What Is a Knee Arthroscopy?
A Knee Arthroscopy is a surgical procedure often referred to as “key hole” surgery. It provides a wonderful way to access the knee whilst minimising the trauma of surgery. As a result, the recovery and pain experienced after is much less than with open procedures. It does not describe what is done inside the knee. It is commonly used to treat meniscal tears, remove loose bodies, reconstruct ligaments, repair cartilage defects and stabilise the patella.
Who Should Have a Knee arthroscopy?
Despite being “key hole” surgery, the decision to operate should not be taken lightly. However, in the correct circumstances, the results can be excellent. People who have mechanical symptoms from torn menisci, locking and pain from loose bodies, can have wonderful results. It can greatly assist when undergoing ACL or ligament reconstructive surgery and patellofemoral stabilisation procedures. Arthroscopy can also be used to biopsy tissue, irrigate and treat septic arthritis.
Why Do People Have Knee arthroscopy?
For the majority of people who have knee arthroscopy surgery, the procedure results in:
- a decrease in pain
- increased mobility
- improvements in activities of daily living
- improved quality of life.
What Are Alternatives to Knee arthroscopy?
Before considering a knee arthroscopy Mr Richardson may try other methods of treatment, such as exercise, walking aids, medication, and time. Many painful conditions of the knee can be short lived, and settle quickly. However if the symptoms are persistent, recurrent or extremely severe, then surgery can be considered.
What Are Possible Complications of Knee Arthroscopy Surgery?
Arthroscopic surgery has minimised the risk of surgery to the knee, decreasing the risk of infection, and allowing rapid mobilization. However, it is not risk free. New technology and advances in surgical techniques have greatly reduced the risks involved with knee arthroscopy.
The most common complication is prolonged swelling and pain. This will generally settle with anti-inflammatories and time. It is rare for infection, but it can still occur. Rare, but serious complications can occur such as blood clots.
To minimise the risk of complications, it’s important to know how to prevent problems and to recognise signs of potential problems early and contact your doctor. For example, tenderness; redness and swelling of your calf; or swelling of your thigh, ankle, or foot could be warning signs of a possible blood clot. Warning signs of infection include fever, chills, tenderness and swelling, or drainage from the wound. You should call your doctor if you experience any of these symptoms.
What Types of Exercise Are Most Suitable Following a Knee Arthroscopy?
For the first 2 weeks you are encouraged to rest, elevate and ice you knee as much as possible. Overdoing exercise will only result in increasing pain and swelling whilst the knee is recovering from surgery. Short walking distances are allowed.
After the 2 week review, you will be allowed to walk in an unlimited capacity, swim, and cycle as desired. Contact sport, or running should be avoided for 4 weeks, or until all effusion or swelling in the knee has resolved.
CARE OF YOUR KNEE AFTER SURGERY
After your surgery you will have a crepe bandage on your knee. When the bandage is removed you will see only small puncture marks made by the surgical instruments. There are no sutures to be removed. The wounds have been closed with steristrips which should be left intact until they fall off, or are removed at the post-operative visit.
Although the procedure may seem minor, the surgery inside your joint is more traumatic and must be given full opportunity to recover. Your recovery will be improved if the guidelines outlined here are followed.
On discharge, you should be provided with:
- post-operative instructions
- review appointment (this will normally have been made for you prior to your surgery and referenced in your information pack)
- DVD of your surgery
CARE OF YOUR KNEE AFTER SURGERY
Swelling and discomfort is normal after surgery. This is most apparent in the first 3 days, after which most of the discomfort should start to settle. Even if you have minimal pain or swelling in the first 3 days you should really rest and not “over do it”.
Unless otherwise instructed, Mr Richardson wants you to walk short distances only in the first 2 weeks.
From 2 weeks you can increase your activity to include unlimited walking, swimming and cycling.
You should not attempt a return to sport or jogging for at least 4 weeks, or until all swelling has settled.
Whilst a return to normal activities is expected and encouraged, it will often take 3 months of a graduated return to activities before you knee starts to feel “normal” again.
ICING YOUR KNEE
Ice has the effect of controlling pain and inflammation and swelling in your knee after surgery. It is most effective in the first 3 days after surgery and should be used regularly in the post-operative period.
Please have an ice pack ready at home for when you are discharged, so it can be applied immediately when you get home. Always use a thin cloth between ice and your skin (Ice can burn if left on your skin). You can use a commercial ice pack, bag of frozen vegetables or crushed ice.
For the first 3 days, ice your knee regularly during waking hours. Apply the ice for 20 minutes, and then remove for an hour before reapplying. Thereafter, apply after exercising or when the knee becomes sore or tight from swelling.
You will leave hospital with a crepe bandage and padding wrapped firmly around your knee. This is designed to protect your wounds and apply pressure to stop bleeding and swelling in your knee.
This can be removed the next day, but please be careful not to remove the underlying waterproof dressings that cover you incisions. The waterproof dressings are to be left intact until your review appointment in 2 weeks. You can shower over the top of these dressings, but they are not to be soaked in a bath or pool. If they become loose they can be replaced simply with a Band-Aid.
If you experience significant bleeding from the wounds it will nearly always settle with the reapplication of the PRESSURE DRESSING, ELEVATION of the knee and application of an ICE PACK .
If at any stage you are worried, please call Mr Richardson’s rooms for further advice. In an emergency situation Mr Richardson can be contacted on his mobile telephone.
Crutches are used to help rest your knee in the first few days after surgery. They are used to assist you mobilse whilst resting your knee. You do NOT have to remain non-weight bearing. You can wean yourself off the crutches as you recover your confidence and regain your muscle strength.
You will be discharged with oral analgesia to help with any pain you might experience.
It is recommended that you have a stronger pain killer the first evening, but from then on, icing, elevation and simple paracetamol will often be adequate. Do not take the strong analgesics if you are not in a lot of pain.
If you require more than what has been supplied upon discharge then please attend to you GP for further prescriptions.
If you develop uncontrolled pain, or become unwell, then please contact Mr Richardson’s rooms for more advice.
If you plan to return to high-level activities, or you are concerned regarding your progress, it is wise to consult a Physiotherapist for appropriate rehabilitation.