If arthrosis progresses, doctors often prescribe surgery - arthroscopy. A special endoscopic instrument equipped with a video camera is inserted into the joint and displays an image with multiple magnification on the monitor. The procedure is performed under anesthesia, gives the patient a good prognosis, but requires a serious, very responsible attitude during the recovery period. What recommendations must be followed to avoid complications in the form of adhesions, contractures and relapses?
Knee arthroscopy is not as scary as rehabilitation after it
What Happens During the Early Recovery Period
After the end of the operation, 2-3 days pass before the drainage tube is removed. This is the early recovery period, during which:
- painkillers and antibacterial drugs are administered;
- an aseptic bandage is applied to the incision area;
- apply an ice pack;
- It is recommended to use a special bandage or elastic bandage for immobilization to prevent swelling.
Any load on the knee is contraindicated. At this stage of treatment for arthrosis or osteoarthritis, it is important to observe bed rest. The bed should be such that the operated leg is in a stable position. Loads on the limb must be strictly dosed - according to the recommendation of the attending physician.
Orthosis and crutches are mandatory companions for the patient in the early recovery period
Do I need special preparation for arthroscopy?
At your first appointment with your orthopedist, you will be told how to prepare for the procedure. The doctor will ask what medications you are taking and may make adjustments to them.
- It is recommended to stop taking aspirin and ibuprofen for several days or weeks before the procedure.
- You should not eat or drink for 6-12 hours the day before.
- If necessary, you will be prescribed additional pain medications.
How is arthroscopy used to determine the cause of knee pain? A practicing orthopedic surgeon-traumatologist tells and shows:
Exercises to restore knee joint function
Already in the early recovery period and after its completion, the patient is prescribed exercises to strengthen the muscles around the operated joint. They should be performed under the supervision of an instructor, gradually increasing the intensity and duration.
On the second day after surgery, light rotation of the ankle is allowed. A little later - in agreement with the doctor and exercise therapy instructor (usually within 3-7 days after surgery) - the patient performs the following exercises:
- Bend your knees while lying on your back so that the action does not cause pain.
- While lying on your stomach, press down with your foot the cushion placed under the foot.
- Raise the straightened leg 30 cm and hold it suspended for 5 seconds.
- Bend your knees while lying on your back with tension in your gluteal muscles.
- In the position of standing sideways against the wall, lift the straightened limb 45° above the floor surface (then a similar action, but with the foot turned outward).
A week after arthroscopy, a different, more intense set of exercises is recommended, where most of the actions are performed in a standing position. If the condition of the joint allows, you can connect an exercise bike or treadmill.
At different periods after knee arthroscopy, different exercises are performed.
In the first week after surgery:
From the first to the fourth week:
From the fifth week to the end of the second month:
What knee diseases can be diagnosed using arthroscopy?
- Inflammatory processes in the knee in acute and chronic form, including gonarthrosis.
- Deforming arthrosis.
- Rupture of the posterior or anterior cruciate ligament.
- Injuries and damage to the meniscus.
- Detection of fragments of torn cartilage (“articular mouse”).
- Baker's cyst.
- Fracture of the bones that form the knee joint.
- Displacement of the kneecap.
- Swelling of the synovial membrane.
- Articular cartilage defects.
- Arthritis.
- The presence of effusion inside the mobile bone joint (including with hemarthrosis).
Arthroscopy is also recommended if difficulties arise with making a diagnosis using other methods. Another indication is discomfort and pain after knee replacement or other knee surgery.
Arthroscopy is often ordered to determine the cause of knee pain.
Drug treatment of arthrosis after arthroscopy
Arthroscopy does not lead to immediate recovery, so medication assistance is necessary during the recovery period. The patient is prescribed non-steroidal anti-inflammatory drugs to prevent complications. You also cannot do without taking chondroprotectors, for example the drug Structum, Dona or Elbona.
Two weeks after arthroscopy you can recover on a treadmill
Indications for surgery
Complete removal of the knee meniscus
inevitable if the diagnosis showed a rupture of most of the body or fragmentation of the cartilaginous layer. Fortunately, this happens extremely rarely. Organ-saving surgery, which is mainly performed, consists of partial removal of the meniscus of the knee joint, that is, resection of only the non-viable area. As for conservative medicine, it is used for minor fiber tears, microtraumas, structural degenerative-dystrophic changes, if they do not provoke pinching and joint instability.
Types of meniscal tears.
According to doctors, patients do not always go to the hospital immediately, but years after they have experienced the injury. And what previously seemed like an ordinary bruise, over time leads to serious complications. Since the shock-absorbing pad does not have a sufficient network of blood vessels, there are practically none, some tears in certain areas cannot heal on their own - they must either be resected or stitched. Meniscus surgery
, and it is reasonable to do it for fresh injuries, which increases the chances of full restoration of motor functions, has the following indications:
- the presence of a vertical break in the midline;
- transverse or longitudinal violation of integrity;
- flap (tongue-like) anterior tears;
- multiple bundles;
- separation of a fragment of cartilage from the main plate;
- pinched meniscus cartilage;
- highly fragmented structures;
- presence of cystic formations.
A removed meniscus in the hands of a traumatologist.
Loose meniscus pieces or torn pieces of cartilage that are constantly wedged between articulating bones are a real disaster for motor support functions and the health of the articular surfaces. Arthrosis is guaranteed if an operation to remove the meniscus of the knee joint, or rather its pathological fragments, was not performed in a timely manner. And advanced osteoarthritis is a direct road to disability. That’s why experts don’t advise tempting fate, but at least go to the emergency room first.
Attention! Internet sources often mention that they allegedly replace the meniscus of the knee joint, mind you, in passing and without any details. The scant information regarding the implantation of donor material or a meniscus implant simply means that such a technique has not yet received approval from orthopedic experts. Due to the insufficient clinical evidence base for its effectiveness, meniscal replacement, unlike knee arthroplasty, has not yet become widespread.
How to improve your diet
After surgical treatment of osteoarthritis of the knee, it is very important to receive substances from food aimed at strengthening the operated tissues. The body should not be deficient in protein, Omega-3 fatty acids, sulfur and selenium. Therefore, during this period it is recommended to include in the diet:
- cottage cheese and fermented milk products;
- cheeses;
- condensed milk;
- egg yolk;
- dried fruits;
- seaweed, shrimp, mussels, seafood;
- broth, aspic, jellied meat;
- compotes, fruit drinks, fruit jellies and marmalades;
- mineral water.
The right diet will help you lose weight
Is it possible to avoid all this?
Knee arthroscopy is a difficult surgical procedure that requires the patient to be patient and carefully follow all recommendations. It is often practiced in the second and third stages of arthrosis, while the problem can be dealt with in another, minimally invasive way.
Intra-articular injections of Noltrex help restore mobility in the knee joint and relieve pain for 9-24 months. The product is a synthetic substitute for synovial fluid. The course includes 2-5 Noltrex injections depending on the extent of the lesion and does not require the patient to undergo a difficult recovery period, as after arthroscopy. The therapeutic effect is noticeable after the second procedure; there are no risks compared to surgery.
Diagnostic examination
The medial (internal) element is most susceptible to damage, since at the anatomical level it is less mobile than the opposite (external) meniscus, which makes it too vulnerable in case of unsuccessful movements, powerful pushes and blows, uncharacteristic turns of the leg in the knee area. Undoubtedly, the lateral component can also suffer an unpleasant fate, however, as observations show, it is damaged 3 times less often. Surgery on the medial type of meniscus of the knee joint is therefore more in demand.
You can understand that the integrity of the fibrocartilaginous tissues is compromised by the sudden appearance of severe pain and the sensation of a peculiar crunch. Also, due to the rupture, the following arise:
- lumbago (locally) when making movements;
- decreased limb mobility;
- suppression of motor functions of the knee
; - difficulty moving, especially when walking up stairs;
- painful clicking followed by knee jamming (blocking movements);
- local swelling, inflammation, local increase in temperature.
Important! Absolutely any cartilage injuries must be treated strictly! You won’t be able to make an accurate diagnosis on your own; you can only assume that something bad has happened to one of the menisci. Only a special diagnostic examination by an orthopedist-traumatologist can confirm or refute your assumptions.
First, the specialist listens to the patient’s complaints, performs a visual and palpation examination, checks the range of motion not only of the knee joint, but also the hip joint, assesses the pain factor by controlled provocation of pain, and tests muscle tissue for the ability to conduct stimulation. All initial findings indicating a clear meniscus problem must be supported by effective imaging to determine:
- in which areas the damage is concentrated;
- what area does it cover;
- what direction and form is this traumatic formation;
- whether nearby structures are damaged (ligaments, capsule, etc.).
For this purpose, they resort to highly informative diagnostic methods that can clearly visualize the anatomical object under study, these include:
- magnetic resonance computed tomography (MRI);
- ultrasound examination of the knee (ultrasound);
- diagnostic arthroscopy
.
As for x-rays, a similar technique can be useful, but only with contrasting of the joint. With conventional radiography, the meniscus
not visible in the photographs. After establishing an accurate diagnosis, the doctor decides which treatment tactics are best applied in a particular case. The patient may be sent for surgery on the meniscus of the knee joint or prescribed conservative therapy.
And in this case, arthrosis of the last stage was diagnosed.
It is impossible not to warn that the risk group includes not only people involved in sports, but also patients who have chronic joint ailments (arthritis, gonarthrosis, etc.). knee surgery at any time.
: The meniscus is easily injured in such conditions.
Fibering of tissues in the joint cavity also indicates trauma.