Arthroscopic knee surgery is the most commonly performed orthopedic (joint) procedure in the US. During this relatively short procedure, the inside of the knee joint is cleaned and repaired with the help of a pencil-sized camera that allows for a more accurate diagnosis. Due to the small incision and reduced damage to the surrounding muscles, tendons, and ligaments, postoperative healing time is usually less than that of conventional open knee surgery. However, there is still a strict postoperative routine that must be followed in order for you to recover 100% from arthroscopic knee surgery.
Step
Part 1 of 3: Following Initial Instructions
Step 1. Listen to your surgeon's instructions
In undergoing arthroscopic knee surgery, you must take the best steps according to the doctor in order to get the best healing. Your knee may not be fully restored, but the best results for your injury will be obtained by following specific recommendations regarding inflammation and pain control.
- Almost all arthroscopic knee surgeries are performed on an outpatient basis and last only a few hours. Arthroscopy can be performed under local, regional, or general anesthesia which will prevent pain during surgery.
- The most common conditions confirming knee arthroscopy are: torn meniscus cartilage, pieces of cartilage within the joint space (also known as "joint mice"), torn or damaged ligaments, chronically inflamed joint lining (called synovium), cartilage misalignment of the knee (patella) or removal of the cyst behind the knee.
Step 2. Take medication as ordered
Your doctor will recommend medication to control pain and inflammation, but also prevent infection and/or blood clots depending on your diagnosis, age and overall health. Do not take the medicine on an empty stomach as it can irritate the inner lining of your stomach and increase the risk of ulcers.
- Non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen, naproxen or aspirin will help you manage inflammation and pain.
- Analgesics such as opioids, diclofenac and acetaminophen will relieve pain, but have no effect on inflammation.
- Antibiotics are prescribed to prevent infection, while anticoagulants are to prevent blood clots.
Step 3. Raise your legs while resting
To naturally prevent inflammation of the knee, elevate your feet higher than heart level with the help of pillows while you rest. Blood and lymph fluid will return to the circulation and not collect in your legs or knees. It's best to elevate your legs while lying on a bed or sofa rather than sitting in a chair.
Total bed rest is not recommended for all types of musculoskeletal injuries because movement (even just limping around the house) is needed to stimulate blood flow and healing. Therefore, complete silence will be counterproductive to you
Step 4. Apply ice to your knee
Ice treatment is very effective for all acute musculoskeletal injuries because it blocks blood vessels (reduces inflammation) and numbs nerve fibers (relieves pain). Cold therapy should be given over and around the wound from surgery for about 15 minutes every 2-3 hours for two days, then decrease in frequency as pain and swelling decrease.
- Applying ice to the knee with a bandage or rubber support will help control inflammation and limit swelling.
- Ice packs or frozen gels should be wrapped in a thin towel before applying the compress to prevent frostbite.
Step 5. Take good care of the bandage
You will leave the hospital wearing a splint on your knee that has been sanitized and will absorb the blood seeping from the wound. The surgeon will show you how to shower and when the bandage should be changed to reduce the chance of infection. The main concern is to keep the surgical incision clean and dry. Use an antiseptic solution on the wound when changing the bandage.
- In most cases, you will be able to completely cleanse your body starting 48 hours after surgery.
- Commonly used antiseptic solutions include iodine, rubbing alcohol and hydrogen peroxide.
- Check with your surgeon after surgery before applying anything to the wound. For example, iodine can hinder wound healing and is not recommended in some surgeries.
Step 6. Watch for signs of infection
Signs of postoperative infection include: increased pain and swelling near the incision, discharge of pus and/or red streaks extending over the injured area, fever and lethargy. If these signs appear, see a doctor immediately.
- Your doctor will treat the infection with systemic antibiotics and a local antiseptic solution.
- In more extreme cases, the infected wound may have pus and fluid should be drained.
Part 2 of 3: Resting the Knees
Step 1. Relax for the first few days
Arthroscopic surgery can immediately relieve almost any pain in the knee, but be careful and resist the urge to do strenuous activities for the first few days so that the knee heals completely. All exercises during the first few postoperative days should be very light and focused on the leg muscles while lying on the bed or couch.
- After a few days, focus on restoring your balance and coordination by increasing the weight on your legs, but supporting yourself with a chair or leaning against a wall so you don't lose your balance.
- Complete inactivity (eg bed rest) is strongly discouraged postoperatively. Muscles and joints need to be moved and get enough blood flow to heal.
Step 2. Use crutches
You will most likely need to be absent from work, especially if it involves standing, walking, driving, or lifting. Recovery from a simple arthroscopic procedure is usually relatively quick (a few weeks), but you may need crutches for a while. If parts of your knee have been repaired or rebuilt, you may not be able to walk without crutches or a knee brace for several weeks, and complete recovery can take several months to years.
Make sure the crutches match your height so you don't injure your shoulder
Step 3. Change your routine at work
If possible, talk about changing tasks with your boss, especially if your job requires physical strength. for example, you could do more sedentary work in the office or work at home with a computer. Driving is also usually limited from 1-3 weeks after an arthroscopic knee procedure so going to work alone may be very difficult.
- The time you can drive will depend on: your injured knee, the transmission of the car, the nature of the procedure, the level of pain, and the use of narcotic pain medication.
- If you use your right knee (to depress the gas and brake pedals), your driving time will be longer.
Part 3 of 3: Rehabilitation
Step 1. Start with no-weight exercises
After a few days, depending on the level of pain, you should be able to do a little exercise while lying on the floor or in bed. You are required to perform regular exercises to restore mobility and knee strength, most of which can be done at home. Your orthopedic surgeon may suggest 20-30 minutes of leg exercises, 2-3 times a day. Begin by contracting around the knee without completely flexing the knee joint.
- Contract your hamstrings: lie down or sit with your knees bent 10 degrees, pull your heels off the floor while tightening the muscles in the back of your thighs, hold for 5 seconds, then relax. Repeat 10x.
- Contract your quadriceps: face down with a rolled towel placed under your ankle on the healed knee. Press the ankle into the towel roll. Your legs should be as straight as possible, hold for 5 seconds, then relax, repeat 10 times.
Step 2. Proceed to training with weights
If you've lightly worked all the muscles around your knee with isometric contractions, try weight training while standing. When you increase the intensity of your workout, you can experience temporary setbacks. If your knee swells or starts to hurt after a certain exercise, stop the activity until your knee no longer hurts.
- Half squat while holding on to the chair hold on to the back of a sturdy chair and stand 15-30 cm from the chair. Do not bend completely. Keep your back straight and hold for 5-10 seconds. Return to standing slowly, relax, and repeat 10 times.
- Quadricep (thigh muscle) stretch: stand with your restored knee bent, gently pulling your heel toward your glutes, which will stretch the front of your leg (thigh). Hold for 5 seconds, relax, and repeat 10 times.
- Forward step-up: step forward and climb onto the stand 15 cm high, guided by the restored leg. Step down and repeat 10x. Increase the height of the seat as your leg strength increases.
Step 3. Proceed to weight resistance training
The final phase of knee rehabilitation is performed using weight resistance via weights or an exercise bike. If you're not used to going to the gym and weight training, consider hiring a personal trainer or physical therapist. A physical therapist can show you stretching and strengthening exercises designed specifically for you. If needed, treat your sore muscles with modalities such as ultrasound therapy or electronic muscle stimulation.
- Use a stationary bike. Ride a stationary bike for 10 minutes a day with the lowest resistance, then increase to 30 minutes with the heavier resistance.
- Try leg extensions with weights if the orthopedist allows. Look for a leg extension machine at the gym and choose the lowest weight. In a sitting position, hook your ankles on the cushioned bumps and try to straighten your legs. Hold for a few seconds and slowly lower the leg back down. Repeat 10 times and increase the weight after a few weeks. Stop exercising if you feel pain and check with your doctor before continuing.
Tips
- Although walking without crutches can be started approximately 2 weeks postoperatively, jogging should be avoided for 6-8 weeks postoperatively because the impact transmitted from the foot to the knee is quite strong.
- Walking and jogging should be gradually incorporated into an exercise program over several weeks.
- Take supplements such as glucosamine and chondroitin to help rehabilitate your knee by increasing lubrication and impact absorption.
- You can return to physical activity after 6-8 weeks (sometimes sooner), unless you have ligament reconstruction. Activities with a rather loud impact need to be avoided for a slightly longer period.
- Quit smoking because it interferes with blood flow, causing muscles and other tissues to be deprived of oxygen and nutrients.
