You took a bad hit to your knee during your neighborhood soccer match. The orthopedic service at the emergency room says you have a torn anterior cruciate ligament (ACL). These cartilage tears are a common sports injury. Luckily for you, arthroscopic surgery has become a common procedure for repairing these types of knee injuries. This is a much less invasive surgery than traditional knee surgery with fewer risks of side effects. If arthroscopy is the approach recommended by your orthopedist, here is what you can expect from the surgery and the subsequent recovery at home.
Surgery in Your Doctor's Office
The arthroscopic procedure will be done in your surgeon's office or an outpatient clinic. No hospitalization is needed, and you'll go home shortly after the surgery.
Once you check in for your appointment, you'll speak with a doctor about your anesthesia choices, which will include:
- a local anesthetic injected into the knee to numb the area where the surgeon will work so you feel no pain
- a regional anesthetic injected into your back which deadens the feeling from your waist down
If you wish, you can stay awake during the procedure and watch it on monitors in the surgical room. Or you can be lightly sedated so you're unaware of the procedure.
Once the anesthetic has been administered and has taken effect, the surgeon makes two small incisions over your knee joint. A small tube with a camera on the end is inserted into one of the incisions. This is guided to the area in your knee joint where the surgeon will repair the torn cartilage. They will be able to see inside of the knee on monitors in the room and through a microscope attachment.
Another tube containing surgical instruments is inserted into the other incision. This is also guided into the knee joint where the surgeon uses the instruments to repair your ACL.
An advantage of arthroscopic surgery over traditional knee surgery is that less of the knee joint is exposed to the air. This reduces your chance of an infection. Smaller incisions also mean faster wound healing and, again, less risk of infection.
When the procedure is complete, the tubes are removed and small bandages are placed over the incisions. You'll be taken to a recovery area to rest while the anesthetic wears off. The surgeon will check on you and release you to go home when satisfied that you're not having any bad reactions to the surgery or anesthetic.
Recovering From Arthroscopic Knee Surgery
Damage to soft tissues in the knee is less than that of traditional knee surgery so your wound healing will happen faster. Unfortunately, cartilage heals slower than other tissue because it lacks the blood supply. It will be several weeks before the ACL has fully healed,
A few days after the surgery, your doctor will have you start physical therapy to regain movement in your knee. The therapist will move your knee through its normal range of motion to stretch the muscles back out. You'll also be shown exercises to do on your own between sessions.
Once your doctor is satisfied with the flexibility of your knee, you'll start on strength training. Again, your therapist will work with you and give you exercises to strengthen the muscles in and around the knee. These muscles will help you move your knee and also protect your knee from another blow.
During all of the physical therapy activities, you'll set a pace with the therapist. Stay within these limits while working with your knee or you risk re-injuring the cartilage before it has a chance to fully heal.
For more information, contact Ultimate Sports or a similar organization.