Recovery from arthroscopy is much faster than recovery from traditional open joint surgeries. Still it is important to follow instructions carefully after you return home.

Swelling : keep the operated limb elevated as much as possible for first few days. Apply ice as recommended by your doctor to relieve swelling and pain.

Wound care : Keep your wound and dressing clean and dry. Your wound should not come in contact with water. Change any bandage immediately if it becomes wet or bloody.

Activity : After most arthroscopic surgeries you can walk unassisted, but your surgeon may advise you to use a brace, crutches, a cane or a walker for a limited period of time after surgery. You can gradually put more weight on your leg as your discomfort subsides.

Medications : You may require pain medications for first few days. Antibiotics may be prescribed in major reconstructions surgeries.

Complications : Potential post operative problems with arthroscopy surgery include infections, blood clots in the legs and an accumulation of blood in the joint. These complications occur infrequently and are minor and easily treatable.

Warning signs : If you notice any of the following, call the concerned orthopaedic surgeon or orthopaedic duty doctor at Sant Parmanand Hospital

• Fever
• Chills
• Persistent warmth or redness around the operated joint
• Persistent or increased pain
• Excessive bleeding
• Tingling or numbness

Rehabilitation programme : Hospital physical therapist will instruct you for ambulation, range of motion and muscle strengthening exercises. Your doctor will specify when you should begin an exercise programme to gain motion and to strengthen muscles around the joint e.g. two commonly used exercises to strengthen the muscles above your knee are : quadriceps setting and straight leg raising exercises.

Arthroscopic surgery is very successful in relieving the pain and swelling from a torn meniscal cartilage. However, the results of arthroscopic surgery for arthritis alone are somewhat unpredictable. While it is relatively easy to excise or repair a torn meniscus, not much can be done if the articular cartilage is significantly frayed or worn from the ends of the bones (arthritis). Current technology does not allow surgical repair or regeneration of the surfacecartilage. In some select cases where only a small area (around one centimeter) of cartilage is missing from the ends of the bones, the bone can be drilled to stimulate a scar to form on the end of the bone. This scar may reduce the pain but it is not as good as normal cartilage. Overall, the results of arthroscopy in arthritic knee is unpredictable and is helpful in only those cases where there are mechanical symptoms due to torn meniscus or loose bodies.

Ligament reconstruction involves replacing the torn ligament with a tendon (graft) from your knee or a synthetic material, and attaching the graft in place with screws. This procedure is performed with the use of the arthroscope. The anterior cruciate ligament (ACL) is the most common ligament requiring reconstruction procedures. The torn ligament is excised arthroscopically and new ligament is prepared by ligament grafts taken from your own body. Bony tunnels are prepared in femur and tibia using specialized instruments through which the new ligament is passed and fixed with special screws. This procedure requires relative rest orleave from your work or studies for about 3 weeks after which you will be allowed normal day to day activities.

Reconstruction of Anterior Cruciate Ligament(ACL)

The ability of a meniscus tear to heal depends primarily on its blood supply. The outer or thicker part of the meniscus receives a fairly good blood supply from the lining of the joint, whereas the inner or thin part has a poor blood supply. Thus, tears at the outer margin of the meniscus are more amenable to successful repair which can be done by placing sutures across the tear by arthroscopic techniques. If the tear is in the thin part, the cartilage will not heal and the torn fragment is typically excised. Old or chronic tears also tend to have a poorer success rate withrepair and are typically trimmed out as well.

The meniscus is a specialized structure that is thicker where it attaches to the lining of the joint and thinner toward the middle of the joint. If you made a cut across it, the meniscus would be triangular or pie shaped.

The meniscus can tear in a number of ways. Tears can result from a sudden twisting-type injury or can occur gradually with age. The tear can be through either the outer thick part or inner thin part. Some tears involve only a small portion of the meniscus, while in others nearly the entire meniscus can be involved.

Meniscus tears can cause symptoms from portions of the torn fragments getting stuck or pulled in between the bones as the knee moves. This can cause snapping or popping, locking, pain, and swelling. Not all meniscus tears cause problems, but when they do the arthroscope can be used to trim out the piece which is torn. Only the portion which is torn is removed.