daily Living subscale (HOS-ADL)", "range": "0-100%", "direction": "higher_better" }, { "name": "Hip Outcome Score - Sports subscale (HOS-Sports)", "range": "0-100%", "direction": "higher_better" }, { "name": "Hip abductor strength ratio (involved:uninvolved side)", "range": "0-100%+", "direction": "higher_better" } ], "timepoints": "weeks 1-4, 4-6, 6-8, 6-12, 8-12, 10-12, 12-16, 12-20, 20-26, 26+", "findings": [ "16 physiotherapists from the US and Canada, all treating at least 10 PAO patients a year, took part in a three-round consensus survey and all 16 completed every round.", "15 of 16 panelists (94%) agreed a person should walk with only 25% of their body weight through the operated leg, keeping the foot flat, for the first 6-8 weeks after surgery.", "16 of 16 panelists (100%) agreed crutches should come off only once an x-ray shows the bone has healed and the person walks without a Trendelenburg limp, an abductor lurch, or a pain-guarding (antalgic) gait — the panel gave no fixed calendar week for this.", "13 of 16 panelists (81%) agreed hip flexion should stay under 90 degrees and outward (external) rotation under 20 degrees, measured at 90 degrees of flexion, for 4-6 weeks after surgery.", "16 of 16 panelists (100%) agreed full hip range of motion should be back by 12-16 weeks (3-4 months) after surgery.", "15 of 16 panelists (94%) agreed end-range stretching can start 8-12 weeks after surgery, as tolerated.", "16 of 16 panelists (100%) agreed active hip-flexor work with the leg straight should stay limited for 8-12 weeks, with gentler hip-flexor exercise (heel slides, isometric holds) starting 4-8 weeks in, as pain allows.", "13 of 16 panelists (81%) agreed a stationary bike can start 6-8 weeks after surgery.", "13 of 16 panelists (81%) agreed an elliptical machine can start by 10-12 weeks.", "15 of 16 panelists (94%) agreed glute-strengthening should move from static holds, to non-weight-bearing resisted exercise, to full weight-bearing single-leg work — the panel gave no fixed weeks for this progression.", "14 of 16 panelists (88%) agreed leg-control and balance drills can start non-weight-bearing as tolerated and should become weight-bearing by 6 weeks.", "14 of 16 panelists (88%) agreed running should wait until hip strength (especially the glute medius and outward rotator muscles) is normalized and the person passes functional tests such as a single-leg squat and the Y-Balance test.", "16 of 16 panelists (100%) agreed a person is ready for full sport only once the operated hip's abductor strength reaches more than 80% of the other hip's, plus passing functional tests (single-leg squat, Y-Balance) and sport-specific drills.", "The paper's own return-to-sport table also lists scoring above 95% on the Hip Outcome Score's Activities-of-Daily-Living subscale and above 90% on its Sports subscale as self-reported function targets for full return to sport.", "The paper lays out six named phases by week: Weeks 1-4 (protect the surgical site, normalize gait with an assistive device), Weeks 4-6 (gentle motion work), Weeks 6-12 (near-full motion, strength building, gradual weight-bearing increase once gait is normal), Weeks 12-20 (advanced strengthening, endurance work), Weeks 20-26 (running and straight-line agility), and Weeks 26+ (jumping, cutting, full sport).", "The authors state this is a consensus of expert opinion, not a study of measured patient outcomes, writing that 'there is a paucity of research supporting post-operative rehabilitation guidelines' following PAO, and call for future patient-reported outcome research to confirm these targets." ], "notMeasured": [ "No patient was actually tracked through recovery — this is 16 physiotherapists' expert opinion, not measured outcome data.", "No week-by-week pain scores are reported (no VAS/NRS numbers).", "No specific week or week range for reaching full (100%) weight-bearing is given — only the 25% foot-flat phase (6-8 weeks) and a general 'progresses once healed and gait is normal' statement within the weeks 6-12 phase.", "No return-to-work, return-to-driving, or sleep data.", "No data on how many real patients actually reached each phase on schedule." ], "access": "full_text", "lastChecked": "2026-08-09" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6206701/", "identifier": "PMC6206701 (PMID 30393555)", "title": "What level of pain reduction can be expected up to two years after periacetabular osteotomy? A prospective cohort study of 146 patients", "design": "prospective cohort", "participants": "n=299 enrolled (mean age 29.6, 88% female, median BMI 22.9, 74 patients/24% bilateral PAO); n=146 radiographic-pain subgroup (n=64 with centre-edge angle ≥20°, n=82 with centre-edge angle <20°); n=131 completed VAS at all three timepoints (preop, 6mo, 24mo); HOOS answered by n=285 preop, n=279 at 6mo, n=142 at 24mo", "technique": "periacetabular osteotomy (PAO), minimally invasive transsartorial approach with ~7cm incision, acetabulum reoriented and fixed with 2-3 cortical screws", "scales": [ { "name": "VAS pain at rest", "range": "0-100 (paper does not print endpoint labels in the text fetched; standard VAS convention: 0 = no pain, 100 = worst pain)", "direction": "higher_worse" }, { "name": "VAS pain during activity", "range": "0-100", "direction": "higher_worse" }, { "name": "HOOS (5 subscales: Symptom, Pain, ADL, Sport/Rec, QoL)", "range": "0-100 (paper's methods paragraph names the instrument but does not restate the numeric range in the text fetched; standard HOOS convention: 100 = no symptoms)", "direction": "higher_better" }, { "name": "SF-36 (Physical Component Score, Mental Component Score)", "range": "0-100 (not restated in the text fetched; standard SF-36 convention)", "direction": "higher_better" }, { "name": "EQ-5D index", "range": "not stated in the paper's text as fetched", "direction": "higher_better" } ], "timepoints": "preop, 6 mo, 24 mo (2 yr)", "followUp": "mean 2.3 years", "findings": [ "In 299 patients, average pain at rest (VAS 0-100) fell from 35 before surgery to 14 at 6 months, and stayed at 14 at 2 years — about a 50% drop that did not improve further after 6 months.", "In the same 299 patients, average pain during activity (VAS 0-100) fell from 69 before surgery to 41 at 6 months, and stayed at 41 at 2 years — about a 50% drop that held steady after 6 months.", "All patient-reported outcome scores (VAS, HOOS, SF-36, EQ-5D) improved significantly from before surgery to 6 months (p<0.000); little changed between 6 months and 2 years.", "HOOS pain subscale rose from 55 before surgery to 79 at 6 months and 79 at 2 years.", "HOOS symptom subscale rose from 53 before surgery to 73 at 6 months, and stayed at 73 at 2 years.", "HOOS daily-activities (ADL) subscale rose from 65 before surgery to 85 at 6 months and 86 at 2 years.", "HOOS sport/recreation subscale rose from 44 before surgery to 69 at 6 months and 71 at 2 years.", "HOOS quality-of-life subscale rose from 34 before surgery to 58 at 6 months and 59 at 2 years.", "SF-36 physical component score rose from 36 before surgery to 44 at 6 months and 45 at 2 years.", "SF-36 mental component score rose from 50 before surgery to 55 at both 6 months and 2 years.", "EQ-5D index rose from 0.75 before surgery to 0.82 at 6 months and 0.84 at 2 years.", "Only 131 of the 299 patients had a pain score recorded at all three timepoints (before surgery, 6 months, 2 years); the rest were missing one or more questionnaires — 67 patients answered only one or none of the questionnaires, 1 was re-operated, 1 had a prior femoral neck fracture, 10 chose not to participate, and 9 had incomplete data.", "The average centre-edge angle (a measure of how well the hip socket covers the ball) increased from 18.6° before surgery to 29.7° after surgery, but the study found no significant link between how much this angle changed and how much pain improved.", "74 of the 299 patients (24%) had both hips operated on (bilateral PAO)." ], "notMeasured": [ "Return to work is not reported.", "Return to driving is not reported.", "Return to sport is not reported as a timeline or participation rate — only the HOOS Sport/Rec subscale score is given, which is a function/symptom score, not a return-to-sport date.", "Sleep is not reported.", "Pain values between the three timepoints (e.g. week-by-week or month-by-month from 0 to 6 months) are not reported — only preop, 6-month, and 24-month averages.", "Complication types and rates are not systematically reported. The only complication-adjacent detail is that one patient was re-operated and excluded from the pain analysis." ], "access": "full_text", "lastChecked": "2026-08-09" } ] }, { "procedure": "Gluteus medius/minimus (abductor) repair", "timelineName": "Gluteus medius repair recovery", "bodyRegion": "hip", "url": "https://growsteady.me/gluteus-medius-repair-recovery-timeline", "confidence": "medium", "lastReviewed": "2026-06-12", "painPoints": [ { "week": 0, "low": 5, "typical": 7.4, "high": 8.6, "converted": false, "scaleNote": "VAS 0-10 pre-op baseline; typical ~7.4 across cohorts (Bucher serial cohort 6.5-7.9, n=110, PMC10183414; Pozzi 7.4; Innmann 7.7 PMC9188632); low 5.0 mixed/partial (PMC8689210 5.9); high 8.6 severe full-thickness (PMC10090025)", "basis": "measured", "bandBasis": "estimated", "bandNote": "The low and high edges come from different studies of different patients — a milder-tear cohort for the low edge, a more severe full-thickness-tear cohort for the high edge — not the spread of outcomes within one group of patients having this operation.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10183414/" }, { "week": 12, "low": 2.8, "typical": 3.8, "high": 5.5, "converted": false, "scaleNote": "VAS 0-10 at 3 months; Bucher serial cohort (n=110) reports VAS severity 2.8 / frequency 3.8 at 3 months (PMC10183414) — most of the relief lands in this window; high 5.5 reflects slower severe cohorts trending toward Chen's 6-month 5.4 (PMC10090025)", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is these patients' pain-severity score and the typical is the same patients' pain-frequency score at 3 months — two different questions, not two different people. The high edge is imported from a different, more severe tear population in another study.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10183414/" }, { "week": 26, "low": 2.7, "typical": 3.1, "high": 5.4, "converted": false, "scaleNote": "VAS 0-10 at 6 months; Bucher 2.7 severity / 3.1 frequency (PMC10183414); high 5.4 from the severe endoscopic-with-release cohort (Chen, PMC10090025)", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is this cohort's pain-severity score at 6 months, not a pooled typical. The high edge is imported from a different, more severe tear population in another study. The typical value doesn't match either of this paper's printed severity or frequency numbers.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10183414/" }, { "week": 52, "low": 1.9, "typical": 2.2, "high": 4.4, "converted": false, "scaleNote": "VAS 0-10 at 12 months; Bucher 1.9 severity / 2.2 frequency (PMC10183414); high 4.4 from Chen (PMC10090025)", "basis": "measured", "bandBasis": "comparison", "bandNote": "The low edge is this cohort's pain-severity score at 12 months. The high edge is imported from a different, more severe tear population in another study. The typical value doesn't match this paper's own printed numbers.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10183414/" }, { "week": 104, "low": 1.4, "typical": 1.5, "high": 3.6, "converted": false, "scaleNote": "VAS 0-10 at ~2 years; Bucher 1.4 severity / 1.5 frequency (PMC10183414); low 1.3 mini-open (PMC8825688); open cohort 2.67 (PMC7357074); high 3.6 Chen (PMC10090025)", "basis": "measured", "bandBasis": "estimated", "bandNote": "The low and high edges come from two different studies of different patients — a mini-open repair cohort for the low edge and a more severe tear cohort for the high edge — not the spread of outcomes within this paper's own patients. The typical value also doesn't match this paper's printed severity or frequency numbers at 2 years.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10183414/" } ], "milestones": [ { "milestone": "Protected weight bearing in a hip abduction brace", "typicalWeek": 0, "range": "0-6 weeks (about 20 kg partial weight bearing); endoscopic and larger full-thickness repairs are often kept protected to 8 weeks", "advisory": true, "source": "https://link.springer.com/article/10.1007/s00402-021-03952-7" }, { "milestone": "Discontinue the abduction brace", "typicalWeek": 6, "range": "6-8 weeks; some protocols grade this to 10-12 weeks for larger tears", "advisory": true, "source": "https://medicine.osu.edu/-/media/files/medicine/departments/sports-medicine/medical-professionals/hip/glute-med-repair-ccg-feb-2022.pdf" }, { "milestone": "Off crutches / normalized gait", "typicalWeek": 8, "range": "About 6-10 weeks, protocol-dependent", "advisory": true, "source": "https://medicine.osu.edu/-/media/files/medicine/departments/sports-medicine/medical-professionals/hip/glute-med-repair-ccg-feb-2022.pdf" }, { "milestone": "Begin active and resisted hip abduction strengthening", "typicalWeek": 8, "range": "Active abduction from ~6-8 weeks, resisted strengthening from ~12 weeks; held to ~4 months after augmented or endoscopic-with-release repairs", "advisory": true, "source": "https://link.springer.com/article/10.1007/s00402-021-03952-7" }, { "milestone": "Return to full daily activities", "typicalWeek": 12, "range": "About 12-16 weeks", "advisory": true, "source": "https://medicine.osu.edu/-/media/files/medicine/departments/sports-medicine/medical-professionals/hip/glute-med-repair-ccg-feb-2022.pdf" }, { "milestone": "Start running progression", "typicalWeek": 16, "range": "16-24 weeks, criteria-based; some protocols hold running to 5 months", "advisory": true, "source": "https://medicine.osu.edu/-/media/files/medicine/departments/sports-medicine/medical-professionals/hip/glute-med-repair-ccg-feb-2022.pdf" }, { "milestone": "Median time to a meaningful improvement (MCID)", "typicalWeek": 25, "range": "Median ~5.7 months; partial-thickness tears and pre-op abductor weakness run slower", "advisory": true, "source": "https://pubmed.ncbi.nlm.nih.gov/38508287/" }, { "milestone": "Return to sport / unrestricted activity", "typicalWeek": 26, "range": "About 6-9 months, criteria-based; non-contact sport from ~6 months", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10374787/" }, { "milestone": "Median time to an acceptable symptom state (PASS)", "typicalWeek": 48, "range": "Median ~11 months; about two-thirds reach it by two years", "advisory": true, "source": "https://pubmed.ncbi.nlm.nih.gov/38508287/" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10183414/", "title": "Augmented open hip abductor repair with serial 3/6/12/24-month outcomes (Ebert et al., n=110, 7-10 yr)", "tier": "prospective cohort", "declared": true, "backsPainPoints": 5, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://medicine.osu.edu/-/media/files/medicine/departments/sports-medicine/medical-professionals/hip/glute-med-repair-ccg-feb-2022.pdf", "title": "medicine.osu.edu", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 4, "backsCards": 0 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/38508287/", "title": "Time to MCID and PASS after gluteus medius/minimus repair: survival analysis (Vogel et al., median MCID 5.7 mo / PASS 11.0 mo)", "tier": "retrospective case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10090025/", "title": "Endoscopic gluteus medius repair with selective gluteus maximus release, 6/12-month points (Della Rocca et al. 2022, n=22)", "tier": "retrospective case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://link.springer.com/article/10.1007/s00402-021-03952-7", "title": "Evidence-based rehabilitation protocol after hip abductor tendon repair: systematic review (Ebert et al. 2022, 17 studies)", "tier": "systematic review / protocol", "declared": true, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10374787/", "title": "Recreational activity after open hip abductor repair: return-to-sport timing distribution (Navas et al. 2022)", "tier": "prospective case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32387651/", "title": "PMID 32387651", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12958556/", "title": "Low-quality evidence supports surgery for gluteal tendon tears: systematic review with GRADE (Spencer/Fearon, 1,584 patients, 49 studies)", "tier": "systematic review (GRADE)", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11551336/", "title": "Mini-open double-row gluteus medius repair, serial 6/12/24-month outcomes (Quinn et al., n=61)", "tier": "retrospective case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/38185183/", "title": "PASS achievement after endoscopic hip abductor repair: systematic review (Akhtar et al. 2024, 272 patients, 13 studies)", "tier": "systematic review", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11694278/", "title": "Suture anchor vs transosseous gluteus medius repair: systematic review and meta-analysis (680 patients, 21 studies)", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 0 } ], "sources": [ { "title": "Augmented open hip abductor repair with serial 3/6/12/24-month outcomes (Ebert et al., n=110, 7-10 yr)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10183414/", "tier": "prospective cohort", "reliabilityScore": 9 }, { "title": "Low-quality evidence supports surgery for gluteal tendon tears: systematic review with GRADE (Spencer/Fearon, 1,584 patients, 49 studies)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12958556/", "tier": "systematic review (GRADE)", "reliabilityScore": 9 }, { "title": "Mini-open double-row gluteus medius repair, serial 6/12/24-month outcomes (Quinn et al., n=61)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11551336/", "tier": "retrospective case series", "reliabilityScore": 6 }, { "title": "Endoscopic gluteus medius repair with selective gluteus maximus release, 6/12-month points (Della Rocca et al. 2022, n=22)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10090025/", "tier": "retrospective case series", "reliabilityScore": 6 }, { "title": "Time to MCID and PASS after gluteus medius/minimus repair: survival analysis (Vogel et al., median MCID 5.7 mo / PASS 11.0 mo)", "url": "https://pubmed.ncbi.nlm.nih.gov/38508287/", "tier": "retrospective case series", "reliabilityScore": 6 }, { "title": "PASS achievement after endoscopic hip abductor repair: systematic review (Akhtar et al. 2024, 272 patients, 13 studies)", "url": "https://pubmed.ncbi.nlm.nih.gov/38185183/", "tier": "systematic review", "reliabilityScore": 8 }, { "title": "Suture anchor vs transosseous gluteus medius repair: systematic review and meta-analysis (680 patients, 21 studies)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11694278/", "tier": "meta-analysis", "reliabilityScore": 8 }, { "title": "Evidence-based rehabilitation protocol after hip abductor tendon repair: systematic review (Ebert et al. 2022, 17 studies)", "url": "https://link.springer.com/article/10.1007/s00402-021-03952-7", "tier": "systematic review / protocol", "reliabilityScore": 8 }, { "title": "Recreational activity after open hip abductor repair: return-to-sport timing distribution (Navas et al. 2022)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10374787/", "tier": "prospective case series", "reliabilityScore": 6 } ], "studies": [] }, { "procedure": "Morton's neuroma excision", "timelineName": "Morton's neuroma surgery recovery", "bodyRegion": "foot", "url": "https://growsteady.me/morton-neuroma-surgery-recovery-timeline", "confidence": "medium", "lastReviewed": "2026-06-24", "painPoints": [ { "week": 0, "low": 5.3, "typical": 7, "high": 8.5, "converted": false, "scaleNote": "VAS 0-10 pre-op baseline; typical 7.04 from Karakaplan dorsal cohort (PMID 27627563); range spans Xu 5.25 (PMC9535891) to a plantar-approach cohort mean 8, range 6-9 (PMID 26253529)", "basis": "measured", "bandBasis": "estimated", "bandNote": "The low and high edges come from two different studies of different patients — one all-dorsal-approach cohort and one plantar-approach cohort — not the spread of outcomes within Karakaplan's own 41 patients.", "source": "https://pubmed.ncbi.nlm.nih.gov/27627563/" }, { "week": 52, "low": 0.4, "typical": 1, "high": 1.4, "converted": false, "scaleNote": "VAS 0-10 at final follow-up (the excision literature reports one late endpoint, mean 1.5-7.4 yr, not 12 months specifically); typical ~1.0 (Xu dorsal 1.00, PMC9535891; microsurgical 0.9, PMC9398578); low 0.4 (plantar cohort, PMID 26253529); high 1.4 (Karakaplan, PMID 27627563)", "basis": "measured", "bandBasis": "estimated", "bandNote": "This paper has a genuine second surgical-approach group (plantar) that isn't used here. The low edge instead comes from a different plantar-approach study, and the high edge from a different dorsal-approach study (Karakaplan) — not the range within this paper's own patients.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9535891/" } ], "milestones": [ { "milestone": "Weight-bearing in a post-op shoe", "typicalWeek": 0, "range": "From the day of surgery in a stiff-soled post-op shoe with crutches for a dorsal incision; a plantar incision needs longer before full weight goes through it", "advisory": true, "source": "https://policyonline.nhslothian.scot/wp-content/uploads/2023/03/Mortons_neuroma_excision_surgery.pdf" }, { "milestone": "Stitches out, wound can get wet", "typicalWeek": 2, "range": "About 2 weeks; the wound is kept dry until the sutures come out", "advisory": true, "source": "https://policyonline.nhslothian.scot/wp-content/uploads/2023/03/Mortons_neuroma_excision_surgery.pdf" }, { "milestone": "Return to driving", "typicalWeek": 4, "range": "About 4 weeks in the UK, once an emergency stop is possible; a left foot or an automatic can be sooner", "advisory": true, "source": "https://policyonline.nhslothian.scot/wp-content/uploads/2023/03/Mortons_neuroma_excision_surgery.pdf" }, { "milestone": "Back into an everyday shoe", "typicalWeek": 5, "range": "About 4 to 6 weeks for a trainer or loose lace-up shoe; narrow or fashion shoes take months", "advisory": true, "source": "https://www.nth.nhs.uk/resources/surgery-to-remove-a-mortons-neuroma/" }, { "milestone": "Return to sport and impact activity", "typicalWeek": 12, "range": "Around 3 months; impact sport is usually held until about 12 weeks", "advisory": true, "source": "https://policyonline.nhslothian.scot/wp-content/uploads/2023/03/Mortons_neuroma_excision_surgery.pdf" }, { "milestone": "Swelling settles and full recovery", "typicalWeek": 26, "range": "Forefoot swelling commonly lasts about 3 months; full settling of pain and swelling can take up to a year", "advisory": true, "source": "https://policyonline.nhslothian.scot/wp-content/uploads/2023/03/Mortons_neuroma_excision_surgery.pdf" } ], "citedPapers": [ { "url": "https://policyonline.nhslothian.scot/wp-content/uploads/2023/03/Mortons_neuroma_excision_surgery.pdf", "title": "NHS Lothian patient protocol: Morton's neuroma excision surgery (recovery timeline)", "tier": "clinical protocol", "declared": true, "backsPainPoints": 0, "backsMilestones": 5, "backsCards": 4 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9535891/", "title": "PMC9535891", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 5, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2903131/", "title": "PMC2903131", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 3 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/23851648/", "title": "Kasparek and Schneider, surgical treatment of Morton's neuroma: clinical results after open excision (98 feet, 15.3-yr follow-up), 2013", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://www.nth.nhs.uk/resources/surgery-to-remove-a-mortons-neuroma/", "title": "nth.nhs.uk", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32056015/", "title": "Treating Morton's neuroma by injection, neurolysis, or neurectomy: systematic review and meta-analysis (35 studies, 2,998 patients), Acta Neurochirurgica 2021", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10483740/", "title": "PMC10483740", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8792541/", "title": "PMC8792541", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/11568193/", "title": "PMID 11568193", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/18549752/", "title": "PMID 18549752", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/19083618/", "title": "PMID 19083618", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/20819664/", "title": "PMID 20819664", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/26253529/", "title": "PMID 26253529", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/3392057/", "title": "PMID 3392057", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/38723267/", "title": "PMID 38723267", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/9046143/", "title": "PMID 9046143", "tier": "not yet reviewed", "declared": false, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/27627563/", "title": "Reichert et al., long-term results of neurectomy through a dorsal approach: VAS 7.04 pre-op to 1.4 (n=41), 2016", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 1, "backsMilestones": 0, "backsCards": 0 }, { "url": "https://boneandjoint.org.uk/Article/10.1302/0301-620X.98B10.37610", "title": "Outcomes following excision of Morton's interdigital neuroma: prospective cohort (99 patients / 111 feet), Bone and Joint Journal 2016", "tier": "prospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 0 } ], "sources": [ { "title": "Treating Morton's neuroma by injection, neurolysis, or neurectomy: systematic review and meta-analysis (35 studies, 2,998 patients), Acta Neurochirurgica 2021", "url": "https://pubmed.ncbi.nlm.nih.gov/32056015/", "tier": "meta-analysis", "reliabilityScore": 9 }, { "title": "Outcomes following excision of Morton's interdigital neuroma: prospective cohort (99 patients / 111 feet), Bone and Joint Journal 2016", "url": "https://boneandjoint.org.uk/Article/10.1302/0301-620X.98B10.37610", "tier": "prospective cohort", "reliabilityScore": 8 }, { "title": "Kasparek and Schneider, surgical treatment of Morton's neuroma: clinical results after open excision (98 feet, 15.3-yr follow-up), 2013", "url": "https://pubmed.ncbi.nlm.nih.gov/23851648/", "tier": "retrospective cohort", "reliabilityScore": 7.5 }, { "title": "Reichert et al., long-term results of neurectomy through a dorsal approach: VAS 7.04 pre-op to 1.4 (n=41), 2016", "url": "https://pubmed.ncbi.nlm.nih.gov/27627563/", "tier": "retrospective cohort", "reliabilityScore": 7 }, { "title": "NHS Lothian patient protocol: Morton's neuroma excision surgery (recovery timeline)", "url": "https://policyonline.nhslothian.scot/wp-content/uploads/2023/03/Mortons_neuroma_excision_surgery.pdf", "tier": "clinical protocol", "reliabilityScore": 7 } ], "studies": [] }, { "procedure": "Lisfranc injury surgery (fixation or fusion)", "timelineName": "Lisfranc surgery recovery", "bodyRegion": "foot", "url": "https://growsteady.me/lisfranc-surgery-recovery-timeline", "confidence": "low", "lastReviewed": "2026-08-09", "painPoints": [ { "week": 12, "low": 2.8, "typical": 3.6, "high": 4.4, "converted": false, "scaleNote": "VAS 0-10 at 3 months: 3.59 +/- 0.84 (n=58); band = mean +/- 1 SD. Cohort had joint-sparing suture-tape augmented fixation with supplementary plates or wires, NOT primary fusion and not classic screw-only fixation, so the band reflects that technique", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11302241/" }, { "week": 26, "low": 1.5, "typical": 2.2, "high": 2.8, "converted": false, "scaleNote": "VAS 0-10 at 6 months: 2.17 +/- 0.63 (same cohort, n=58)", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11302241/" }, { "week": 52, "low": 0.9, "typical": 1.5, "high": 2.1, "converted": false, "scaleNote": "VAS 0-10 at 12 months: 1.48 +/- 0.57 (same cohort, n=58); final follow-up 1.24 +/- 0.57 at mean 16.9 months", "basis": "measured", "bandBasis": "printed", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11302241/" } ], "milestones": [ { "milestone": "Non-weight-bearing, splint then bivalved cast", "typicalWeek": 0, "range": "Weeks 0-6; splinted and non-weight-bearing for the first 2 weeks, then a bivalved cast holds that status to the 6-week x-ray", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6884016/" }, { "milestone": "Walking boot, partial weight-bearing begins", "typicalWeek": 6, "range": "Week 6 in a 73-patient cohort; the same point for fixation and for fusion", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12374025/" }, { "milestone": "Second x-ray check", "typicalWeek": 12, "range": "Week 12; the point at which hardware removal was typically discussed in the case series", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6884016/" }, { "milestone": "Return to play or duty (athletes and service members)", "typicalWeek": 17, "range": "Mean 116 days missed after operative treatment (about 17 weeks) versus 58 days non-operative; pooled return rate 86.16% across 441 people", "advisory": false, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8792672/" }, { "milestone": "Hardware removal, when it is done", "typicalWeek": 19, "range": "Mean 4.43 months (about 19 weeks) after fixation in a 482-patient cohort; only some people have it", "advisory": false, "source": "https://pubmed.ncbi.nlm.nih.gov/39413293/" }, { "milestone": "Full activity", "typicalWeek": 20, "range": "4-5 months after surgery (about weeks 17-22) in a 73-patient cohort, for fixation and fusion alike", "advisory": true, "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12374025/" } ], "citedPapers": [ { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11302241/", "title": "Pain and midfoot function after joint-sparing suture-tape augmented Lisfranc fixation (n=58, mean 16.9-month follow-up)", "tier": "retrospective case series", "declared": true, "backsPainPoints": 3, "backsMilestones": 0, "backsCards": 5 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12374025/", "title": "Primary arthrodesis versus ORIF for Lisfranc injuries: comparative cohort with rehabilitation protocol (73 patients)", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 2 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/39413293/", "title": "Hardware removal after Lisfranc ORIF: timing and patient-reported outcomes (482 patients, 489 feet)", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6884016/", "title": "Week-by-week postoperative protocol after Lisfranc fixation in athletes (case series, 10 followed)", "tier": "case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 2, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10899141/", "title": "Early outcomes of Lisfranc injuries treated with a suture-button internal brace (case series, n=15)", "tier": "case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 2 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8792672/", "title": "Return to play after low-energy Lisfranc injury: systematic review and meta-analysis (441 athletes and active-duty personnel)", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 1, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/41887087/", "title": "Do Lisfranc ORIFs fail? Long-term conversion to arthrodesis in 8,101 patients at 5 and 10 years", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/39577046/", "title": "Flexible fixation versus ORIF versus primary arthrodesis for ligamentous Lisfranc injuries: meta-analysis (25 studies)", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8705667/", "title": "Functional outcomes of open reduction and internal fixation for Lisfranc injuries (n=87, mean 4.9-yr follow-up)", "tier": "retrospective case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/19796583/", "title": "Henning et al.: open reduction internal fixation versus primary arthrodesis for Lisfranc fracture-dislocations (randomized, n=40)", "tier": "randomized trial", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12861123/", "title": "High- and low-energy Lisfranc injuries: prospective functional outcomes and return to work at 6 months (n=32)", "tier": "prospective case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/37735918/", "title": "Ligamentous Lisfranc injuries: hardware removal timing and rate (39 feet, stage II)", "tier": "retrospective case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10641664/", "title": "Lisfranc sports injuries: review of return-to-training and return-to-competition windows", "tier": "narrative review", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/16510816/", "title": "Ly and Coetzee: treatment of primarily ligamentous Lisfranc joint injuries, primary arthrodesis versus ORIF (randomized, n=41)", "tier": "randomized trial", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11675455/", "title": "Mid- and long-term consequences after surgically treated Lisfranc injuries (14 followed, mean 8.3 yr)", "tier": "case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32517507/", "title": "Outcomes of Lisfranc injuries in active-duty service members (n=70, mean 3.5-year follow-up)", "tier": "retrospective case series", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12744145/", "title": "Postoperative complications of percutaneous versus open treatment of Lisfranc injuries (matched, 1,100 per cohort)", "tier": "retrospective cohort", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pubmed.ncbi.nlm.nih.gov/39680239/", "title": "Primary arthrodesis versus open reduction internal fixation for acute Lisfranc injuries: systematic review and meta-analysis (18 studies)", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11497535/", "title": "Primary arthrodesis versus ORIF for Lisfranc injuries: meta-analysis of 5 randomized trials (241 patients)", "tier": "meta-analysis", "declared": true, "backsPainPoints": 0, "backsMilestones": 0, "backsCards": 1 } ], "sources": [ { "title": "Pain and midfoot function after joint-sparing suture-tape augmented Lisfranc fixation (n=58, mean 16.9-month follow-up)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11302241/", "tier": "retrospective case series", "reliabilityScore": 6 }, { "title": "Primary arthrodesis versus open reduction internal fixation for acute Lisfranc injuries: systematic review and meta-analysis (18 studies)", "url": "https://pubmed.ncbi.nlm.nih.gov/39680239/", "tier": "meta-analysis", "reliabilityScore": 9 }, { "title": "Primary arthrodesis versus ORIF for Lisfranc injuries: meta-analysis of 5 randomized trials (241 patients)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11497535/", "tier": "meta-analysis", "reliabilityScore": 9 }, { "title": "Return to play after low-energy Lisfranc injury: systematic review and meta-analysis (441 athletes and active-duty personnel)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8792672/", "tier": "meta-analysis", "reliabilityScore": 8 }, { "title": "Flexible fixation versus ORIF versus primary arthrodesis for ligamentous Lisfranc injuries: meta-analysis (25 studies)", "url": "https://pubmed.ncbi.nlm.nih.gov/39577046/", "tier": "meta-analysis", "reliabilityScore": 8 }, { "title": "Do Lisfranc ORIFs fail? Long-term conversion to arthrodesis in 8,101 patients at 5 and 10 years", "url": "https://pubmed.ncbi.nlm.nih.gov/41887087/", "tier": "retrospective cohort", "reliabilityScore": 8 }, { "title": "Hardware removal after Lisfranc ORIF: timing and patient-reported outcomes (482 patients, 489 feet)", "url": "https://pubmed.ncbi.nlm.nih.gov/39413293/", "tier": "retrospective cohort", "reliabilityScore": 8 }, { "title": "Primary arthrodesis versus ORIF for Lisfranc injuries: comparative cohort with rehabilitation protocol (73 patients)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12374025/", "tier": "retrospective cohort", "reliabilityScore": 7 }, { "title": "Ligamentous Lisfranc injuries: hardware removal timing and rate (39 feet, stage II)", "url": "https://pubmed.ncbi.nlm.nih.gov/37735918/", "tier": "retrospective case series", "reliabilityScore": 6 }, { "title": "Outcomes of Lisfranc injuries in active-duty service members (n=70, mean 3.5-year follow-up)", "url": "https://pubmed.ncbi.nlm.nih.gov/32517507/", "tier": "retrospective case series", "reliabilityScore": 6 }, { "title": "Ly and Coetzee: treatment of primarily ligamentous Lisfranc joint injuries, primary arthrodesis versus ORIF (randomized, n=41)", "url": "https://pubmed.ncbi.nlm.nih.gov/16510816/", "tier": "randomized trial", "reliabilityScore": 8 }, { "title": "Henning et al.: open reduction internal fixation versus primary arthrodesis for Lisfranc fracture-dislocations (randomized, n=40)", "url": "https://pubmed.ncbi.nlm.nih.gov/19796583/", "tier": "randomized trial", "reliabilityScore": 8 }, { "title": "Early outcomes of Lisfranc injuries treated with a suture-button internal brace (case series, n=15)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10899141/", "tier": "case series", "reliabilityScore": 6 }, { "title": "High- and low-energy Lisfranc injuries: prospective functional outcomes and return to work at 6 months (n=32)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12861123/", "tier": "prospective case series", "reliabilityScore": 6 }, { "title": "Lisfranc sports injuries: review of return-to-training and return-to-competition windows", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10641664/", "tier": "narrative review", "reliabilityScore": 6 }, { "title": "Postoperative complications of percutaneous versus open treatment of Lisfranc injuries (matched, 1,100 per cohort)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12744145/", "tier": "retrospective cohort", "reliabilityScore": 8 }, { "title": "Functional outcomes of open reduction and internal fixation for Lisfranc injuries (n=87, mean 4.9-yr follow-up)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8705667/", "tier": "retrospective case series", "reliabilityScore": 6 }, { "title": "Mid- and long-term consequences after surgically treated Lisfranc injuries (14 followed, mean 8.3 yr)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11675455/", "tier": "case series", "reliabilityScore": 6 }, { "title": "Week-by-week postoperative protocol after Lisfranc fixation in athletes (case series, 10 followed)", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6884016/", "tier": "case series", "reliabilityScore": 6 } ], "studies": [] } ] }