I’m going to have a fancy reconstructive surgery on my knee. It’s called a femoral-fibular graft and reconstruction. The surgeon told me there will be certain activities I’ll have to avoid. Is this forever or just during the healing time?

Probably both but you’ll want to double-check on that and ask the surgeon directly. The femoral-fibular reconstructive surgery is designed to restore the soft tissue structures of the posterolateral (back/side) corner of the knee joint.

When multiple ligaments in the knee are torn or damaged, the joint can become unstable. It slides too far into external rotation and gaps too much along the lateral (side) of the knee joint.

A piece of tendon from the Achilles (heel) is used to replace the damaged fibular collateral ligament (FCL) and the popliteus muscle-tendon-ligament (PMTL). The joint capsule that is torn along that back corner is incorporated into the graft in order to restore stability to the area.

But as much as the graft restores normal knee biomechanics, it is not a fully anatomic (natural) unit. In order to avoid overloading the graft (even after healing and recovery), patients are advised to avoid high-impact activities. Only low-impact activities such as biking or swimming are encouraged. This is to protect the knee joint.

By following your surgeon’s advice, you will be able to participate in daily activities (at work and at home) and low-impact recreational and sports without pain. There is a fairly high rate of joint degeneration and arthritis in patients who have had this procedure. These recommendations may help slow down the degenerative process but this has not been proven with studies yet.