Arthroscopy Surgery For Knee Cartilage Tears
Knee arthroscopy has been a huge advance in the management of many knee conditions with cartilage tears one of the most effective operations. You should have had a course of physiotherapy before arthroscopy as some cartilage tears settle without surgery.
If the knee remains locked after an injury, surgical treatment is usually carried out as soon as possible. Commonly there is only limited pain and joint swelling so non-operative treatment is prescribed, initially rest and anti-inflammation drugs. This is followed by physiotherapy to strengthen the thigh muscles and rehabilitate normal function.
Surgery may be needed if there are repeated episodes of pain, swelling, locking or giving way which interfere significantly with daily activities or sports.
Magnetic resonance imaging (MRI) scanning may be performed to confirm the exact diagnosis before surgery.
Arthroscopy is the commonest method used to operate on knee cartilage tears, with the instrument called an arthroscope. This is a very slim telescopic tube with a light at the end, enabling it to be inserted into the knee through a very small incision.
A skilled operator can see all the important knee structures, and can remove cartilage tears using instruments inserted down the arthroscope. The surgeon will only remove the torn or abnormal parts of the cartilage and can trim an abnormal discoid cartilage back to a normal crescent shape, releasing its fluid into the knee joint if it has a cyst.
Arthroscopic surgery is carried out mainly as a day case procedure and there is usually little pain involved. Within a few hours a physiotherapist will advise you what exercises to perform and get you walking again.
Walking aids are not usually required unless previously used for other reasons, or pain is significant. Small strips are often used to close the wound and a follow up clinic appointment arranged at about two weeks after surgery.
Rehabilitation after surgery
You should get better day by day so if any significant pain or swelling develops you should contact your doctor. Post-operative problems may be due to blood or fluid collecting in the knee, or rarely infection.
Full weight bearing on your knee may well be possible immediately and completely comfortable in a few days. Full bending (flexion) of the knee usually returns between 1 and 2 weeks, and pushing this movement is generally not recommended.
Working hard at the straightening (extension) exercises of your knee is important. The quadriceps (main thigh muscle) must be strong to stabilise your knee. Your knee also needs the ability to go absolutely straight after your surgery.
Jobs and normal activities
Return to a less active job is normally possible by two weeks, any sooner may make the knee swell up and be painful. Return to a more strenuous job is more likely at four to six weeks.
You should take the advice of the hospital unit on when it is safe to drive again. If you do not feel able to drive your insurance may well be invalid. If it is your right leg affected the usual advice is to wait until your follow-up appointment with the knee surgeon in the clinic and ask then. It is less clear with the left leg and you should take the advice of your doctor or insurance company.