Knee arthroscopy surgery is the orthopedic (joint) procedure that is performed most often in the United States. During the relatively fast surgery, the surgeon cleans and repairs the structures inside the knee with the aid of a pencil-sized video camera, which allows for a more accurate diagnosis. Due to the fact that a small incision is made and the damage to surrounding muscles, tendons and ligaments is reduced, the healing time from this procedure is typically shorter than with a traditional "open" surgery. However, it is important to follow strict post-operative measures to fully recover from knee arthroscopy.
Steps
Part 1 of 3: Follow the Getting Started Instructions
Step 1. Listen to the surgeon's directions
After undergoing knee arthroscopy, it is important to respect as much as possible the opinion of the orthopedist regarding the most appropriate procedures to heal better. Your knee probably won't come back perfect, but by following the specific directions for controlling inflammation and pain, as well as stimulating healing, you can get the best prognosis for the specific type of injury you have suffered.
- Most of these arthroscopic procedures are performed on an outpatient basis and generally last no more than a few hours. They can be performed under local, regional or general anesthesia to avoid pain.
- The most common injuries justifying knee arthroscopy are: tearing of the cartilage of the meniscus, pieces of cartilage that enter the joint space (known as osteochondritis), torn or damaged ligaments, chronic inflammation of the joint linings (called synovitis), misalignment of the patella or removal of a cyst behind the knee.
Step 2. Take medications as prescribed
Based on your diagnosis, age and overall health condition, your doctor may recommend targeted medications to manage pain and inflammation, but also to avoid possible infections and / or blood clots. Make sure you don't take any medications between meals, as this could irritate the stomach walls and increase the risk of ulcers.
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or aspirin, can help you control inflammation and pain.
- Pain relievers such as opioids, diclofenac, or acetaminophen relieve pain but not inflammation.
- Antibiotics are prescribed to prevent infections, while anticoagulants are prescribed to avoid thrombosis.
Step 3. Lift your leg when you rest
To try to avoid knee inflammation naturally, you can raise the limb higher than the level of the heart by using pillows during rest. This helps the blood and lymphatic fluids get back into circulation, rather than getting stuck in the lower leg or knee area. It is easier to lift the limb while lying on a sofa than when sitting in a chair.
It is not recommended to remain at complete rest when you have a musculoskeletal injury, because it is necessary to do some movement (even just a little limp around the house), in order to stimulate blood circulation and promote healing. Therefore, it's okay to get some rest, but total inactivity is counterproductive
Step 4. Apply ice around the knee
This is an important treatment for all injuries involving bones and muscles because it helps narrow blood vessels (reducing inflammation) and numbs nerve fibers (relieving pain). You should apply the cold pack on and around the surgery incision for about 15 minutes every 2-3 hours for a couple of days; then reduce the frequency as the pain and swelling subside.
- You can hold the ice against the knee with a bandage or elastic support to try to keep inflammation under control.
- Make sure you always wrap the ice or frozen gel pack in a thin towel to avoid cold burns on the skin.
Step 5. Take proper care of the bandage
Upon discharge from the hospital, a sterile bandage will be applied to cover your knee, in order to absorb the blood that comes out of the incision. Your surgeon will give you instructions on when you can shower or bathe and when you need to change the bandage to reduce the chances of infection. The main purpose is to keep the incision clean and dry. It is a good idea to use antiseptic solutions when changing the bandage.
- In most cases, it is possible to wash the body completely after about 48 hours after surgery.
- Among the most common antiseptic products are iodine tincture, denatured alcohol and hydrogen peroxide.
- Talk to your surgeon before applying anything to the wound. For example, iodine tincture can prevent healing, and it is no coincidence that it is a remedy less and less used by doctors.
Step 6. Look for signs of infection
After surgery, you should watch for increased pain and swelling in the incision area, drainage of pus and / or red streaks extending from the affected area, fever and lethargy. If you notice any of these symptoms, you should see your doctor immediately.
- The doctor will prescribe systemic antibiotics and antiseptic solutions to treat the infection.
- In more extreme cases it is possible to drain pus and other fluids from the infected knee.
Part 2 of 3: Keep the Knee at Rest
Step 1. Rest for the first few days of recovery
Arthroscopy surgery can relieve most knee pains almost immediately, but it is important to be very cautious and resist the urge to perform strenuous activities during the very first few days. If you want to do some physical activity right after surgery, make sure it is very light exercise, focus on muscle contractions in the leg and movement without carrying weights, such as lightly lifting the affected limb while lying on the sofa or bed. read.
- After a few days, focus the exercises on recovering balance and coordination by putting more weight on the leg, but always supporting yourself with a chair or supporting yourself against the wall so as not to fall.
- It is not recommended to be completely inactive (such as resting in bed) after surgery, because muscles and joints must move and blood must flow to heal better.
Step 2. Use crutches
You will likely need to avoid going to work for some time, especially if your duties involve standing, walking, driving, or lifting weights for a long time. Recovery from a simple arthroscopy procedure is usually relatively quick (a few weeks), but crutches may need to be used during this time. If part of your knee has been rebuilt or repaired, you may not be able to walk without this aid or a brace for several weeks, and complete healing may take a few months or even a year.
Make sure the crutches are set correctly for your height, otherwise you could develop a shoulder injury
Step 3. Change your duties at work
If you do physical work, you should speak to the owner about other less demanding tasks if possible. For example, you might be doing some more sedentary activities at the office or working from home on the computer. It is also generally wise to limit driving to 1-3 weeks after undergoing this type of knee procedure; therefore even just getting to work could be very difficult.
- When you can go back to driving depends on the knee involved, whether you own a car with an automatic or manual gearbox, the nature of the procedure, the level of pain and even whether you are taking narcotic pain relievers.
- If your right knee has been operated on (needed to press the accelerator and brake) you need to wait a longer period before returning to driving.
Part 3 of 3: Rehabilitation
Step 1. Start with exercises that don't involve weight bearing
After a few days, depending on the level of pain, it may be safe to perform some exercises while lying on the floor or bed. It is necessary to carry out regular exercises to regain the mobility of the knee and strengthen it; almost always these are movements that you can safely do at home. Your orthopedic surgeon may recommend that you do leg exercises for about 20-30 minutes, 2 or 3 times a day. Start contracting the muscles around the knee without bending the joint too much for now.
- Contract the back muscles: lie down or sit down with the knee bent about 10 degrees, push the heel against the floor and contract the hamstrings as much as possible; hold the position for 5 seconds and then relax; repeat 10 times.
- Contract the quadriceps: lie in the prone position by placing a rolled towel under the ankle corresponding to the affected knee; push your ankle as hard as you can against the rolled sheet; in this way the leg should straighten as much as possible; hold the position for 5 seconds and then relax the limb; repeat 10 times.
Step 2. Move on to exercises that involve putting weight on the operated leg
Once you have started exercising the muscles surrounding the knee a little with isometric contractions, try to put some weight on by standing up. As you increase the intensity of the exercises, you may experience some temporary setbacks - if your knee starts to swell or you feel pain during a specific exercise, stop it until the joint recovers.
- Do partial squats with the help of a chair: Grab the back of a sturdy back or counter while keeping your feet about 6 to 6 inches from the support. Don't squat down completely. Keep your back straight and hold the position for 5-10 seconds. Slowly return to an upright position, rest and repeat the exercise 10 times.
- Stretch your quadriceps (thigh muscles) to a standing position: Stand with your healed knee bent, gently pull your heel towards your buttocks to create a stretch in the front of your thigh. Hold the tension for 5 seconds, relax and repeat 10 times.
- Perform the step up: take a step forward with the leg that needs to heal, climbing on a stool about 15 cm in height. Get off the stool and do 10 repetitions. Increase the height of the stool or platform as the leg gets stronger and stronger.
Step 3. Proceed with resistance exercises with weights
The last stage of knee rehabilitation involves increasing strength and endurance using weight lifting machines or an exercise bike. If you're not used to going to the gym and doing strength exercises, you can turn to a personal trainer or physical therapist for help. The professional will be able to show you specific and personalized stretching and strengthening exercises for the knee and will treat muscle pain with specific procedures, such as ultrasound therapy or electrical muscle stimulation.
- Use the exercise bike. Start by pedaling 10 minutes a day with the lowest resistance setting, then extend the exercise up to 30 minutes with more resistance.
- Try leg extensions with weights. Use the machine for this exercise at the gym and set the minimum weight. Getting into a sitting position, fit your ankles around the padded supports and try to straighten your legs. Hold the position for a few seconds and then slowly lower your legs back down. Repeat 10 times and gradually increase the weights over a few weeks.
Advice
- Although you can start walking without crutches about two weeks after surgery, you should avoid running for at least 6-8 weeks, due to the noticeable impact and shock that is transmitted from the feet to the knees.
- You should integrate light running and walking back into your physical activity routine gradually over a few weeks.
- You can take supplements such as glucosamine and chondroitin to help your knee recover by increasing lubrication and therefore the ability to absorb shock.
- Unless you've had a ligament reconstruction done, you should be able to resume most physical activities after 6-8 weeks - sometimes even earlier. However, you must avoid high impact exercises for a longer period.
- Avoid smoking, as smoking impairs blood circulation, as a result the muscles and other tissues are deprived of the necessary oxygen and nutrients.
