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Frequently Asked Questions: Knee Arthroscopy |
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Call Valley Orthopedic Associates at 425-656-5060 immediately if you experience any of the following:
- Increasing redness, particularly spreading from the incisions
- Rapidly increasing pain and swelling
- Fevers greater than 101.5◦ F
- Persistent drainage from your wound
- Calf swelling or pain, particularly if associated with ankle motion
- Severe ankle swelling that does not decrease or resolve overnight
How long does the surgical procedure take and what exactly is done?
The actual surgery time is usually about 30 minutes. If extensive work
is needed, the procedure may last up to 45 minutes. Most people "go to
sleep completely" during surgery with a general anesthetic. Some have
surgery with a spinal anesthetic.
Three or four small incisions are made to allow special instruments,
including a fiber-optic camera, to be placed into your knee. Sterile
saline (salt water) is brought into the knee joint continuously with
tubing to provide a clear view for the surgeon. Torn parts of the
meniscus and/or damaged cartilage on the bone surfaces are carefully
removed with special arthroscopic instruments. The end result is a knee
lined with smooth and stable tissues rather than rough edges.
What is the recovery time?
Everyone heals from their knee surgery at a different pace. If
necessary, patients use crutches or a walker for one to three days
after surgery. If your pain is minimal then you do not have to use
crutches or a walker. Once more comfortable, most people are able to
walk with just a slight limp within five days after surgery. Some
people find a cane to be helpful. If you use a cane, place it in the
hand opposite the knee that was operated on.
It takes up to six weeks for the knee joint to re-establish normal
joint fluid after arthroscopic surgery. Because of this, you may not
realize the benefits of your surgery for four to six weeks. There is a
high degree of variability in recovery times. Some patients are able to
return to regular activities within two weeks, but most require roughly
six weeks before they can resume full activities - including sports -
comfortably. Reduction of pain and swelling and improvement in
strength, motion, and coordination may continue for three to four
months.
Will I have stitches and when do they come out?
In most cases the small incisions are closed with Steri-strips and no
stitches are used. Steri-strips are somewhat waterproof, lasting seven
to 10 days and then they begin to peel back at the edges.
If stitches are used, they may be under the level of the skin and will
absorb with time. If they are nylon stitches, they will need to be
removed seven to 14 days after surgery. This will be done at your first
post-operative visit.
How long do I need to use a bandage?
The initial bandage often gets soaked with fluid and blood. Drainage
after surgery should gradually decrease after 48 hours, and then
Band-Aids are usually sufficient over the small incisions. If
desired, dry sterile gauze pads and an Ace wrap can be continued to
protect the incisions from irritation from clothing, pets, young
children, etc. Once the incisions are completely dry the use of a
bandage is optional.
Do I need a knee brace?
Knee braces after simple arthroscopic knee surgery are rarely used.
However, if your surgery involves more than just removal of torn
cartilage or meniscus - for example, if you have a meniscal repair -
your knee may be placed in a brace after surgery. If you have a
neoprene sleeve for your knee that you used before surgery and desire
to use it after surgery, do not begin wearing it until your wounds have
completely stopped draining. If you use a neoprene sleeve, be sure to
take it off for several hours a day to allow your skin to breathe.
When can I shower?
You can shower 48 hours after your surgery if there is no drainage from
your incisions. Do not scrub directly over your incisions and gently
pat the incisions dry after showering.
When can I immerse my knee in water to bathe or swim?
Two weeks after surgery if there is no drainage from your incisions.
How long will I be on pain medications?
You will likely need some form of pain medication for two to three
weeks. Again, there is a high degree of variability with some
using narcotic medication for less than one week, and others for up to
four weeks. Most people are able to wean off narcotic medication
within one month and switch to an over-the-counter pain medication such
as Tylenol or ibuprofen.
If you do not have serious medical problems such as hypertension, heart
disease, kidney or liver impairment, or a history of prior
stomach/intestinal ulcers or reflux, it may be helpful to take an
anti-inflammatory medication in addition to your narcotic medication
immediately after surgery. Your surgeon will usually recommend this at
the time of surgery if appropriate. Stop all anti-inflammatory
medications if they cause severe stomach pain, bloody stools, or severe
swelling in your extremities.
Do I need physical therapy?
Many patients are sent to physical therapy after knee arthroscopy, and
this is usually decided at the first post-operative visit. Some
patients regain motion very quickly and have minimal swelling and
therapy may not be necessary for them. Or, they may only have to go
once or twice to learn a home program. Your surgeon will decide what is
best for you.
What exercises should I do after surgery?
You are encouraged to bend and straighten your knee as much as pain
allows immediately after standard knee arthroscopy. Remember, however,
that your knee may be swollen and full motion may be difficult for the
first few days. You may tighten your quadriceps muscle right after
surgery and we encourage straight leg raises if they are not too
painful. Massaging the patella (kneecap) with your leg straight is also
beneficial. Using your fingers, push the patella in all four directions
(up, down, left, and right) and hold it for 10 seconds in each
direction. This helps prevent scar formation and tightness around the
patella during the recovery period.
You can put as much weight on your leg as is comfortable immediately
after surgery. Again, the usual need for crutches or a walker is about
two or three days. Riding on an exercise bike, using a treadmill or
elliptical machine, or just plain walking are all good exercises to
begin once the knee is less painful. Do not be surprised if your knee
has a tendency to swell after such activities; remember to ice and
elevate the knee afterwards.
Can I exercise with weights?
Generally, not for the first three weeks. However, as each person's
strength varies, some patients are able to resume weight training
exercises with their legs sooner than three weeks. Use light
weights to begin with and progress gradually.
When can I drive?
You can drive as soon as you feel comfortable, but YOU MUST NOT DRIVE IF YOU ARE TAKING NARCOTICS!
If you drive a standard transmission vehicle and had surgery on your
left knee, you should wait one week before driving to avoid causing
more pain/irritation from operating the clutch. If you need to drive
long distances within two weeks after your surgery, you should take
frequent breaks to stand up, stretch, and walk for 10 minutes per hour
to decrease the risk of a blood clot forming.
When can I return to work?
This depends on your profession. Typically, if your work is primarily
sedentary you may be able to return within one week. If your work is
extremely rigorous, you may require eight to 10 weeks before you return
to full duty. Your physician will help you determine an appropriate
return-to-work date, and will also provide any needed paperwork.
When can I travel?
You may travel as soon as you feel comfortable, but it is recommended
that long trips be avoided for two weeks after surgery due to an
increased risk of blood clots in the legs. If a long trip is
unavoidable in the early post-operative period, we recommend that you
get up to stretch or walk for at least 10 minutes per hour to decrease
the risk of a blood clot.
Should I use ice or heat?
Ice should be used for the first several days, particularly if you have
a lot of swelling or discomfort. Ice is also helpful if you develop
swelling after exercising. Once the initial swelling has decreased, you
may use either ice and/or heat depending on which helps you the
most. Some patients report that using heat prior to activities
helps "warm up" the knee.
When do I need to follow up with my surgeon?
Follow-up appointments should be made post-operatively at seven to 10
days, again at four to six weeks and then again at three months if you
are not better. The three month appointment is not necessary if
things are going well.
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VOA Renton Clinic  4011 Talbot Road S
Suite 300
Renton, WA 98055
Phone: 425.656.5060
Fax: 425.656.5047
VOA Covington Clinic  27005 168th Pl SE
Suite 201
Covington, WA 98042
Phone: 253.630.3660
Fax: 253.631.1591 |
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Frequently Asked Questions: Knee Arthroscopy 
