Operation on the knee joint

Surgical treatment of diseases of the knee joint

The knee joint is injured more than others. Serious consequences with ligament ruptures, damage to the meniscus and articular bone surfaces can not be cured by conservative methods. Crucial is the timely operation on the knee joint.

Who is shown the operative treatment of the knee

Indications for surgical treatment depend on the specific pathology.

There are diseases in which conservative therapy in combination with physiotherapy (arthrosoarthritis, sprain) is acceptable and gives good results.

But there are also pathological changes in the knee, in which surgical treatment should be used as early as possible, since delay causes complications during the operation, makes the recovery period.

Temporary contraindication to any kind of surgical intervention:

• presence of acute respiratory infection, untreated influenza, herpes;
• for women - the period of menstruation, the timing of three days before and after.

What needs to be done during the preparation for the operation?

Before the surgery, all patients must undergo a general examination, which includes:

• analysis of blood and urine;
• determination of the blood group and Rh factor;
• HIV testing, RW, viral hepatitis;
• sugar and bilirubin;
• ECG and consultation of the therapist to patients after 50 years of age.

A week before the scheduled operation, you must stop drinking alcohol. On the eve, you can not dine supper. On the day of surgery, you can not eat in the morning.

Plastic anterior cruciate ligament after rupture

Can I do with endoscopic methods?

Arthroscopy is gradually becoming an accessible method for any traumatology department. The operation spares soft tissues, refers to low-trauma interventions. Advantages of arthroscopy:

• at the same time is a method of diagnosis, helps to visually see and assess the degree of damage;
• Excludes a large incision, this minimizes the edema of the tissues and the risk of infection;
• Operative surgeons do not need to take care of the fixation and immobility of the leg;
• rehabilitation begins early, the period of incapacity for work is reduced;
• the length of stay on the hospital bed is reduced, which increases its turnover and a greater number of operated patients.

How is arthroscopy performed?

The operation is performed under spinal anesthesia. Over the joint, two punctures or small incisions are made:

• in the first enter the arthroscope,
• through the second - various tools for manipulation.

With the help of saline solution "inflate" the articular bag. This is necessary for a thorough inspection and access to all areas of the cavity. The whole procedure takes an hour.

When using an arthroscope, the articular bag is not opened

When patients with diseases and knee injuries need surgery?

Indications for patients with osteoarthritis:

• with the second degree of arthrosis, significant improvement in movement and loss of pain is guaranteed for up to three years;
• at the third degree the cartilaginous tissue is almost completely destroyed, the joint surfaces alone are not restored, the pains become permanent, arise at rest and at night, painkillers and procedures do not give the desired effect.

The purpose of intervention in meniscus damage is:

• elimination of tearing and crushing of tissue;
• connection of detachment of parts from the body.

Types of surgical interventions on the knee joints with osteoarthritis

Depending on the age of the patient and the nature of the damage to the knee, surgical treatment assumes different levels of intervention.

Arthroscopic debridement

This type of operation gives a temporary effect, but is quite effective in the second stage of arthrosis, when a part of the cartilaginous surface of the joint is still preserved, and the pains are associated with movements. Conducted actions are regarded as minimal. They consist in elimination of the reasons of pains - dying particles of a cartilage floating in an articulate bag.

With the help of an arthroscope, the surgeon enters the cavity of the knee joint and extracts cartilaginous particles. The duration of the improvement period lasts up to two years.

Carotid arthrodesis

We advise you to read:Surgery for knee replacement

This operation is of a radical nature. It is performed with complete destruction of articular surfaces and bone components.

The knee joint is opened, all remains of the cartilage are removed. The bone parts of the tibia, femur and patella form along the contact surface for complete destruction of the motor function. This is called ankylosis.

Practically the joint is removed and replaced by a fixed fusion of bones.

On the one hand, the person gets rid of the pain and the non-working joint, on the other - still I would like to establish at least a minimal function of the knee to walk without limping. Therefore, such a technique is currently very rare.

Use of periarticular osteotomy

The operation is technically complex. The intervention is similar to arthrodesis, but the articular surfaces are pre-cut so that when compared they are at the optimal angle and compensate for the load on the entire joint.

The postoperative period in this case is different for a long period (up to six months), and the effect is temporary.

Joint prosthetics

Types of surgical methods for damage to the meniscus

Operations on the meniscus are carried out in two versions:

• arthrotomy - open method, accompanied by autopsy;
• endoscopic method (arthroscopy) - with the help of a small arthroscope.

Types of surgical interventions include:

• removal of the entire meniscus or part thereof;
• restoration of the meniscus;
• graft transplantation.

Open transaction type

The operation of removing the meniscus

Removal of part or all of the meniscus is required when the cartilage layer is completely crushed, tearing off. Currently, traumatologists are trying to remove only the damaged part and trim the edges. It is believed that the extraction of the entire meniscus provokes the further development of arthrosis.

Restoring the Meniscus

To restore the meniscus by superimposing a special suture during arthroscopy, a number of conditions and indications for surgery are required:

• the time of intervention is as close as possible to injury;
• the patient's age is up to 40 years and the absence of any dystrophic processes in the cartilage.

When carrying out arthroscopy, the presence of:

• rupture along the central longitudinal vertical line;
• detachment of a part of the meniscus and a distance of no more than 4 mm;
• breaks on the peripheral part with or without offset.

The edges of the combined surfaces are corrected, they achieve full alignment and fit. Nonviable areas are removed.

Fixation of the detached part inside the joint capsule is made by special types of sutures. Which of them apply, the surgeon decides after examining the damage. Various medical devices are used:

• screws,
• arrows,
• dart,
• buttons,
• fixatives with resorption.

The operation is more successful when a rupture occurs in the red or red and white zones. Here blood circulation is better developed, therefore, healing is faster. If time is lost, the break has turned into a chronic disease and is in the white zone, the chances of a good engraftment decrease.

How is a meniscus transplant performed?

Transplantation involves replacing the damaged part or the entire meniscus with a synthetic version or a donor form. As a donor can be frozen and processed tissue of the corpse. The search for a suitable transplant takes a long time.

Requirements for transplantation

The material replacing the meniscus tissue should:

• have a porous structure to allow blood vessels to penetrate inside;
• fully meet the required dimensions.

Indications

Surgeons offer meniscus transplantation in the following cases:

• with complete fragmentation and the absence of another possibility to restore their own tissues;
• at the age of the patient up to 40 years.

Contraindicated replacement:

• in the elderly;
• if there are persistent degenerative changes in the joint;
• if there are chronic concomitant diseases (diabetes mellitus, polyarthritis, severe atherosclerosis, ischemia of the heart and cerebral vessels).

What complications are possible

A positive effect of operative treatment of the knee joint is observed in 85% of cases. However, complications can sometimes be recorded in the form of:

• bleeding due to vascular damage;
• rupture of ligaments and nerve endings;
• development of infection in the joint bag.

How is the recovery period?

After the operation, the patient is prescribed the necessary medicines, physiotherapeutic procedures to improve tissue repair, prevent scar scarring, and develop articular surfaces. The rehabilitation course necessarily includes physical exercises.

Symptoms of joint damage disappear not immediately, but after 6-8 weeks. The patient must be prepared to meet all the requirements.

Rehabilitation schemes

The course of events in the recovery scheme for each patient should be individual. It depends on the mode of operation, the level of immunity.

With sparing operations

Load the joint is allowed little by little on the second day (stand by the bed, walk in the ward), but for 7 days you need to use crutches.

The patient is discharged to work after 1-2 weeks, and after 3 weeks you can practice on a stationary bike and add a load.

A month later, participation in sports games (volleyball, football), tennis, athletics.

It is shown wearing a fixative bandage with a load on the joint

After stitching the meniscus

For four weeks the patient should use crutches to unload the operated joint. Only after the fifth week is it allowed to walk.

For sports training you can start no earlier than 8 weeks on the permission of a doctor.

A full sports load is shown only after six months.

For joint transplantation

The load is limited for up to 6 weeks. Increased physical activity is possible after two months. Permission to return to a sports career should only be obtained from the attending physician after a follow-up examination.

Most often operations on knee joints are conducted on a fee basis. This is determined by the cost of the services of a specialized clinic in the region, the volume of planned changes, the quality of the transplant. In the clinics of Moscow, different operations have a price of 6 to 80 thousand rubles.

Israeli centers conduct high-tech operations using transplants of leading firms in the US and UK for 20-25 thousand. dollars.

A source: http://MoyaSpina.ru/lechenie/hirurgicheskoe-zabolevaniy-kolennogo-sustava

What are the operations on the knee joint?

The knee joint is a movable articulation of the femoral and tibia bones. Also important components of this education are ligaments and menisci. In the knee, there are the following ligaments: lateral, posterior and intraarticular.

One of the most important are the cruciate ligaments, among which the anterior cruciate ligament (PKC) is separately isolated, which is most often susceptible to trauma.

Its wear resistance is provided by many factors, the most important of which are the high strength of bones that form it, the increased density of cartilaginous surfaces.

Knee diseases that can lead to surgical treatment

The PKC gap

Diseases of the knee joint are divided into traumatic, infectious, inflammatory. The most common injuries are.

These can be fractures, dislocations (which are most often accompanied by ligament ruptures), ligament ruptures, meniscus damage.

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The most serious are fractures, since even after prolonged rehabilitation it is rarely possible to restore the function of the limb by 100%.

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Infectious diseases are divided into septic and rheumatic diseases. The difference between them is that in the septic, pus formation takes place, which can lead to melting of the bone, and rheumatic lead exclusively to inflammation, impaired function of the knee.

Inflammatory diseases can occur due to many factors. But all of them are united by a clinical manifestation, which will be the same in all cases.

What kind of preparation is required for knee surgery

Operative manipulation on the knee does not require specific training. It is necessary to prepare the operating field and prepare for anesthesia.

Spinal anesthesia

The following types of anesthesia can be used for knee surgery: endotracheal, intravenous anesthesia, conductive anesthesia, spinal anesthesia.

Less commonly, local anesthesia can be used with anesthetics such as novocaine or lidocaine. The choice of anesthesia depends on the type, volume of the operation.

But such operations as prosthetic knee joint should be carried out under general anesthesia with using muscle relaxants, to provide the most convenient access to the surgical site manipulations.

What are the operations on the knee

1. Puncture of the knee joint is one of the simplest manipulations on the knee. This manipulation is performed to determine the presence, amount of exudate or administration of drugs directly to the localization of the problem.

   Puncture is performed under local anesthesia with a special needle.

2. Stitching of ligament rupture is carried out in case of violation of their integrity. Stitching is carried out using special suture materials. Disruptions can occur with dislocations, fracture-dislocations, fractures.

   For such an operation, a wide operating access is used or resort to the use of an arthroscope, endoscopic device, which allows for surgical intervention with a smaller injuries. Most often, anterior cruciate ligament (pcs) is torn.

3. Arthroscopy of the knee is an endoscopic operation that is performed with a diagnostic or therapeutic purpose.

   With the help of a special device, under the control of the camera, the LED, it is possible to carry out many types operations on the knee, which became a good analogue of surgical treatment with conventional arthrotomy (strip operation).

4. An open reposition of fragments is used to compare fragments in fractures that are located either on the joint surface or in the immediate vicinity of it.

   This operation involves the use of osteosynthesis - fastening fragments with the help of special fasteners made of hypoallergenic materials. It can be staples, spokes screws.

   This fixing allows to provide the most minimal consequences after a fracture.

5. Arthroplasty is an operative intervention to restore and correct the articular surfaces of bones.

   This intervention is performed to remove defects or ossification sites on the cartilage. Defects are eliminated with the help of special pastes, mixtures, which after hardening are in no way inferior in density hyaline cartilage.

   In parallel with surgical treatment, medication is carried out with the use of preparations for the restoration of joints and cartilage.

6. Resection of the knee joint is a fairly extensive operation, which is carried out in the case of purulent fusions or extensive knee fractures.

   This intervention involves the removal of not only the joint itself, but also the damaged bone sites. Most often after this, another operation is carried out for joint or leg replacement (in cases where the lower third of the thigh is amputated).

   This operation for the complexity of the exercise is comparable to the operation of Latarjer on the shoulder joint.

7. Prosthesis of the knee joint is a replacement of an endoprosthesis, which is made of special alloys and polymers.

   These prostheses are produced in various sizes, from different materials in order to be individually to choose a prosthesis for each patient, depending on its size and individual sensitivity to components. To date, such prostheses can almost completely restore the function of the lower limb. In some cases, only the joint surface can be replaced.

8. Removal of the cyst of the knee joint - this manipulation implies the removal of cystic joints of the knee joint. It does not cause any difficulties and lasts about 30-40 minutes. Among them, a separate place is occupied by the cyst baker.

Also, one of the types of surgery is intervention to replace the patella.

Restrictions after surgical interventions

Hemarthrosis

After surgical treatment, it is necessary to limit the load on the leg. This is achieved by observing bed rest, and after - walking with crutches, chopsticks and other special items.

To prevent the development of hemarthrosis, use a tight bandage with an elastic bandage. This ensures the compression of the blood vessels and, accordingly, the best haemostatics after the operative actions.

Complications of knee surgery

For all surgical interventions, the most dangerous is the development of septic complications. At the site of the operation in such cases begins to appear, and then accumulate a purulent discharge.

This can lead to purulent melting of the bone and even the development of sepsis. Such problems often end with repeated operations, up to resection of the knee joint or amputation.

This can be avoided by using powerful antibiotics and introducing antiseptics into the joint.

Rehabilitation after operations on the knee joint

Loads on the knee after surgery should be gradual

Each of the types of surgical interventions requires an individual selection of a plan for rehabilitation measures.

Most often, rehabilitation after surgery on the knee joint is a gradual strengthening of the muscles, located next to the joint, its development, but this is all done with a gradual increase load.

All these activities are aimed at restoring and returning to a full-fledged way of life.

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Surgical actions on the knee require high qualification from the doctor. But the effect of treatment will depend not only on the success of surgical treatment, but also on the patient.

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He must adhere to all the recommendations of a doctor and rehabilitologist. Also important is the rehabilitation plan.

All these components provide the best outcome of the disease.

We advise you to read:sternal puncture

Attention!The information on the site is presented by specialists, but is of a fact-finding nature and can not be used for self-treatment. Be sure to consult a doctor!

A source: http://VseOperacii.com/oda/operacii-na-kolennom-sustave.html

Operations on the knee joint

Operations on the knee joint- a large group of surgical interventions, differing in indications, scope and goals, the achievement of which is planned as a result of treatment.

If the ligaments are damaged, intra-articular fractures, acute purulent arthritis, operations on the knee joint are carried out urgently.

Planned surgical interventions are aimed at eliminating the consequences of trauma or knee disease, improving the function of the joint or the supporting function of the affected limb.

Operations on the knee joint include a large list of techniques and methods of arthroplasty, arthrodesis, resection, osteosynthesis, removal of the meniscus, restoration of ligaments, etc.

If the ligaments are damaged, intra-articular fractures, acute purulent arthritis, operations on the knee joint are carried out urgently.

Planned surgical interventions are aimed at eliminating the consequences of trauma or knee disease, improving the function of the joint or the supporting function of the affected limb.

Operations on the knee joint include a large list of techniques and methods of arthroplasty, arthrodesis, resection, osteosynthesis, removal of the meniscus, restoration of ligaments, etc.

Emergency and planned surgical interventions

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Emergency operations on the knee joint are performed urgently (for several hours or days).

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The aim of the interventions is to prevent complications and improve long-term outcomes of treatment.

The group of emergency operations include surgical interventions for fresh ligament tears, open patellar osteosynthesis, arthrotomy with acute purulent arthritis, etc.

The goal of planned surgical interventions at the knee joint in traumatology is to eliminate the consequences of trauma by restoring integrity of damaged structures (for example, plastic for chronic ligament damage) or by removing them (for example, resection of a damaged meniscus).

In some cases, planned operations are carried out to improve the quality of life of patients and do not involve the restoration of a normal anatomical shape or all functions of the limb.

An example of such interventions is arthrodesis of the knee joint (removal of mobility, fixation of the joint in a particular, functionally advantageous position), carried out to restore the limb's limb ability after severe injuries, purulent diseases, etc.

Operations on soft tissues, bones and intraarticular structures

Elements of different operations can be combined in different combinations depending on the purpose of the intervention.

Features of surgical interventions

Surgical interventions on the knee joint are usually performed under general anesthesia or spinal anesthesia.

There are many accesses to the knee joint: lateral, anterolateral, posterior, posterolateral, etc. The surgeon chooses the access taking into account the localization and the nature of the pathology.

Some interventions are carried out from several accesses.

In the course of plastic surgeries, additional incisions are made on the thigh (to take the wide fascia strip used for restoration ligaments, creating a soft tissue cushion between the bones in arthroplasty, etc.) or on the tibia (to take a bone graft from the tibial bones).

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After operations on the knee joint blood may accumulate in its cavity (hemarthrosis), therefore in In the early postoperative period, one or more knee punctures are often required the joint.

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After surgical intervention, a plaster or plastic linget is usually applied to the limb. The term of wearing longiets is determined by the purpose of immobilization.

In the case where fixation is carried out to create rest, gypsum is usually removed after 1-2 weeks. If immobilization is necessary for the fusion of internal structures (bones, ligaments, etc.).

), wearing gypsum or plastic longes can last several weeks or even months.

The term, after which you can load the limb or make movements in the joint, is determined by the attending physician.

A source: http://www.krasotaimedicina.ru/treatment/operations-knee-joint/

Types of operations on the knee joint

The modern rhythm of life is distinguished by mobility and speed. Therefore, healthy knees today - a pledge of a high quality of life.

When there is pain, then the body warns us of danger, being a kind of red light bulb of health.

After all, knee joints are designed in such a way as to withstand enormous loads and make a large number of movements almost every minute. People active can reach up to twenty thousand a day.

Therefore, it is very important to respond in time, to see a doctor and determine the cause of the pain. This will save you many problems in the future.

There are two main causes - numerous injuries and arthrosis of the knee joint. The latter are also dangerous because in the initial stages they can pass unnoticed, day after day destroying anatomic components of the knee joint - ligaments, muscles, meniscus, tendons and periarticular bags.

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With modern methods of diagnosis, an experienced orthopedist will be able to determine that the knee needs treatment, even when the disease does not yet manifest itself, thus preventing a dangerous disease.

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In such situations, the doctor prescribes conservative treatment. Operations on the knee are carried out when such treatment does not help or in emergency situations with severe injuries.

Indications for knee surgery

Problems with knee joints are most often associated with injuries, problems of an infectious and inflammatory nature, of which the most common and requiring urgent surgical intervention is precisely injury.

Nowadays, people even in old age do a lot of fitness and other sports, drive cars, move much, than they exert themselves to great physical loads. Hence the high traumatism. These are dislocations, fractures, ligament ruptures, severe damage to the meniscus.

After all, the knee, despite the enormous load, is almost not protected by muscle tissue, so very much is prone not only to bruises and cones, but also to much more serious problems, even in normal occupations sports.

Septic are characterized by the formation of purulent sacs in the focus of inflammation.

A rheumatic - inflammatory processes that lead to violations of the functions of the joints.

Operations on the knee joint differ in indications, volume and results that can be achieved as a result of surgical intervention.

Operation on the knee joint can be of an emergency or planned nature.

• Emergency operations on the knee are carried out for several hours, and if the situation suffers, then for several days. Often they are associated with ligament ruptures, open fractures of the joints, acute purulent arthritis. Such operations on the knee joint are performed in order to prevent further destruction and inflammatory processes, to facilitate subsequent therapeutic treatment.
• Scheduled operations on the knee have different goals. Very often they are aimed at eliminating the consequences of chronic trauma, improving the functions of the joint and its anatomical components, returning mobility to the lower extremities.

In this case, it is possible both to restore the integrity of the damaged structure and to completely delete it.

Sometimes planned knee joint surgery is performed to improve the quality of life and fix the joint in a certain position for a while to get rid of the pain and restore the foot's ability to rest.

Types of operations on the knee joint can be performed on different anatomical structures:

• operative intervention associated with soft tissues, for example, with Becker's cyst;
• surgery on the periarticular parts - operations to restore the meniscus, restore the integrity of the cruciate ligaments;
• operations on bone tissue, for example, osteosynthesis of the knee.

Often, surgical intervention is combined.

Types of operations on the knee joint:

• a fence of a puncture from a knee joint. Conduct it under local anesthesia with a special medical needle. The goal is to identify the presence, quantity and composition of the periarticular fluid and to administer a drug, analgesic or anti-inflammatory, directly to the inflammatory focus;
• restoration of the integrity of ligaments in fractures or dislocations. Often this is due to the anterior cruciate ligament. In this case, surgical intervention can occur with an arthroscope or an endoscope for less traumatism;
• arthroscopy of the knee - is carried out with the help of a modern instrument and is the least sparing and requiring a minimum period of rehabilitation. It is used for internal inspection. Only two incisions are made, through which the particles of bone and cartilage tissue are removed with the help of light-emitting diodes and a camera, the joint surfaces that lead to arthrosis are aligned. Pain and postoperative risks in this case are reduced to almost zero. Excellent alternative to cavitary surgery;
• open reposition of wreckage - is used for fractures, when it is necessary to find, compare and assemble correctly fragments of bone tissue. Basically they are near the joint or on it. The fragments are fastened by means of special devices - staples, tires, staples, screws. They are made of high quality hypoallergenic medical material;
• arthroplasty - helps to restore damaged articular surfaces with the help of special medical mixtures and formulations. When solidified, they provide restoration of mobility and cessation of pain. In parallel, drug treatment is performed;
• resection of the knee joint is one of the most complex abdominal operations, which involves the removal of the joint itself, and sometimes of the bone sites. It is used in emergency cases with purulent inflammation or extensive crushing of the knee as a result of trauma;
• prosthesis of the knee joint, including a prosthesis of the meniscus - an intervention that allows almost completely restore the mobility of the lower limbs. Assigned in cases where the joint can no longer be repaired by other methods and methods. Prostheses are made of various materials, plastic, ceramics or iron, various configurations, so that you can pick them individually in each case. The material does not cause allergic reactions and is fully compatible with biological parameters of the human body. Serves can be up to 25 years after proper rehabilitation. The patient completely restores activity, gets rid of pain and leads a normal life;
• the removal of cyst-like formations - lasts only half an hour, does not cause complications and complications.

Preparation for knee surgery

They do not require extensive and lengthy preparation. The main thing is to prepare the surgeon's workplace and decide on anesthesia.

• endotracheal;
• intravenous;
• conduction anesthesia;
• spinal anesthesia;
• local anesthesia with lidocaine, analgin, or other similar drugs.

The choice of anesthesia depends on the decision of the anesthesiologist and is related to the type and timing of the operation. Cavities, such as a prosthesis of the meniscus or prosthetics of any other joint, require general anesthesia for the most convenient access to the surgical site.

Usually anesthesiologists do not go on about patients, who require even the most simple intervention of general anesthesia.

After all, medications affect the subsequent process of rehabilitation, weaken the body, which so needs the forces.

This happens even with young people, not to mention the patients at a more mature age. Therefore, the process of anesthesia must be taken very seriously.

Possible complications

The most dangerous in the postoperative period is the inflammatory process, as a result of which formation and accumulation of purulent fluid may occur at the site of the operation.

Such septic formations can result in bone sepsis, repeated surgery, joint resection or even amputation. Doctors usually prescribe strong antibiotics and antiseptics, which are injected with a puncture directly into the joint.

At the site of surgery, hematomas often occur or hemorrhage is formed, when blood accumulates in the periarticular bag.

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In this case, also a puncture is used to pump out the liquid. To prevent the development of hemarthrosis, elastic bandages are usually applied to compress the blood vessels.

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Thus, the best hemostatic is achieved.

Restorative period after knee surgery

Has its own characteristics, is determined by a specialist and depends on several factors:

• type of surgical operation;
• severity of the disease;
• age and individual characteristics of the patient.

With arthroscopy of the knee joint pain will disappear only after a few months, but the period of complete recovery of mobility will take about a month or a little more than that. Return to everyday business the patient will be able after this time.

Surgical intervention, in which the knee is replaced completely, requires a longer recovery process. It takes time for the patient to fully manage the ligaments and get used to the prosthesis.

With an osteotomy in a hospital, the patient spends only three days. Then he is discharged, but the rehabilitation course at home requires extra time and patience.

The orthopedist makes the patient do the simplest exercises, and he moves with the help of walkers or crutches.

During the rehabilitation period, there is a gradual increase in the load on the muscles and their recovery. Procedures are prescribed strictly individually and only by the attending physician. It is very important to withstand the prescribed bed rest, when the joints and ligaments are in complete rest.

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Non-compliance with complete rest can increase the risk of complications, disruption of the integrity of anatomical structures, the occurrence of purulent infections and the appearance of blood in the articular lumens.

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Ignoring the doctor's recommendations can result not only in complications that are life-threatening and its quality, but also negate the operation itself and its planned results. Therefore, it is possible to begin to load legs and produce any movements from the period established by the surgeon.

Operations on the knee joint require high qualification and experience of medical practice.

But very much depends on the patient himself, who should follow the doctor's recommendations from the first minute after surgery and until the last day of the recovery period.

Only in this case the outcome of the surgical intervention and the disease itself will be positive.

A source: http://dlyasustavov.ru/vidy-operacij-na-koleno

Arthroscopy of the knee joint: surgery and consequences

I like the class

Arthroscopy of the knee joint involves surgery in the knee area with such problems like rupture and other severe meniscus lesions, cartilage trauma, cyst, arthrosis, dislocation patella, etc.

Introduced under the skin during surgery, the arthroscope displays on the monitor video information about what happens in the knee joint.

The degree of intervention depends on the complexity of the process, starting with the washing of the meniscus or tissues, and ending with correcting the dislocations and repairing the damaged ligaments.

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The complexity of the operation also affects the duration of subsequent rehabilitation. Advantages of arthroscopy are very minor injuries, small size of the incision, short recovery period.

The effectiveness of such treatment is said in reviews - arthroscopy of the knee joint chooses the majority of those suffering from a knee injury.

Methods of anesthesia

The operation begins on the knee joint with anesthesia. Doctors apply the following basic methods of anesthesia:

• local anesthesia - easy to perform, safe and does not require the involvement of an anesthesiologist; It is used less often than others, since it operates for a short period;
• conductive anesthesia - used with 1% lidocaine solution blocking several basic nerves; The duration of this type of anesthesia is, hours;
• spinal anesthesia with the use of marcain is the most common form of anesthesia; to its merits the possibility to extend the duration of anesthesia with a catheter, as well as maintaining a permanent connection with operated;
• general anesthesia - carried out with the involvement of an anesthesiologist, you can control the duration of the action.

During arthroscopy of the knee joint, anesthesia is chosen based on how the operation will be performed and what level of difficulty.

The process of arthroscopy

Before the operation, a tourniquet is placed on the thigh of the patient, or a so-called turnstile, which does not allow blood to enter the joint cavity. This makes it possible for the doctor to see the operable site better.

All tools are inserted through three holes with a size of 5 mm to 7 mm.

The examination and further actions are also assisted by the introduction of a special fluid into the joint cavity, which comes through one of the instruments.

Through the incisions, the meniscus is removed, ligament repair and other manipulations are performed. After the end of the operation and removal of all instruments and fluids, a medicine is introduced that promotes rehabilitation.

It can be various anti-inflammatory drugs. Arthroscopic sanitation of the knee joint is used to exclude the possibility of new lesions.

After surgery, sterile pressing bandages are applied to the knee.

Postoperative complications

As in many other cases involving surgical intervention, arthroscopy of the knee joint can cause some complications, among which is:

• caused by anesthesia - are not directly related to arthroscopy itself;
• problems with the vascular system - arise when the vein or artery is being bruised;
• stretching of ligaments - the cause is an excessive increase in the distance between the bones when examining the meniscus;
• Arthritis - in case of infection in the wound;
• hemarthrosis - is extremely rare; occurs as a result of severe hemorrhage in the joint.

Postoperative rehabilitation

As a rule, knee arthroscopy involves the passage of a rehabilitation course after surgery. The recovery period can exceed 6 months, and for greater efficiency it is desirable to engage leg-strengthening exercises for up to 1 year.

The outpatient treatment period includes:

• dressings under the supervision of a doctor (conducted on the 1 st, 3 rd and 9 th days after surgery);
• use of drugs that prevent inflammation;
• lymphatic drainage;
• various loads (their degree depends on the complexity of the operation performed).

In addition, after arthroscopy, the rehabilitation of the knee joint involves:

• stimulation of the hip muscles with electricity;
• massage, passive shearing of the patella;
• use of "Artromot" - a drug used for passive movements in the joint;
• special course of physiotherapy.

A patient who has undergone the first stage of rehabilitation can proceed to the second stage, which consists of a set of exercises.

These lessons are simple, everyone can repeat them at home - this is the main advantage of the therapeutic and sports complex (LFK).

Below are the main exercises of lfk after arthroscopy of the knee joint:

1. In the supine position on the back, raise and lower the straight leg (lifting the foot - 15 times, repeating the exercise - 3 times, perform every 2 hours);
2. In the supine position on the side (the side of the healthy leg), lift the operated leg (lifting the leg for 10 seconds, repeating 10 times every 2 hours);
3. When massaging, move the kneecap (10 times, 2 times a day);
4. To go for short distances (thus the speed should be small, the run is forbidden);
5. Ride every week on a bicycle (for 15 minutes).

There are other complexes, more extended, they are all aimed at recovery after arthroscopy of the knee joint. If all the exercises are performed without difficulties, then after the rehabilitation treatment complex, you can begin to play sports.

In general, the postoperative recovery period will require the patient at least 3 campaigns to the doctor for advice.

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At the initial stage, joint punctures can be performed (in case of edema).

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In case the arthroscopic operation on the knee joint was successful and the patient feels well, the seams will be removed in the very near future.

Effects

No matter how successful the operation is, the knee structure will never be the same. From what will be the subsequent recovery, depends on the patient's further actions.

The better the rehabilitation after arthroscopy of the knee joint, the less the consequences are expected.

For example, if activity is too active, the joint fluid flows into the postoperative period, which can lead to infiltration inside the joints.

There may be a problem with postoperative scar.

It is necessary to try to avoid infection of the scars, because in rare cases surgical help is required in inflammatory processes.

Sometimes the limited movement can evolve into algodystrophic syndrome, expressed in the form of pain.

The time of development of this disease can last from 12 to 18 months, and therefore immediately it can not be detected.

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People with advanced age are most prone to undesirable consequences after arthroscopy.

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The cost of arthroscopy of the knee depends on the complexity of the operation and the clinic that the patient chose. The price varies from 15 000 rubles. and may exceed 4, 00 rubles. The patients' comments indicate how effective this method of treatment is.

Reviews

I was given arthroscopy a year and a half ago, the operation was successful.

Now the joint works well, during the rehabilitation period I performed all exercises and doctor's recommendations.

Now I can again do my favorite sport - cycling. Of course, you need to be careful of injuries, so I use a bandage.

After the arthroscopy, thanks to the skill of the doctor and rehabilitation procedures, I quickly "got to my feet" in the literal sense of the word.

It's good that everything is already behind, I'll be more careful from now on. After arthroscopy, I do not notice significant changes in the work of the knee.

I like the class

A source: http://sustavu.ru/bolezni-sustavov/artroskopiya-kolennogo-sustava.html