You have had an arthroscopy. This procedure involves the examination of the inside of your knee using a telescope (arthroscope), through two or more small punctures at the front of your knee. A variety of surgical procedures can be done with this technique.
Local anaesthetic has been injected into your knee. When this wears off, your knee may become more painful. It may also swell. Therefore, the day after surgery may be more uncomfortable than the day of surgery. It is better to use pain killers when the pain is starting, rather to wait until it has already built up.
As a general principle, it is best to start with regular paracetamol (2 tablets, every 6 hours). If this is not enough you will have been prescribed something stronger, such as Endone, Tramadol or Panadeine forte. Endone and Tramadol can be taken in addition to paracetamol. Panadeine forte is used instead of paracetamol.
You may also have been prescribed anti-inflammatory tablets to help with pain relief in the first few days after surgery. These should be taken with food. If you get indigestion or have ongoing nausea, the anti-inflammatory tablets should be stopped.
An increase in pain and swelling at about four or five days following surgery is not uncommon. Rest, ice, compression and elevation will also help reduce your symptoms (see below).
The small puncture wounds are held together by small tapes (Steristrips). They are covered by waterproof plastic patches, so you can shower directly onto the knee. The dressings can be completely removed after 4 or 5 days. The cuts can be left open if healed and dry, or covered with a Bandaid if still moist.
Swelling is common after an arthroscopy. Fluid in the joint results in generalised swelling and is most obvious above the patella (kneecap). Swelling is also common around the incisions and this can take some months to resolve.
Swelling will be helped by applying the R.I.C.E. principles – rest, ice, compression, elevation.
REST: During the first 3 days you should rest with your leg elevated as much as possible. You can then gradually increase your activity, guided by your pain and swelling.
ICE: For the first week you should try to ice your knee 3 times a day for 20 minutes. After this time ice the knee following exercise and at the end of the day until your swelling reduces (usually about 2-4 weeks).
COMPRESSION: You will usually have a Tubigrip stocking around you knee. Sometimes you will have a bandage. The bandage can be replaced by a compression stocking on the day after surgery. The compression stocking should be worn during the day until your swelling reduces (usually about 2-4 weeks).ELEVATION
Unless otherwise instructed, you can place as much weight on the leg as comfortable with the help of crutches for the first 2 to 3 days following surgery. To start with, the pattern of walking is “crutches, bad leg, good leg”. Once you are more comfortable, the crutches and operated leg go forward together. You may find it easier just to use one crutch. Use it with the opposite arm i.e. for a left knee operation, use the crutch with your right arm.
To manage steps with crutches, use the following guide:
- UP: good leg, bad leg, crutches.
- DOWN: crutches, bad leg, good leg.
Begin this exercise program the day after your operation and continue it for the first two weeks.
Knee Locking using the Quadriceps
With a rolled towel under your heel, tighten the quadriceps muscle at the front of your thigh and push your knee into the bed. Hold for 5 seconds and relax. Repeat 10 to 20 times, 2-3 times a day.
Straight Leg Raises
Lying flat, lock your knee straight and then lift the whole leg about 30cms off the bed. Hold for 3 seconds and relax. Repeat 10 to 20 times, 2-3 times a day.
Slide your heel up towards your bottom as far as comfortable. Hold 3 seconds. Repeat 10 times, 2-3 times a day. Gradually regain your full movement.
Knee Bending on your Stomach (Prone)
Begin this exercise about 3 days after your operation. Lie on your stomach and bend your knee as far as comfortable. Hold for 3 seconds and relax. Repeat 10 times, 2-3 times a day.
After 10-14 days you should be able to start riding an exercise bike. You may find it more comfortable to raise the seat. Start out with no resistance and for 5-10 minutes on the first day. Gradually increase the resistance and the time as pain and swelling allow.
You will usually have a review appointent with your surgeon within the first 2-3 weeks. They will discuss further progression of activities at that time. The following list provides an approximate guide:
|Exercise bike||1-2 weeks|
|Exercise walking||2-6 weeks|
Time off work
These times are guidelines only and may vary depending on your surgery.
These notes have been prepared by orthopaedic surgeons at OrthoSport Victoria. They are general overviews and information aimed for use by their specific patients and reflects their views, opinions and recommendations. This does not constitute medical advice. The contents are provided for information and education purposes only and not for the purpose of rendering medical advice. Please seek the advice of your specific surgeon or other health care provider with any questions regarding medical conditions and treatment.