It is important for a person taking any prescription or over-the-counter OTC medications to discuss them with the doctor. An individual may need to stop taking some medications ahead of the surgery. This may even include common OTC medications, such as ibuprofen Advil. A person may need to stop eating up to 12 hours before the procedure, especially if they will be general anesthesia.
A doctor should provide plenty of information about what a person is allowed to eat or drink. Some doctors prescribe pain medication in advance. A person should fill this prescription before the surgery so that they will be prepared for recovery.
A doctor may inject a local anesthetic to numb the affected knee only. If both knees are affected, the doctor may use a regional anesthetic to numb the person from the waist down. In some cases, doctors will use a general anesthetic. In this case, the person will be completely asleep during the procedure.
If the person is awake, they may be allowed to watch the procedure on a monitor. This is entirely optional, and some people may not be comfortable viewing this. The procedure starts with a few small cuts in the knee. Surgeons use a pump to push saline solution into the area. This will expand the knee, making it easier for the doctors to see their work.
After the knee is expanded, the surgeons insert the arthroscope. The attached camera allows the surgeons to explore the area and identify any problems. They may confirm earlier diagnoses, and they may take pictures. If the problem can be fixed with arthroscopy, the surgeons will insert small tools through the arthroscope and use them to correct the issue. After the problem is fixed, the surgeons will remove the tools, use the pump to drain the saline from the knee, and stitch up the incisions.
The use of anesthesia also comes with risks. In some people, it may cause allergic reactions or breathing difficulties. Most people leave the hospital on the day of the operation with specific instructions about how to handle recovery.
Doctors will typically give specific instructions before a person leaves the hospital. Rehabilitation to gain full ROM should occur within weeks.
Heavy work or sports may be restricted for the first weeks. Followed by 2 weeks of limited motion before resuming daily activities. Physical therapy starts right after surgery. The patient should be able to bear weight on the knee while standing or walking, immediately after surgery with a brace. The patient is expected to walk with crutches for weeks after surgery. Rehabilitation is intended to control pan and swelling, achieve maximum range of motion and full load walking.
Patients with a low impact job can return to work weeks after surgery, drive after weeks, and return to heavy work or sports months after surgery. Articular cartilage is the cartilage at the end of the bones. Damage can occur from trauma or normal wear and tear. Arthroscopy is used to remove loose pieces of cartilage. A microfracture procedure makes tiny holes in the bone marrow of the damaged cartilage to generate new cartilage. After surgery the joint must be protected while the cartilage heals.
No weight bearing is permitted for the first few weeks after surgery. Physical therapy to restore mobility may include continuous passive movement therapy which moves the joint through ROM constantly. Rehabilitation is focused on strengthening the joint and muscles. The patellar tendon attaches to muscles in the knee to help you straighten your leg.
Rather the patient will wear a brace and do physical therapy for weeks while the tendon heals. Surgical options are arthroscopic surgery or full open surgery. Larger tears and ruptures are disabling injuries and usually require open surgery to regain full knee function.
Surgery may outpatient procedure or a short hospital stay, with a spinal anesthetic, or general anesthesia. Rehab starts on the operating room table.
Physical therapy generally begins at a frequency of three times a week for four to six weeks. Your physical therapist will communicate and coordinate care with your healthcare provider and determine if you need more visits after the initial frequency is close to completion.
Arthroscopic procedures that involve the removal of damaged structures such as cartilage typically require less rehabilitation to return to normal activities. More involved surgeries that involve repair of damaged structures, such as a repair of the anterior cruciate ligament ACL , posterior cruciate ligament PCL , or meniscus , can require six months to a year of physical therapy.
As a general timeline, you can expect to return to the full extent of your usual activities within six to eight weeks after the surgery, but procedures like repairs of a meniscus, ACL, or PCL often require several months for complete rehabilitation. A meniscus repair can take between three and six months to recover and return to unrestricted activity while it can take between six and 12 months to fully recover from an ACL or PCL reconstruction.
Your return to work will be dependent upon your specific job duties. For sedentary jobs that involve sitting for most of the day, you may be able to return to work as soon as one to two weeks after the surgery. For more active jobs that entail physical demands, including prolonged standing, you will be able to return to work after several weeks of rehabilitation.
Your surgeon will give you clearance to return to work after your knee has healed enough to tolerate your work duties. You may have weight-bearing restrictions following your knee arthroscopy that limit the amount of pressure you can put through your leg while standing and walking. Your surgeon will inform you when it is safe to bear weight through your leg. You may be given crutches to help you walk after the operation to avoid putting too much pressure on the knee before it is fully healed.
Many arthroscopic knee procedures allow "weight bearing as tolerated" on the leg that was operated on. This means that you can stand and walk on your leg while bearing as much of your body weight as you can comfortably handle. If you are unable to walk without exhibiting increased pain, a significant limp, or poor balance, you will be able to use crutches to assist with offloading your knee joint until you progress with your rehabilitation and make improvements in your leg strength and pain levels.
Your physical therapist will continually monitor your progress and let you know when using crutches will no longer be necessary. Weight bearing as tolerated is typically allowed after procedures that involve repair or removal of cartilage, removal of a portion of the synovial membrane, a meniscectomy , or lateral release of the patellar retinaculum.
For other more involved arthroscopic procedures like ACL or PCL reconstruction, meniscus repair, and microfracture surgery , you will have to follow non-weight-bearing restrictions in the beginning weeks of your recovery. This means that you will not be able to stand or put any weight through your leg until cleared by your surgeon.
Crutches are most commonly used to help you walk while maintaining non-weight-bearing status on your operated knee, but a rolling walker or wheelchair is sometimes necessary initially for patients who cannot use crutches due to poor balance and strength. If you were given a knee brace to wear after your surgery, you should wear it all times except for showering and performing the non-weight-bearing exercises, completed while sitting or lying down, provided by your physical therapist.
All standing exercises should be performed with the brace on. Your surgeon will instruct you as to when it is safe to remove the brace and walk and exercise without it. Recovery from knee arthroscopy can vary depending on the procedure performed. It is important to follow all instructions from your surgeon and physical therapist to promote optimal healing and recovery for the best possible outcome. Recommendations for optimal recovery include:.
You may experience pain and discomfort in your knee after the operation. Your healthcare provider will prescribe you pain medication to help manage symptoms after the surgery. Each incision site will be covered with a small bandage after the surgery is completed. You may shower within a few days after the surgery, but your incision sites should remain covered and dry for four to five days after the operation.
You can use a plastic bag or plastic wrap to cover your knee in order to shower without the incisions and bandages getting wet. Your surgeon will give you specific instructions about how long to keep the bandages covering the surgical sites. Once you remove the bandages, wash gently around the incisions and pat dry. 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.
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