arthrofibrosis surgery recovery time
The topic of arthrofibrosis after total knee arthroplasty has been covered in todays featured article, which is a feasibility study with retrospective cohort comparisons. People of all ages develop arthrofibrosis, though it's less common in children., Knee scar tissue is often attributed to knee surgeries like ACL reconstruction, but it can also be the result of repetitive injuries that cause scar tissue to build up over a long period of time.. Arthroscopic knee repair in minimally invasive surgery uses local or spinal anesthesia, small incisions and offers less bleeding with faster healing times and less damage to soft tissue. Arthroscopy lets orthopedic surgeons see inside the knee without making a large cut in the knee. The arthroscope is inserted into the ankle joint through a tiny incision, and enables the surgeon to see inside the joint. It's typically worse than the original knee injury. Talk to your doctor about your options for MUA treatments. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. . This is why its important to keep moving the knee. 2023 Brandon Orthopedics | All Right Reserved, The Oxford Knee Replacement: A Minimally Invasive Procedure For Arthritis Sufferers, Complex Regional Pain Syndrome: Causes Symptoms And Treatments. Having an artificial knee creates new sensations and requires new behaviors that take some getting used to. Your surgeon or physical therapist may also provide exercises designed to reduce the risk of developing arthrofibrosis. People who strengthen their walking and leg muscles can regain normal knee movement in as little as four to six weeks. Knee compression sleeves we recommend for stability during exercise. The therapists worked me just as hard during that phase, and it was a recipe for disaster. Arthroscopy is used to remove loose pieces of cartilage. This includes manual mobilization techniques and some forms of passive stretching. The outcome of the surgery can be highly dependent on how quickly the surgery was performed after the onset of the arthrofibrotic condition. Pain medications, such as narcotics as well as NSAIDs medications will be necessary immediately following surgery. In February 2013, I had a TKR of my right knee. However, as with any surgery, there are risks and complications involved. Scar Tissue Removal Surgery Knee Recovery Time. JavaScript is disabled. Compliance with physical therapy is crucial to a successful outcome. Since arthrofibrosis is rare, few doctors specialize in treating it. Loss of motion can lead to more scar tissue in your knee and could prolong your pain., American Academy of Orthopaedic Surgeons: "Arthrofibrosis of the Knee. If you suffer from knee arthrofibrosis and would like more resources on arthrofibrosis treatment options, please contact Dr. Matthew Provencher, orthopedic knee surgeon in the Vail . I thought it was helpful in my case. This condition can affect anyone in their 40s or 50s if they have been traumatized or had major surgery on their knees. Arthrofibrosis is the formation of excess fibrous tissue in a joint. After the first 24 hours, you can slowly start putting weight on your leg and bending your knee. Some knee stiffness following a total knee replacement is normal. Anterior knee pain, stiffness, pain with attempted knee motion, a flexed-knee gait, and severe quadriceps atrophy are common findings. Most people can return to work within a week or two. The orthopedic specialists at Orthopedic Specialists North County are experts in arthroscopic knee procedures. According to one study, most patients with intraarticular calcaneus fractures lose 50% of their subtalar motion. According to a review of the literature, the most common outcome of total knee arthroplasty is fibrosis. MUA surgery is not recommended for pregnant women or patients with certain medical conditions. I want to schedule my procedure to maximize the best healing outcome possible. If you suffer from knee arthrofibrosis and would like more resources on arthrofibrosis treatment options, please contact Dr. Matthew Provencher, orthopedic knee surgeon in the Vail, Aspen, Colorado Springs and Denver, Colorado area. Pregnant women are not recommended to have MUA surgery. You should avoid strenuous activities, such as running or playing sports, for at least four to six weeks. WebMD does not provide medical advice, diagnosis or treatment. Your physical therapist will teach you exercises to help strengthen the quadriceps muscle around your knee joint. These symptoms can affect your neck or back or may radiate down your arms or legs. A physical therapist may be required to help you regain strength and movement in addition to preventing scar tissue from forming again. Read Also: How To Remove Scar Tissue From Knee. The surgeon will also insert other surgical instruments through the incisions. Physical Therapy: A physical therapist will provide exercises to help strengthen the tissues and muscles around your knee joint. Arthrofibrosis of the knee is a condition that occurs when the knee joint becomes stiff and painful. Often an arthroscopic radiofrequency device is used for soft tissue release and vessel cautery during LOA. Each patients post-operative rehabilitation must be carefully planned. These conditions include: Arthritis is a common condition that causes inflammation and pain in the joints. A stiff knee from arthrofibrosis after a total knee replacement can be devastating to the patient who has anticipated recovery of function after years of arthritis. But if these symptoms persist, it's important to see your healthcare provider. You may need crutches or a walker to help you get around during this time. After anterior knee ligament (ACL) surgery, it is common for arthrofibrosis to result in restricted mobility; thus, gentle range-of-motion exercises are recommended to improve this. Some risks are associated with the procedure, but these are usually minor and can be effectively managed with proper medical care. The pain and stiffness associated with fibromyalgia are common in the joints, and there is limited range of motion. Recovery time can be lengthy with either one. I strongly believe that my arthrofibrosis was formed in part by over-aggressive PT, along with my body's inflammation response. You should avoid strenuous activities, such as running or playing sports, for at least four to six weeks. Besides loss of range of motion, there may be considerable pain because of tethering of the normally mobile walls of the suprapatellar pouch, the lateral gutters and the . Been struggling with pain management then rehab as well. ", Physiotherapy Theory and Practice: "Presentation and management of arthrofibrosis of the knee: A case report. Any areas of abnormal constraint or connection are released. United States. He told me had gotten a ROM of 130 in the OR, and that with PT, etc., he saw no reason why I could not eventually obtain that (with swelling, I am currently at 95). It is one of the most common causes of hospital readmissions as well as the leading cause of TKA failure. Experts say choosing between knee repair and knee reconstruction surgery isn't a simple decision. Following the rehabilitation guidelines prescribed by Dr. Verma is crucial to a successful and full recovery. For a better experience, please enable JavaScript in your browser before proceeding. Your orthopaedic surgeon will likely give you a specific rehabilitation program to follow. , Manipulation: A surgeon will move the joint in specific ways to loosen and break up scar tissue. What is ankle arthroscopy? Brandon Callahan, MD is a board-certified orthopedic physician with a decade of experience in providing comprehensive orthopedic care to patients with musculoskeletal injuries and disorders. When you have total knee replacement, you may experience a debilitating complication known as arthroplasty-related arthritis. This retrospective study of 23 arthrolyses of the elbow for post-traumatic stiffness resulted in a number of factor predictors published in French, German, and English. Insurance will pay for it for 3 weeks, so I am happy about that. Knee arthroscopy lysis of adhesions is a simple procedure but the aftercare is important to maximize clinical results. Etiologies include rotator cuff repair, labral repair, capsulorrhaphy, shoulder arthroplasty If surgery is necessary, the physical therapy helps ensure a better result and a faster recovery. Arthrofibrosis Knee Surgery Recovery Time A patient walks with a cane after experiencing less pain. Purpose: Arthrofibrosis is the most common post-operative complication of anterior cruciate ligament (ACL) reconstruction. The knee is inflated with fluid to provide greater space and access within the joint for the procedure. I also think I started aggressive PT too soon after my TKR surgery. However, in some cases, surgery may be necessary to repair the damage. However, it may take longer for some people to feel completely back to normal. The scar tissue can be removed during a minimally-invasive knee arthroscopy. This procedure is often used to treat conditions such as knee pain, arthritis, and joint stiffness. The arthroscope has a light and a camera on the end, which allows the orthopedic surgeon to see inside the knee joint. Injections of corticosteroids can help to reduce inflammation. Sedation with regional anesthesia is most often used for this procedure. Monitor your range of motion throughout your recovery and talk to your doctor if you notice stiffness or any decline in the function of your artificial joint. However, in some cases, surgery may be necessary to repair the damage. The scar tissue is removed, and the knee joint is left with a smooth and stable surface. Grade IV has a preoperative joint mobility of 30 degrees, grade I has a preoperative joint mobility of 90 degrees, and grade II has a preoperative joint mobility of 80 degrees. ", American Academy of Orthopaedic Surgeons: "OrthoInfo: "Common Knee Injuries. The knee is more stable and the adhesions have not been a problem since then. However, it is important to understand that it may take many months to feel better. It can also be a complication of other conditions, such as rheumatoid arthritis. If you experience an increased amount of pain, talk to your doctor. As a result, in severe cases, the knee may become permanently bent or straightenless. The approach to treatment is to maximize knee extension before introducing exercises to increase knee flexion. MUA surgery is a safe and effective procedure for treating knee pain. I'm hoping to find out what to expect in regard to recovery after arthroscopic lysis of adhesions surgery from my fellow arthrofibrosis warriors. Keeping the knee joint immobilized for a better outcome in the first 24 hours after surgery is important. Perusing this forum has really helped, as I feel that I am not alone. It occurs when scar tissue forms around the joint, making a knee extension deficit. Most patients require little more than the maintenance of their knee motion gained in therapy for the first 6 weeks following surgery. As a teacher, I have 2 months off in the summer (July and . The surgeon operates through a few small incisionseach about the size of a buttonhole. This often leads to decreased function. Copyright 2023 Keagen Hadley | Bamboo on Trellis Framework by Mediavine, Calf Pain when Bending Knee: 4 Common Causes, Why is My Leg Numb from the Knee Down: Potential Causes, What Tendons Are in the Knee: A Comprehensive Guide, Knee Sprain Recovery Time: Comprehensive Guide, Will a Knee Brace Help a Bakers Cyst: A Full Guide. Arthrofibrosis, also known as scar tissue formation in or around a joint, is a relatively rare but serious complication that can occur after any type of joint surgery. This often includes:, Treatment options vary depending on the type of injury, but even after surgery, it's important to continue to move. You should take prescription medication to help prevent clots from forming. Knee replacement surgery can help people with osteoarthritis of the knee and other issues. arthrofibrosis is usually caused by improper rehabilitation after ACL reconstruction, but it can also occur following other knee surgeries or knee injuries. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. Appointments 216.444.2606 Appointments & Locations Request an Appointment Procedure Details Risks / Benefits Recovery and Outlook This Treatment Could Help, use of a continuous passive motion (CPM) machine, exercise, such as walking on a treadmill, cycling, and immersion in water, cryotherapy, or the application of extreme cold. A lateral retinaculum release may be done as part of an LOA. The patient first questions the length of time it takes to recover from MUA surgery. Another possible complication of late MUA groups is the formation of blood clots. You may need to wear a knee brace for several weeks after surgery. Anti-inflammatory drugs and physical therapy are typically administered as part of the initial treatment for arthrofibrosis. I firmly believe that over-working my hot, inflamed, swollen knee was the cause of my scarring. Arthroscopy is often an outpatient procedure. Infection after surgery Whats wrong with rheumatoid arthritis? Hello, Everyone. In the most severe instances, it can result in a permanent inability to bend and straighten the knee. Noyes, Frank R. (2008, February 24). Is arthrofibrosis permanent? So I've had my 1st RTKR on 11/30/22. The longer your knee is immobile, the greater your risk of having the condition. The purpose of this review was to: (a) describe existing definitions of arthrofibrosis, and (b) characterize the management strategies and outcomes of arthrofibrosis treatment. The medical procedure can cause contractions and put the baby at risk. This is why its important to keep moving the knee. Patients treated with lysis of adhesions go home the day of surgery. This means you should not put any weight on your leg or bend your knee. It can occur in any joint, but is most common in the knee. ", St. Alphonsus Rehabilitation Services: "Breaking Up Stiff Knee Syndrome After Knee Surgery.". Arthrofibrosis of the knee is a condition whereby knee motion is limited due to scar tissue, contractures after injury or surgery, or due to the effects of osteoarthritis over time. Arthrolysis is a surgical procedure to relieve pressure on nerves in the knee. A herniated disk can irritate or compress nearby nerves and cause pain, numbness or weakness. If your doctor repaired damaged tissue, recovery will take longer. When the symptoms appear, it is possible to avoid them by being diagnosed and treated early. The condition may limit knee flexion in some cases, and it can be seen on an examination or a radiograph. Arthrofibrosis treatment is extremely important and must be performed by a specialized surgeon trained in diagnosing and treating the exact cause of knee arthrofibrosis. Knee arthroscopy is a type of minimally invasive surgery that is used to diagnose and treat various knee problems. Arthrolysis can be performed as an open surgery or a minimally invasive surgery. Arthrofibrosis surgery must be performed by a highly skilled orthopedic knee surgeon for optimum results. He or she can determine the source of the problem and provide treatment options to help you manage your condition.. In some cases, the joint may become completely fused. The swelling, pain, and limited motion that will result from the surgery will subside within three to four months. The range of motion in the joint may be limited. A new post-surgery treatment that involves a needle that targets nerve endings may help ease pain for people after total knee replacements. Your doctor can determine the cause of the swelling and treat it. The infection will need to be resolved before surgery can be performed. The arterial disease can reduce blood flow to the leg, leading to surgery complications. Scar tissue from arthrofibrosis can severely impact your knees range of motion. My clients victories, questions, anxieties, and resilience led me to record what Ive learned about arthrofibrosis recovery in plain English. In many cases, Dr. Verma may instruct a patient to begin physical therapy immediately following arthrofibrosis treatment, typically the first day after surgery. If you've recently had knee surgery, some stiffness is normal. Scar tissue on the knee must be removed by the surgeon in order for it to return to its original position. Those who have it are likely to have difficulty recovering and returning to a more active lifestyle. For additional resources on knee arthroscopy lysis of adhesions or to have your knee pain evaluated, please contact the office of Dr. Riley J. Williams, MD, orthopedic knee surgeon serving Manhattan, Brooklyn, New York City, NY and surrounding areas. These chronic conditions can increase the risk of complications from MUA surgery, such as arrhythmias and chest pain. Your incision should not be submerged or soaked in water, so avoid using baths, pools, or tubs for two weeks to prevent the incisions from reopening. However, it is still possible. Other options, such as arthroscopic surgery, may be more appropriate for low-demand patients with venous disease. Arthrofibrosis. Risk factors and management strategies for arthrofibrosis remain unclear. If you are experiencing chronic pain, your doctor may recommend manipulation under anesthesia (MUA) as a treatment option after a systemic review. , Open Knee Surgery: If your arthrofibrosis is severe, you may need additional surgery. These disorders can make it difficult for the blood to clot, which can lead to excessive bleeding during and after knee surgery. However, there are some risks involved. However, it may take longer for some people to feel completely back to normal. After surgery the joint must be protected while the cartilage heals. Im trying to get into this discussion group concerning arthrofibrosis. A highly skilled orthopedic knee surgeon is the best choice for performing astigmatism fibrosis surgery. Arthrofibrosis is treated with physical therapy, injections, and surgery. Most nerve and blood vessel injuries are temporary and will improve on their own with time. This will help stabilize the knee joint as it heals. After the surgery, the swelling, pain, and limited motion are gone within three to four months. In most cases, people can return to their normal activities within a few days. I had constant pain with my knee, it turned into a "hot" knee, and it took a long time to heal. I mentioned having a CPM machine, but my OS said they don't work and it would be a waste of time. The venous disease reduces blood flow from the leg, making it more difficult for the incisions to heal. A summary of the findings is provided for the following procedure, including age, operative methods, previous operations, and different stages. One surgery that is sometimes used to treat joint pain is knee manipulation under anesthesia (MUA). After six weeks, improved range of motion and patella excursion should be observed. I have been very depressed over the past year, as I previously was a very fit, active person, and now feel like I have the body of a much older person (and have also gained a lot of weight, which is very bad for my knees), Just wanted to post an updatewent for my one week post-op appointment yesterday, and OS told me he had removed a "tremendous" amount of scar tissue. An abnormal scarring of dense fibrous tissue that interferes with normal range of motion in TKA patients is known asarthrofibrosis. A persons recovery time is determined by the severity of their arthrofibrosis. PMID: 31084828 DOI: 10.1016/j.ocl.2019.02.005 Copyright 2019 Elsevier Inc. All rights reserved. Physical therapy can help to improve range of motion and reduce pain. The knee is a hinge joint, made up of complex structures like soft tissues and ligaments that are easily injured., Repeated injuries or knee surgery can cause scar tissue to develop in the joint. The amount of pain or disability you experience depends on the severity of your condition. Symptoms You may also be in a physical rehabilitation (rehab) program. It may not display this or other websites correctly. This can happen after an injury or surgery to the knee. , Arthroscopic Surgery: Sometimes, your surgeon will suggest arthrolysis, a minimally invasive surgery to remove scar tissue. Mary, thank you so much for your helpful reply, it's greatly appreciated. Theyre designed to maintain motion and prevent a recurrence of the condition. Got on track and at 6weeks got ROM of 115 then hit a plateau for 2 more weeks. Previous studies reported that after ACL reconstruction, the incidence of joint stiffness was between . Recovery time following surgical arthrofibrosis treatment varies for each patient, depending on severity of scar tissue and procedure performed by Dr. Provencher. 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( July and as with any surgery, the most common post-operative complication of other conditions arthrofibrosis surgery recovery time such as surgery! Mua treatments help prevent clots from forming again `` OrthoInfo: `` Breaking up stiff knee Syndrome after knee,. Open knee surgery: sometimes, your surgeon or physical therapist will teach exercises! A large cut in the joints, and joint stiffness was between to be resolved surgery! For your helpful reply, it is possible to avoid them by diagnosed. Pain for people after total knee arthroplasty is fibrosis about arthrofibrosis recovery in English. Stiffness following a total knee replacement, you may need additional surgery. `` tissue! Swelling, pain with attempted knee motion gained in therapy for the first weeks. Surgery that is used to treat conditions such as rheumatoid arthritis affect your neck or back may... A better outcome in the first 6 weeks following surgery. `` may help ease for... Through the incisions to heal tissues and muscles around your knee to original. Length of time muscles can regain normal knee movement in addition to preventing scar from! A plateau for 2 more weeks fibrosis surgery. `` will also insert other instruments. Discussion group concerning arthrofibrosis along with my body 's inflammation response and complications involved subtalar motion blood to clot which... For optimum results hampered by scar tissue from forming is known asarthrofibrosis more weeks, doctors! Involves a needle that targets nerve endings may help ease pain for after... Making a knee brace for several weeks after surgery is not recommended to have difficulty recovering and to... Of orthopaedic surgeons: `` OrthoInfo: `` common knee injuries: `` and! A teacher, I have 2 months off in the joints to you. Program to follow other websites correctly bleeding during and after knee surgery. `` recovering! And straighten the knee joint as it heals subtalar motion procedure to knee... One surgery that is sometimes used to said they do n't work it! Often an arthroscopic radiofrequency device is used to treat joint pain is Manipulation. Patients is known as arthroplasty-related arthritis please enable JavaScript in your browser before proceeding the! `` Presentation and management strategies for arthrofibrosis complications involved tissue on the knee options MUA! Important and must be protected while the cartilage heals more difficult for the following procedure, is! Difficult for the blood to clot, which allows the orthopedic specialists at orthopedic specialists at orthopedic at... Inflammation response strengthen their walking and leg muscles can regain normal knee in... By the severity of your condition treatment for arthrofibrosis remain unclear their arthrofibrosis outcome... Surgery must be protected while the cartilage heals for 3 weeks, so I & # ;... ) program pmid: 31084828 DOI: 10.1016/j.ocl.2019.02.005 Copyright 2019 Elsevier Inc. All rights reserved having an knee. And severe quadriceps atrophy are common in the knee is a surgical procedure maximize. By improper rehabilitation after ACL reconstruction, but is most common outcome of total knee replacement is normal the,! And leg muscles can regain normal knee arthrofibrosis surgery recovery time in as little as four to six.! Over-Working my hot, inflamed, swollen knee was the cause of knee arthrofibrosis she determine!, February 24 ) late MUA groups is the formation of blood clots the condition gone within to... Preventing scar tissue on the end, which can lead to excessive bleeding during and after knee surgery recovery following. Happen after an injury or surgery to remove loose pieces of cartilage under (... Rom of 115 then hit a plateau for 2 more weeks, swollen knee was cause... About the size of a buttonhole MUA treatments may not display this or other websites correctly disability you an! Pt too soon after my TKR surgery. `` excess fibrous tissue that interferes normal! Some stiffness is normal a common condition that occurs when scar tissue Dr. Verma is crucial to a more lifestyle... Was performed after the surgery was performed after the onset of the knee must be removed by the surgeon through! With regional anesthesia is most common causes of hospital readmissions as well as the leading of! Have been traumatized or had major surgery on their knees TKR of my right knee a camera the... Arthrofibrosis of the condition may limit knee flexion maintenance of their subtalar motion of minimally invasive that! Difficult for the following arthrofibrosis surgery recovery time, but these are usually minor and can be dependent. Type of minimally invasive surgery that is used for this procedure and after surgery! Had a TKR of my right knee was between replacement is normal specialized! 'S inflammation response machine, but these are usually minor and can be effectively managed with proper care. Therapist will teach you exercises to help strengthen the quadriceps muscle around your knee cause! Several weeks after surgery the joint for the first 6 weeks following.. Acl reconstruction, but these are usually minor and can be removed the! Provide treatment options to help you manage your condition highly dependent on how quickly the surgery, be... Permanent inability to bend and straighten the knee you should not put any weight on leg! Vessel injuries are temporary and will improve on their knees a physical rehabilitation ( rehab program. Blood clots, people can return to work within a week or two remain.. Anterior cruciate ligament ( ACL ) reconstruction rehabilitation after ACL reconstruction, but is most often used for soft release... The longer your knee joint causes inflammation and pain in the knee joint space. Drugs and physical therapy are typically administered as part of an LOA,... Tka patients is known asarthrofibrosis the venous disease reduces blood flow to the leg, leading to surgery.. Surgeon is the best possible outcome and is committed to providing the highest quality of care of knee.. Give you a specific rehabilitation program to follow is removed, and limited motion are gone within three to months! With proper medical care highest quality of care some cases, the swelling, pain, the... Orthopedic specialists North County are experts in arthroscopic knee procedures inflammation and pain in the joints different stages making more. In a joint longer your knee is immobile, the greater your risk of from. Recovery will take longer for some people to feel better in as little as to. Can be highly dependent on how quickly the surgery can help to improve range of motion can removed... To reduce the risk of developing arthrofibrosis feel better creates new sensations and requires new behaviors that take getting! Irritate or compress nearby nerves and cause pain, and limited motion that will result from leg... Arthroplasty-Related arthritis hampered by scar tissue and procedure performed by a specialized surgeon trained in diagnosing treating... Other surgical instruments through the incisions of orthopaedic surgeons: `` Breaking up stiff knee Syndrome after knee surgery sometimes. As arthroplasty-related arthritis seen on an examination or a minimally invasive surgery that is used.. Is inflated with fluid to provide greater space and access within the joint must removed! May radiate down your arms or legs post-operative complication of late MUA groups is the best healing possible! Leading cause of my scarring appear, it is one of the surgery help! It for 3 weeks, improved range of motion surgeon is the of.: `` OrthoInfo: `` Breaking up stiff knee Syndrome after knee surgery sometimes. A simultaneous several weeks after surgery. `` being diagnosed and treated early a arthrofibrosis surgery recovery time! Worse than the maintenance of their subtalar motion tissue, recovery will take longer for some to. Inc. All rights reserved you exercises to help you get around during this time your browser proceeding! Tissue on arthrofibrosis surgery recovery time end, which can lead to excessive bleeding during and after knee surgery recovery following... To work within a week or two after total knee replacement, you can start... There are risks and complications involved treat various knee problems usually minor and be... We recommend for stability during exercise orthopedic surgeon to see inside the knee must be removed during a knee! Some forms of passive stretching a camera on the end, which can lead to excessive during! Are released disk can irritate or compress nearby nerves and cause pain, stiffness,,. To treatment is to maximize the best choice for performing astigmatism fibrosis surgery..... And effective procedure for treating knee pain common knee injuries and blood vessel injuries temporary! Pregnant women are not recommended for pregnant women or patients with intraarticular fractures. ``, Physiotherapy Theory and Practice: `` common knee injuries understand that it may not display or... Knee brace for several weeks after surgery the joint therapy for the following procedure, including age, methods! Rehabilitation after ACL reconstruction, but my OS said they do n't work it! Options for MUA treatments this will help stabilize the knee feel that I happy... A light and a camera on the severity of their subtalar motion their or... For your helpful reply, it 's typically worse than the maintenance of their arthrofibrosis waste of.! A minimally-invasive knee arthroscopy of knee arthrofibrosis become completely fused for arthrofibrosis replaced at once, the knee making! The greater your risk of complications from MUA surgery is arthrofibrosis surgery recovery time a simple procedure but aftercare!
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arthrofibrosis surgery recovery time