ARTHROSCOPY

“An arthroscopy is a type of keyhole surgery for checking or repairing your joints. Keyhole surgery is where only small cuts are made into the body. Arthroscopy is most commonly used on the knees. It can also be used on the ankles, hips, shoulders, wrists and elbows. It can help find what’s causing pain, swelling and stiffness in your joints.”

Why is Arthroscopy done?

An arthroscopy can be done for several reasons.

1. To find the cause of joint problems

An arthroscopy is often done to check what’s causing symptoms such as:

  • joint pain
  • swelling and stiffness
  • joints locking, moving out of position or giving way.

2. To check the health of your joints

Sometimes we will do an arthroscopy to see how well a joint is working.

This can help if you have:

  • damaged your joint, for example a sports injury
  • a condition that can damage joints over time, such as osteoarthritis

3. To repair damage to your joints

We may also be able to repair some joint damage during the arthroscopy.

This can include:

  • removing damaged sections of the tough tissue covering the surface of your joint (cartilage)
  • repairing tears to the strips of tissue connecting the bones of your joint (ligaments)
  • using a sterile liquid to wash out damaged bits of tissue stopping the joint from working properly.

ACL injuries 

If you tear the anterior cruciate ligament (ACL) in your knee, you may need to have reconstructive surgery.

The ACL is a tough band of tissue joining the thigh bone to the shin bone at the knee joint.

It runs diagonally through the inside of the knee and gives the knee joint stability. It also helps to control the back-and-forth movement of the lower leg.

Common causes of an ACL injury include:

  • landing incorrectly from a jump
  • stopping suddenly
  • changing direction suddenly
  • having a collision, such as during a football tackle or accident

If the ACL is torn, your knee may become very unstable and lose its full range of movement.

This can make it difficult to perform certain movements, such as turning on the spot. Some sports may be impossible to play.

Before having surgery

Before having ACL surgery, you may need to wait for any swelling to go down and for the full range of movement to return to your knee.

You may also need to wait until the muscles at the front of your thigh (quadriceps) and back of your thigh (hamstrings) are as strong as possible.

If you do not have the full range of movement in your knee before having surgery, your recovery will be more difficult.

It’s likely to take at least 3 weeks after the injury occurred for the full range of movement to return.

Before having surgery, you may be referred for physiotherapy to help you regain the full range of movement in your knee.

Your physiotherapist may show you some stretches that you can do at home to help keep your leg flexible. They may also recommend low-impact exercise, such as swimming for fitness or cycling. 

These types of activities will improve your muscle strength without placing too much weight on your knee. You should avoid any sports or activities that involve twisting, turning, or jumping.

ACL reconstruction surgery

Once the knee is ready to be operated upon for ACL reconstruction, you will be required to get some blood tests and other investigations done in preparation for the surgery. Thereafter, a physician consultation Is needed to obtain approval for surgery. Since this ligament does not heal well when repaired, It is reconstructed by using the body’s own tissue, called a graft. The grafts used for this reconstruction are expendable i.e. their removal does not cause any residual deficits and they are able to function like the ACL when implanted.

Recovery after ACL Surgery

Physiotherapy is begun on the day of surgery with an aim to rehabilitate your knee.

The operated knee is placed in a long knee brace, for full time wear, for about 3 weeks.

Your knee will be placed in a continuous passive machine (CPM) by the physiotherapist to move the knee, which helps reduce the swelling.

Weight bearing as tolerated is usually allowed from the next day. One may use an elbow crutch for comfort for a few days. Icing the knee helps reduce pain and swelling.

Discharge from the hospital is usually after one but sometimes, after two days.

After going home, you must follow the Physiotherapy protocol given to you.