Knee arthroscopy rehabilitation

9 minutes Posted by Lyubov Dobretsova 30146

Arthroscopy is a minimally invasive surgical procedure designed to examine and / or treat problem joints. In the course of such a procedure, you can establish an accurate diagnosis and, if necessary, simultaneously correct the pathology.

Arthroscopic intervention is indispensable for such injuries and diseases:

  • damage to articular cartilage;
  • injuries of the cartilage shock absorber of the joint;
  • Keneg disease (separation of a small area of ​​cartilage from the adjacent bone with its displacement into the joint cavity);
  • damage to the ligaments of the knee joint;
  • dislocation of the patella;
  • chondromatosis of the knee joint (the formation of rounded cartilaginous formations in the joint cavity);
  • synovitis (inflammation of the synovial membrane);
  • gonarthrosis of the knee joint;
  • unclear clinical picture – controversial diagnosis;
  • complaints after previously performed operations on the joint.

Patients who are just about to have such a procedure and those who have already experienced it are interested in the general question – how is rehabilitation after arthroscopy of the knee joint? And this is correct, since the success of this manipulation depends not only on the competent conduct of the procedure itself, but also on the proper development of the knee joint in the recovery period.

Inpatient rehabilitation

When performing arthroscopy on the knee joints, the duration of hospital stay in all patients is different, but on average they do not exceed 24 hours. Although with arthroplasty of the cruciate ligaments, the patient can be hospitalized for 72 hours, and with an uncomplicated meniscus operation, they can let him go home after 3-4 hours.

Recovery after arthroscopy of the knee joint begins immediately at the medical facility. For these purposes, a number of procedures are performed:

  1. Immediately after arthroscopy, antibiotic therapy is prescribed. Broad-spectrum drugs are used.
  2. To relieve pain, analgesics from the NSAID group are used.
  3. Postoperative edema is eliminated using a manual or hardware lymphatic drainage massage.
  4. To ensure complete rest, the knee joint is fixed with a special orthosis bandage and keep the limb straight. And in the case of arthroplasty, a hinge joint with a bending angle of 20 ° is used.
  5. For the prevention of thromboembolism, patients are recommended to wear an elastic bandage or compression hosiery during the first 3-5 days, and anticoagulants are prescribed.
  6. In the first 24–72 hours, cold is applied to the affected joint with breaks of half an hour.
  7. Already on the first day a complex of therapeutic exercises is prescribed – isometric gymnastics and light movements in the ankle joint. And when drainage is removed, passive movements in the knee joint are added and the patient is placed on his feet, resting on crutches or a cane.

If the meniscus was removed, rehabilitation after surgery takes a little time and the first exercises are allowed to be done by the end of the first day.

Home Recovery

If the patient underwent arthroscopy of the knee joint, then rehabilitation after surgery should be continued without fail at home. A positive outcome largely depends on whether the patient adhered to such rules:

  • If the patient keeps his legs raised for the first 1-3 days, this will help reduce swelling.
  • It is important to keep surgical incisions in the knee area dry and clean. The dressing change is supervised by a doctor. Water procedures should be performed with extreme caution.
  • It is important for the patient not to forget to take anti-inflammatory and vascular drugs prescribed by the doctor.
  • The first 5-7 days, the patient should wear an elastic bandage. If necessary, lymphatic drainage and cryotherapy are prescribed.
  • On the 8th day after the operation, a therapeutic massage in the knee area can be prescribed. It is more correct that such manipulations are performed by an experienced specialist. However, some patients use a training video, which can be easily found on the Internet and perform self-massage at home.

The attending physician monitors the features of motor activity during the rehabilitation period:

  1. After removing the meniscus on the day of surgery, walking with moderate exercise is recommended. During the first week it would be nice to use a cane or crutches. If ligature was imposed on the meniscus, then the foot is spared for a month and only move with the help of crutches.
  2. After plastic surgery of the ligaments of the knee joint during the recovery period, crutches with elbow support up to 21 days should be used. The first 2-3 days should avoid the load on the operated limb, but if there is no severe pain, then the axial load is increased.

A follow-up examination by a specialist and a change in dressings occurs in the first 24 hours after surgical procedures, and then every 2–5 days. During the procedure, the patient is replaced with aseptic dressings and, if necessary, the accumulated fluid is sucked out. Surgical suture material is removed for 7-12 days after the manipulation.

Physiotherapy

Exercise therapy after arthroscopy of the knee joint is recommended for absolutely all patients, although an individual approach is used in this matter. The program is divided into several stages, depending on the dosing load:

  1. The first stage is exercises with minimal load, which can be performed on the same day when arthroscopy was done. The knee is fixed, and the patient slightly extends the legs in the knee joint, while using the quadriceps muscles of the thigh.
  2. The second stage – a set of exercises with increased load, is carried out at home, but under the supervision of a specialist. Exercises are aimed at increasing joint mobility, as well as those that are performed in a fixed position.
  3. The third stage is designed for 3 weeks. Now the patient must increase the range of motion in the knee joint, and a special load is used to increase the load on the lower leg.
  4. The fourth stage is designed for 6 weeks and implies a significant increase in the load on the affected limb. For this, the emphasis is on the leg, on which arthroscopy was performed. It is bent at an angle of 30 to 80 degrees, and the second performs movements in a circle. In addition, the patient must walk for a quarter of an hour or engage in cycling for 10 minutes a day.

A set of exercises after arthroscopy of the knee joint on the 3rd day after surgery may include such techniques:

  • Exercising the femoral muscles in the back. The patient lies on his back and bends the limbs in the knee joints so as not to experience pain. The heels should be pressed to the floor, and the femoral muscles in the back should be strained. In this static position, you need to withstand 5 seconds, and then you can relax.
  • Exercising the femoral muscles in front. The patient is lying on his stomach. Under the foot put a roller twisted from a towel or other fabric. The leg should be straightened as much as possible and stay in such a static position for 5 seconds, after which you can relax.
  • Raising a straightened leg when the body is in a horizontal position. The limb, which was subjected to arthroscopy, must be put on a flat surface, and the second should be bent at the knee joint. The affected limb should be straightened, slowly raise it 30 cm from the supporting surface, and be in this static position for 5 seconds. After that, slowly take your starting position.
  • Exercising the muscles of the buttocks when the body is in a horizontal position. The limbs should be bent at the knee joints, and the distal section should be supported on a flat surface. The muscles in the buttocks should be tightened and fixed for 5 seconds, and then relax.
  • Each dose of the complex should be repeated 10 times.

Physical therapy, which is performed in a later period, includes the following techniques:

  • Reinforced knee joint development. The patient occupies a horizontal position with emphasis on the back, and a roller is placed under the knee. The limb should be straightened as best as possible in the knee, resting on the roller, and be in this static position for 5 seconds. Then you need to slowly take the starting position.
  • Lifting a straight leg when the body is horizontal with emphasis on the back. A healthy limb should be bent at the knee joint, and the operated one should be straightened and laid on a flat surface. The essence of the exercise is to slowly raise the leg by 45 degrees and hold it for 5 seconds every 15 degrees of lifting. Thus, the exercise is divided into 3 sets with a 60 second break between each. Then the leg is returned to its original position.
  • Partial crouching by the chair. Necessary equipment – a chair with the back turned to the patient. It must be placed 30 cm away from you. You need to sit down so that a right angle is formed, and you can stay in this position for up to 10 seconds, holding on to the back of the chair.
  • Exercising the anterior thigh muscle group. The patient should put a chair in front of him, focus on a healthy leg and lean on the back of the chair. At this time, the operated leg should be bent at the knee and at the same time with your hand grab the foot. Then the foot should be slowly pulled to the buttock and so linger for 5 seconds. After this, the foot should be slowly lowered to the floor.
  • Partial squats on one leg. In this case, also can not do without a chair. A healthy limb needs to be bent so that the fingers touch the floor. The patient’s foot should be crouched so that an angle of 120 degrees is formed and lingers for 5 seconds. Then slowly return to the starting position.
  • Steps on the step platform. As an inventory you will need a step board. It should become an affected limb, transfer body weight to it and straighten up. Then you need to return to the starting position.
  • Each exercise should be repeated 10 times.

If the training is too active, the patient may temporarily feel deterioration. If the patient notices that the knee is swollen and hot, then it is necessary to reduce the load or temporarily, generally, to abandon classes. If relapse occurs, then the limbs should be completely at rest, put on a pressure bandage, keep the leg up and apply cold to the joint. If swelling has not subsided within 3 days, then you should consult your doctor.

Reviews

Patient reviews on the rehabilitation of the knee after arthroscopy can be found in a variety of ways. But as a rule, everyone praises such surgical manipulations and does not imagine what happened to them if they were afraid to do it.

Arthroscopy of the knee joint rarely leads to serious complications, but how quickly the patient gets to his feet depends largely on a properly organized rehabilitation period. Complete recovery of the knee joint after surgery may take a different time. Even if the patient notes that recovery after arthroscopy is proceeding at a slow pace, you should not give up classes and your efforts will be rewarded.

Features of rehabilitation after arthroscopy of the knee joint, recovery stage

Sports injury, fracture, ligament rupture, chronic joint diseases – all this can lead to the need for meniscus surgery. Arthroscopy is the latest technique to examine and heal all hidden structures of the knee joints by introducing surgical devices into small incisions. Thanks to this type of intervention, even with excision of the meniscus, it is possible to restore the preoperative degree of exercise, including physical exercise. How exactly the operation is performed can be seen from the video below.

Meniscus arthroscopy

Rehabilitation phases after arthroscopy

Despite the fact that arthroscopy is a gentle type of intervention, the recovery process after it should be approached with full responsibility. Rehabilitation after arthroscopy of the knee joint is an essential element of treatment. Failure to comply with medical recommendations and a harmful enhanced load regime can lead to complications and worsening of the patient’s condition, even if the operation to remove or repair the meniscus was performed flawlessly.

In medicine, several recovery phases after laparoscopy are shared, and each of them has its own characteristics. Rehabilitation begins immediately after medical intervention, and its completion can be discussed after the full return of the former physical activity, restoration of the muscles of the limbs and ligaments.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Early recovery period

Immediately after completion of the arthroscopy procedure, an early recovery period begins, which lasts until drainage is removed (on average, 3 days). Patients are prescribed broad-spectrum antibiotics and analgesics that relieve pain after surgery, in the form of injections and tablet preparations.

Ice is applied to the knee for half an hour (special package or heating pad), then the limb is fixed with an elastic bandage or compression knit from the foot to the middle of the thigh. A rigid orthosis or splint is used in rare cases on the recommendation of the attending physician.

The first 2-3 days after the intervention, it is recommended to spare the limb and often keep it in a raised position (on a pillow above the level of the heart). Support load is minimized using a cane or crutches. Ice is applied to the knee three times a day for 15-20 minutes. If plastic surgery of the joint or its transplantation was performed, it is necessary to protect the leg as much as possible and fix it with elastic bandages for about 2 weeks.

Surgical limb support

During the early recovery period, a set of exercises is mandatory, which is done several times a day in the supine position. Training is carried out within 20-30 minutes. It:

  • ideomotor exercises (performed mentally);
  • work with the quadriceps femoris and buttocks (tension, contraction);
  • leg lift (straight);
  • light rotational movements of the ankle.

Stage of early healing

After removal of the drainage, the stage of early healing begins, which lasts about a week. In this postoperative period, exercises in the sitting position and standing with mandatory support are added to the gymnastics in the supine position. If the orthosis is not shown, then before developing and pumping up the leg, a knee pad is put on the operated knee.

Patients are recommended to exercise on an exercise bike without load under the supervision of a specialist, walking without fatigue, swimming in the pool, aimed at strengthening the muscles and ligaments. If swelling occurs at the site of the intervention, a drainage massage is prescribed to the patient. Best if done by a specialist.

Surgery on the meniscus of the knee – massage in the postoperative period

After resection, the state of surgical incisions should be carefully monitored, keeping them in absolute cleanliness and dryness. Water procedures are performed extremely carefully, trying not to wet the area that has undergone medical intervention.

Every 2-3 days, aseptic dressings are changed, the accumulated liquid is sucked off, if necessary. Seams are usually removed on the 7th-9th day after surgery (patches are removed 4 days after surgery).

Stage of late healing (10-14 days)

At this stage, power is connected to the flywheels. Patients are shown exercises on a stationary bike with gradual weights, on a treadmill (starting at 10 minutes at a slow pace), keeping the legs on weight, half-squats. If the patient after physical education feels a deterioration in well-being, a knee swelling is noted, the place of intervention begins to burn, then the load decreases or is completely excluded for several days. Cold is applied to the joint, a pressure bandage is put on the leg. If after 3 days the condition does not normalize, you must consult a doctor.

At all stages of rehabilitation after resection of the meniscus and until complete recovery, it is important to strengthen joint tissues with a special diet. Foods rich in proteins, selenium, sulfur and omega-3 fatty acids should predominate in the patient’s diet. It:

  • dairy and dairy products;
  • seafood;
  • eggs (yolks);
  • seaweed;
  • jelly, aspic, jelly;
  • broths of meat, fish and poultry;
  • honey;
  • dried fruits.

Such a menu will accelerate recovery, help strengthen not only the knee, but also the muscle corset.

Recovery stage

2 weeks after surgery by arthroscopy, if there is no contraindication to the doctor or instructor of exercise therapy, the patient can begin to walk with a full load on the leg – without crutches, but in an orthosis. During this period, it is important to strengthen the muscles of the hips and buttocks, for which functional exercises aimed at restoring stamina and strength are recommended. These are block exercise machines, weight training, coordination exercises.

Arthroscopy of the knee – recovery after surgery

The emphasis is placed on the operated limb, which is forced to bend and unbend, which avoids the occurrence of adhesions or stiffness of the joint. At the same time, it’s too early to think about a full-fledged sports mode: high-amplitude, sharp or twisting movements are prohibited for 2 months.

When to go?

The decision to start full loads on the operated leg is made by the attending physician. This largely depends on the type of arthroscopy. For example, during the reconstruction of the meniscus, one should not step on a limb for several weeks (up to a month), and when it is removed, exercise therapy begins a few days after the operation.

Deadlines

The patient takes the first steps without crutches 2-3 weeks after the operation. They refuse the orthosis after a few weeks. A few months are usually enough to completely restore all joints. But the restrictions are not completely lifted. For example, contact sports can only be done 9 months after meniscus arthroscopy.

An integrated approach helps to reduce the period of rehabilitation. The recovery program includes therapeutic exercises recommended by the physician for physiotherapy, rejection of sun baths that slow healing, and smoking, a habit that impairs blood circulation. Compliance with a special diet and drugs that strengthen joint and cartilage tissue will make the recovery process as short as possible.

Important! It is worth noting that the development of the knee in different patients takes different times. One person begins to fully walk and work after 2 weeks, another may take several months. You should not stop halfway and do not interrupt the classes recommended by the doctor.

Physiotherapy

A suitable cycle of physiotherapeutic procedures is one of the main elements of recovery after endoprosthetics. The choice of therapy should be entrusted to a doctor who will take into account all the physiological characteristics of the patient, his current state of health, history and ultrasound, the presence or absence of contraindications. Among the most popular and effective practices are:

  1. laser therapy;
  2. electrical stimulation;
  3. electrophoresis;
  4. magnetotherapy;
  5. UHF;
  6. massage treatments.

Laser therapy – physiotherapy for recovery after arthroscopy

Physical techniques are most often prescribed comprehensively and at all stages of recovery after surgery. This has a stimulating effect on the regeneration process after partial or complete removal of the meniscus, normalizes metabolic processes, improves lymph outflow, reduces pain, and shortens the rehabilitation period.

Contraindications for physiotherapy

Physiotherapeutic procedures are not indicated for every patient undergoing arthroscopy. An obstacle to the implementation of therapeutic measures that accelerate recovery may be:

  • pregnancy;
  • fever associated with the consequences of the operation or other health conditions;
  • chronic diseases in the acute stage;
  • neoplasms of a benign or malignant nature;
  • bleeding.

If there are contraindications, treatment is selected individually, taking into account the characteristics of the patient’s health. This applies both to physiotherapy, accelerating recovery after arthroscopy of the lateral or medial meniscus, and taking medications that have a beneficial effect on the condition of the joints.

Conclusion

Arthroscopy is an operation after which a complete recovery is possible, but this only happens if all medical recommendations are followed. Dangerous is not only an excessive load on the operated leg, but also complete inactivity that disrupts blood flow, without which a quick return to normal life is impossible. The following complex of simple and effective exercises will help the joint to rehabilitate itself at home:

Rehabilitation after arthroscopy of the knee: recovery periods and effective exercises

Any, even the most insignificant, surgical intervention requires a number of postoperative measures aimed at restoring the functioning of the operated organ.

This applies to both the internal organs of a person and the musculoskeletal system. Rehabilitation after arthroscopy of the knee joint is the most important measure designed to ensure the fastest and most complete restoration of the functions of the lower limb.

If you do not follow the recommendations of the doctors who prescribed the course of rehabilitation treatment, then the recovery may be delayed, or, worse, undesirable complications may arise. Rehabilitation after arthroscopy is prescribed by the attending physician by default, without the consent of the patient.

What is arthroscopy

Various methods are used to diagnose knee joint disease:

  • external examination, palpation;
  • magnetic resonance imaging;
  • radiography;
  • CT scan;
  • arthroscopy.

This method has been actively used recently not only for diagnosis, but also for treatment. The method is a minimal invasive surgery.

For diagnosis, a small skin incision is made in the area of ​​the knee, into which an arthroscope, which is a kind of endoscope, is inserted.

In one session of arthroscopy, treatment is possible – to remove or stitch damaged meniscus fragments, to treat cartilage damage.

Arthroscopy of the knee

Such a study is usually carried out with pain in the knee, with stiffness in movement, in case of physical deformation of the meniscus or cartilage.

This method can also be used in case of spontaneous swelling of the legs, with impaired stability, with an obvious cruciate ligament defect.

Restoring Knee Functionality

Those who have yet to undergo this operation are worried about how long rehabilitation can take place after arthroscopy of the knee joint.

The same question worries those who have just undergone this operation.

This is a completely natural question, because the full functioning of the leg depends on how well the knee joint was planned and developed. The duration of the rehabilitation course is also affected by its methodology.

The rehabilitation period in a hospital

After the patient underwent surgery, he remains for some time in the hospital.

This time for different cases of the disease is different, but does not exceed three days for the most complex operations.

The average treatment time in the inpatient department of a medical institution after surgery is no more than a day.

After simple operations, such as an uncomplicated meniscus operation, the patient is discharged from the clinic after three to four hours.

The rehabilitation process after knee arthroscopy surgery begins at the facility immediately after the procedure.

After the operation has been completed, stitches are done and dressing is done, the patient is prescribed antibiotic-based drug therapy.

To stop the pain, pain medications from non-steroidal anti-inflammatory drugs are prescribed. To relieve edema, lymphatic drainage massage is prescribed.

Articulated bandage after arthroscopy of the knee

To fix the knee joint and keep it completely at rest, apply an orthosis bandage. If arthroplasty was performed, then a hinged orthosis with a bending angle of 20 ° is used to fix the leg.

During the first three to five days, patients are advised to wear compression stockings to prevent thromboembolism. For internal use, drugs that prevent the formation of blood clots are prescribed.

In order for the restoration of the knee joint after arthroscopy to be successful, already in the first 24 hours a complex of physical therapeutic exercises is prescribed.

After the drainage is removed, passive movements can be performed, the patient is allowed to stand on his feet with crutches or a cane.

The rehabilitation period at home

If the patient underwent this operation, then rehabilitation after arthroscopy of the knee joint at home should be carried out without fail.

In the process of rehabilitation, several rules must be followed, the implementation of which depends on how quickly the recovery period passes:

  1. in the first three days, keep your legs elevated to reduce swelling;
  2. cuts near the knee to keep clean and dry;
  3. Dressings should be performed only under medical supervision;
  4. during water procedures, do not wet the incision site;
  5. be sure to take medications prescribed by a doctor;
  6. wear compression stockings or an elastic bandage for the first week;
  7. after a week, you can begin to do therapeutic massage.

Therapeutic exercise

To restore recovery after surgery, arthroscopy of the knee joint was successful, the doctor prescribes a course of physiotherapy exercises.

Depending on the age of the patient, his physical condition, the doctor prescribes this or that complex.

But, regardless of anything, the course of exercise therapy after arthroscopy of the knee joint is mandatory for all patients without exception. This course is divided into several stages.

At the first, initial, stage, the patient performs the prescribed exercises with a minimum load, and these exercises can begin to be done several hours after the end of the operation.

Exercise therapy under the supervision of a specialist during recovery after arthroscopy of the knee joint

At the second stage, under the supervision of a specialist in exercise therapy at home, a set of exercises with increased load is performed. The goal of these exercises is to increase knee mobility.

Over the next three weeks, gymnastics after arthroscopy of the knee joint is performed with a more intense load, with an increase in range of motion and with the use of a metered load, which will load the shin.

At the fourth stage, designed for six weeks, physiotherapy after arthroscopy of the knee joint moves to a qualitatively new level, which implies a significant increase in physical activity.

Massage

In order for the restoration of the knee joint after arthroscopy to be successful, without any relapse, and also to eliminate edema that occurs after surgery, the doctor prescribes lymphatic drainage massage, performed by specialists manually.

Massage to restore knee function

And a week after the operation, the doctor prescribes a therapeutic massage, which should be performed by an experienced specialist.

Self-massage is allowed, but under the supervision of a specialist in the initial stages.

How long does a full recovery take after arthroscopy

Complete restoration of limb functionality occurs differently in different people.

The wound heals in two to three days after the operation, after which the patient is discharged from the hospital.

But the rehabilitation process continues, which is constantly monitored by the doctor, and makes appropriate adjustments as the recovery progresses.

Depending on the age and physical condition of the patient, the actual terms of the rehabilitation period range from two months to a year.

Conclusion

Only on how correctly the simple rules of rehabilitation will be followed depends on how fast the return to a full life will be.

Rehabilitation after arthroscopy of the knee

Recovery after arthroscopy of the knee joint is easier and faster than in the case of a full surgical intervention. Nevertheless, doctors recommend that patients with caution and thoroughness follow all postoperative recommendations so as not to harm the joint.

The main activities in the hospital

Recovery after surgery of arthroscopy of the knee joint in a clinic is stretched no longer than 15-30 hours. As a rule, the wound heals in a few days, and full motor activity returns to the joint over a period of two weeks to 2-3 months.

After arthroscopic intervention in a hospital, each patient undergoes the following procedures:

  • single (or, if indicated, double) administration of antibacterial drugs to prevent infection;
  • to prevent thromboembolic complications, you should wear an elastic bandage or compression knitwear on the operated knee. In the same period, patients are shown anticoagulants, drugs of low molecular weight heparin.
  • Cryotherapy has a good clinical effect (performed 1-3 days after arthroscopy of the knee joint, cold is prescribed locally with an interval between manipulations of 30-40 minutes).
  • Early rehabilitation after arthroscopy is associated with the immobilization of the operated joint (it is fixed with an orthosis bandage). The leg should be in a straightened position. During surgery, cruciate ligaments are applied with articulated orthoses (or a postoperative splint), the limb is bent at a 20-degree angle.
  • Symptomatic therapy involves the use of painkillers, non-steroidal anti-inflammatory drugs.
  • In order to eliminate postoperative edema, the patient is required to undergo hardware lymphatic drainage or manual lymphatic drainage massage.
  • Physiotherapy exercises on the first day after surgery include an isometric set of exercises for the femoral muscles and movements of the ankle joint. The next day, the development of the knee joint with exercises (after removing the drainage) and using additional support (canes, crutches) can be added to the specified gymnastics.

Ambulatory recovery

Upon returning home, in order to minimize the risk of postoperative complications, it is necessary to follow the recommendations of the orthopedic surgeon as accurately as possible. First of all, within a few days after arthroscopy of the meniscus of the knee joint or another type of surgical intervention, you should keep the “working” limb as high as possible. Wounds on the knee should remain dry and clean, taking a bath (shower) is necessary only on the advice of the attending physician.

Minimally invasive arthroscopic intervention can reduce the rehabilitation period to several months, or even weeks. The traumatologist should examine the operated leg 24 hours after the operation, and then on 3-4 and 7-12 days. If necessary, the specialist replaces aseptic dressings on the knee, performs joint puncture (if indications are present), and evacuates the fluid.

The nature and intensity of the patient’s motor activity depends on the type of intervention. Rehabilitation after arthroplasty involves the use of crutches with support under the elbow for three weeks. In the absence of pain, you can gradually increase the axial load on the operated limb. Recovery from a meniscus operation involves wearing a soft or semi-rigid knee pad, which can be replaced with an elastic bandage.

Your doctor may also recommend:

  • electrical stimulation of the femoral muscles;
  • light massage;
  • physiotherapeutic procedures;
  • immobilization of the patella.

Recovery steps

Meniscus resection and other surgical interventions on the knee joint suggest performing isometric exercises on the gluteal muscles, hip biceps and quadriceps, and foot movements during all periods of rehabilitation. As you recover, subsequently, active flexion-extension of the knee in a closed loop is added (the heel is firmly pressed to the floor). Gymnastics after arthroscopy (LFK) also includes exercises aimed at strengthening all the muscles of the lower extremities (for example, the leg is lifted up by pulling the sock on itself, kept in a static position for 5-7 minutes).

Already at 4-6 weeks after arthroscopy of the meniscus, the patient is allowed to walk with an orthosis with full support on the operated leg (either with a crutch or, in general, without it). It all depends on the general well-being and condition of the patient’s joint. If rehabilitation is going according to plan, then by this time a person should unbend, bend the knee (up to 90 degrees) without discomfort. Walking should be slow, “meaningful”, without limp. The essence of training in this period is to strengthen, increase the activity of the thigh muscles.

Allowed exercises for 6-8 rehabilitation week:

  • walking on a functional orthosis;
  • strength training in block simulators;
  • swimming;
  • gymnastics to improve coordination.

It is important to remember that the cruciate ligament of the knee has not yet been “rebuilt”, therefore, needs protection. In this regard, twisting, swinging movements of the operated limb are prohibited. So, an 8-10 week of recovery is needed to strengthen, develop leg muscles, as well as coordination training. The best choice at this time is exercise on a stationary bike, swimming, lunges, maintaining balance on a special inflatable pillow.

Hiking in the fresh air during this period can be quite lengthy. Every patient who has undergone surgery on the knee joint must understand that a properly selected load, massage and other rehabilitation measures can prevent possible complications of arthroscopy. In this regard, all recommendations of an orthopedist must be treated with a great deal of responsibility.

It is noteworthy that when using an arthroscope, the risk of the negative consequences of the operation is minimized, but you should be extremely careful to prevent secondary infection, the development of knee arthritis, hemarthrosis (local hemorrhage).

Recovery procedures after knee arthroscopy

Arthroscopy of the knee joint, unlike traditional surgical treatment, provides a less severe and faster course of the rehabilitation period, however, at this time, all necessary precautions must be followed in order not to harm the articular joint undergoing this operation.

Rehabilitation period after knee arthroscopy

With arthroscopic treatment of diseases of the knee joint, the duration of hospitalization can be different (on average, the length of stay in the hospital today is 15-30 hours). In most cases, during operations on menisci, the stationary stage of treatment is several hours, and with cruciate ligament arthroplasty – 1-3 days.

If you have arthroscopy of the knee joint, recovery after surgery is quick and relatively painless. As a rule, after 2-3 days the wound from the arthroscope heals, however, it may take from two weeks to 2-3 months to completely restore the knee joint.

Rehabilitation activities in the hospital

After the operation, the patient is hospitalized for some time. The following recovery procedures are performed:

  1. After arthroscopy, a single (if necessary, double, after 24 hours) administration of broad-spectrum antibiotics is prescribed (intraoperative antibiotic prophylaxis).
  2. In order to prevent thromboembolic complications, patients are shown wearing an elastic bandage or compressive knitwear (first 3-5 days after surgery). Also, low molecular weight heparin and anticoagulants (in tablet form) are introduced during this period.
  3. Cryotherapy has proven itself well in the postoperative period (cold is prescribed locally within 1-3 days with an interval of 30-40 minutes).
  4. In the early postoperative period, the patient should ensure complete rest. For this, the knee joint is fixed with an orthosis bandage. The operated limb should be in a straightened position. Rehabilitation after cruciate ligament repair requires the use of a hinged orthosis with a bending angle of 20 degrees or a postoperative splint.
  5. Without fail, the patient is given analgesic therapy, and non-stero >For successful recovery after surgery, several basic rules must be observed:

  1. Upon returning home, in order to avoid complications, you should strictly follow the instructions of the orthopedic surgeon. First of all, to reduce swelling, the first few days you need to keep your legs as high as possible. Patients leave the inpatient ward with a bandage on their knees. It is very important that the cuts remain dry and clean. Water procedures (shower or bath), as well as changing dressings, are carried out strictly according to the instructions of the attending physician.
  2. Inspection of the traumatologist and dressings are made in the first 24 hours after the operation, and then on the 3-4th and 7-12th days. During the procedure, the patient is replaced with aseptic dressings, and if necessary, a knee joint is punctured, followed by fluid evacuation. Sutures, as a rule, are removed on the 7-12th day.
  3. Recovery on an outpatient basis takes place with the mandatory use of anti-inflammatory and vascular drugs prescribed by your doctor.
  4. During the week, the application of an elastic bandage on the limb.
  5. Within 3-5 days, local cold treatment is indicated, and also, if necessary, lymphatic drainage is prescribed.
  6. The patient’s motor activity is monitored by the attending physician (it depends on the type of operation performed).

So, after a meniscectomy, the patient is shown walking with a metered load on the leg from the first day after the operation. It is necessary to use a cane or special crutches with support under the elbow for a week after the operation. If an arthroscopic meniscus suture is performed, movement with crutches without leg support should be carried out for four weeks.

For plastic surgery of the anterior cruciate ligament, recovery in the postoperative period also involves the use of crutches with support under the elbow for three weeks. The first few days, the patient moves without load on the leg, and then, when walking, the foot is placed on the floor (without transferring gravity to the operated limb). In the absence of pain, a gradual increase in axial load is produced.

Additional fixation of the articular joint after arthroplasty

In the process of rehabilitation after surgery on the meniscus, the patient is shown wearing a semi-rigid or soft knee pad or applying an elastic bandage to the articular surface. Plastic surgery involves fixation of the knee by a postoperative articulated orthosis.

However, after arthroscopy, for medical reasons, electrical stimulation of the thigh muscles, light massage, mobilization of the patella and physiotherapeutic procedures are prescribed.

Therapeutic gymnastics by periods

Almost all patients who underwent arthroscopy of the knee are shown isometric tension of the gluteal muscles, flexors and extensors of the thigh and foot movements. Also, during the recovery process, active movements in the knee, which are carried out in a closed circuit, are added (during movement, the heel should be in contact with the surface).

Gradually, exercises are added that strengthen the muscles of the limb (in the supine position, slow raising of the straight leg (toe) and keeping it on weight for 5-7 seconds). A similar exercise is performed in a standing position, and gymnastics with a tourniquet for the development of calf muscles and swimming is well established.

IV-VI week

The patient is allowed to walk in the orthosis with full support on the leg, or movement with one crutch, or no additional support at all (this depends on the general condition of the patient).

By this time, a person should smoothly bend and bend the knee to 90 degrees. You should walk in small steps, slowly, without limping on the operated leg.

Exercise exercises during this period should be aimed at strengthening the muscles of the thigh (exercises with light resistance, slow spring squats, an exercise bike with a minimum load, exercises in the pool). In the event that after physical education, the knee joint swells, and the pain intensifies, urgent consultation of a specialist is necessary.

VI-VIII week

During this period, the patient is shown strength training, exercises and walking in a functional orthosis, training aimed at coordinating movements, classes in the pool and exercises on block simulators.

However, it should be borne in mind that the ligament of the knee joint is in the process of restructuring, and therefore, its strength is reduced, and the articular joint needs protection. Therefore, the restoration should take place without torsion loads, sharp bending, extension and swing movements of the operated limb.

VIII-XII week

Exercises should be aimed at strengthening the muscles of the limbs and coordination of movements (swimming, exercise bike, exercises with the platform, maintaining balance on a special inflatable pillow, side steps and accurate lunges). During this period, walking is allowed without restrictions.

Video review of a patient about rehabilitation after knee arthroscopy

The result?

Each patient undergoing knee arthroscopy should understand that properly organized rehabilitation will prevent the development of possible complications. It should be noted that during surgery using an arthroscope they are quite rare, however, during the recovery process, you must be very careful to prevent the penetration of infection and the development of arthritis of the knee joint, as well as to prevent the occurrence of hemarthrosis (hemorrhage in the joint cavity).

However, excessive activity and rash actions can provoke leakage of joint fluid and subsequent infiltration inside the knee joint, as well as a number of other unpleasant moments.

Rehabilitation after knee arthroscopy

In order for rehabilitation after knee arthroscopy to proceed without complications and negative consequences, it is necessary to strictly follow all the doctor’s recommendations, take prescribed medications, perform exercises, attend massage and physiotherapy. While the rehabilitation period lasts and the knee loads should be dosed, the sick person is given a sick leave certificate.

Stages of rehabilitation after arthroscopy of the knee

Arthroscopy of the knee joint is necessary for injuries of the limb, tears on the meniscus and cartilage, dislocations, the formation of pathological cysts, as well as the progression of arthrosis and other degenerative-dystrophic pathologies. After arthroscopy of the knee, a recovery postoperative period will follow, the timing of which will depend on the individual characteristics of the patient’s body, the degree of damage, or the severity of the progression of the disease.

Early term

It lasts an average of 3-4 days, during this period the seams are tightened, drainage is removed. To avoid complications, in the first 5-7 days after surgery on the knee joint, the patient needs to be in the hospital. While the seam is being tightened, it must be covered with an antiseptic dressing, and in order to prevent the formation of edema, an elastic bandage is applied to the leg or compression stockings are put on. To prevent complications, the patient is recommended to lie mainly in the first 2-3 days. Walking is allowed little by little, resting on crutches or a walker.

Orthopedic orthosis after arthroscopy immobilizes the knee joint. The bandage will help to evenly distribute the load on the operated limb, due to which it will be possible to quickly restore the functionality of the joint. When the risk of developing postoperative complications is over, the doctor will prescribe a set of therapeutic exercises that are selected individually.

Feature Recovery

To prevent contractures and scar formation during the rehabilitation period, physiotherapy exercises are prescribed. First, exercise therapy after arthroscopy of the knee joint is carried out under the supervision of a physiotherapist. When the intensity can be increased, exercises are allowed to be performed at home. After 1-2 days after surgery, warm-up gymnastics is prescribed, during which careful rotational movements of the ankle must be performed. If there are no contraindications, the LFK complex expands, but while the rehabilitation period will continue, the intensity of the loads should be monitored by the doctor. It is contraindicated to independently change the exercises to more complex ones. Without the permission of the doctor, it is dangerous to abandon crutches in advance.

For the early restoration of the functions of the joint structures, the lateral and cruciate ligaments, it is recommended to observe the following rules:

  • Carefully stand up from the bed and touch the floor with the operated foot, but do not transfer body weight onto it.
  • To give the limbs a horizontal position, which will facilitate the outflow of blood.
  • Do not squat.
  • Control the angle of flexion of the knee.

Rehabilitation methods

Medications

Inpatient hospitalization of the patient in the first 5-7 days after surgery is necessary to prevent postoperative complications. To avoid infection, antibiotics are prescribed in injections. Non-steroidal anti-inflammatory drugs will help relieve swelling and relieve pain. At first it is recommended to give injections, then you can switch to tablets. Throughout the recovery period, it is necessary to take chondroprotective agents, which contribute to the restoration and regeneration of articular cartilage. The injections are applied in courses for a long time. The following tools have proven themselves well:

Features of food

In order to recover faster after arthroscopy of the knee joint, it is important to adjust your diet, especially if arthrosis was the reason for the surgery. It is recommended to enrich the menu with dishes rich in protein, sulfur, selenium, omega-3 fatty acids. Since in the postoperative period, motor activity will be limited, it is important to control your weight. Therefore, in the diet should prevail:

  • lean meat and fish,
  • vegetables and fruits,
  • cottage cheese and sour-milk drinks,
  • eggs,
  • some honey
  • nuts and dried fruits
  • seafood,
  • jellied meat and broths,
  • marmalade, fruit jelly.

Products containing simple carbohydrates, sugar, fat are excluded from the menu. Dishes are recommended to be steamed, grilled, in the oven or just boiled. It is also important to normalize the drinking regime. To restore the elasticity and elasticity of the cartilage structures, it is recommended to drink at least 1,5 liters of pure mineral water without gas during the day.

Medical complex LFK

In the first weeks, while the patient moves on crutches, exercises are performed mainly in the supine position. You can perform these exercises:

    Alternately raise even limbs, slowly swinging them to the s >

Performing gymnastics, it is recommended to wear orthopedic knee pads and special shoes that immobilize the joint. If the doctor permits, you can use an exercise bike, step platform for training. Active sport is contraindicated in the first six months of rehabilitation. When the condition normalizes, the intensity of classes can be increased:

  • In a standing position, leaning on the back of the chair, take the operated limb to the side.
  • Position the legs shoulder-width apart and bend them slightly at the knees. Hold in this position for 15-20 seconds.
  • Sitting on a chair, raise the limbs bent in the joints as high as possible.
  • In the same position, hold the fitness ball between the hips and try to squeeze it as much as possible.

Physiotherapy

Physiotherapy is an integral part of the recovery period after arthroscopy on the knee joint. But if a person has a fever and the general condition has not yet returned to normal, any physiotherapeutic procedures are strictly contraindicated. When the risk of complications has passed, courses of the following procedures are prescribed:

  • magnetotherapy
  • laser therapy
  • electrophoresis
  • electrical stimulation
  • acupuncture.

Physiotherapy will help to establish blood circulation in the affected area, accelerate the restoration and regeneration of articular structures. When the knee stops hurting, you can visit the bath. Warming up procedures favorably affect the state of the whole organism. The Russian bath and light massage pats with a birch broom are famous for its restorative effect.

Manual massage

In order for treatment after arthroscopy to be effective, it is recommended to combine physiotherapy with massage manipulations that will help:

  • strengthen the muscles and ligaments of the knee,
  • normalize blood circulation in damaged tissues,
  • prevent relapse of the disease,
  • improve overall health.

Therapy should be carried out by a specially trained manual therapist, unprofessional massage after arthroscopy of the knee joint provokes dangerous consequences.

How to avoid complications?

So that after arthroscopic surgery in the recovery period there are no complications, you must strictly follow the medical instructions and not be in a hurry to increase the load on the operated limb. Even after the closure of the sick leave and full recovery, it is important to monitor the condition of the joint, perform training exercises, wear comfortable shoes. It is important for women to choose models that have low heels, otherwise you can provoke new complications and impaired functioning of the joint. If the joint has stopped functioning normally, it is forbidden to self-medicate or wait for the problem to disappear on its own. For suspicious symptoms, you should immediately visit a doctor and find out the diagnosis.

Morozov Georgiy

Georgy Morozov, rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases.

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