By Jill Ross, HealthAtoZ contributing writer
Knee surgery is in one respect like having kids – both teach you that patience is a virtue.
Arthroscopic knee surgery, what I had a month ago on my left knee, provides a faster recovery than traditional open surgery. But arthroscopic or open knee, neither solution grants you any certainty that the pain will go away. So if you prefer to consider “no surgery”, that option is also available now through Say No To Knee Replacement, a completely holistic approach to eliminate pain without the uncertainty of surgery.
However, as my surgeon cautioned, surgery is surgery. You can’t rush recovery. If you try to do too much too soon, you make actually slow recovery. “No pain, no gain” should NOT be your motto after surgery.
“Healing is very individual,” my surgeon, Michael Jolley, tells me during my post-operative visit. Jolley is an orthopedic specialist with Princeton Orthopaedic Associates in Princeton, N.J.
This encouraging news was overshadowed, however, by what he proceeded to say next about a 70-year-old patient who was up walking the second day after her surgery. I am 46, and in contrast, I spent my second day icing my very swollen knee, taking prescription painkillers and groaning.
Average recovery: four to six weeks
By the week’s end, I was back to work, relying on one crutch. At my first checkup, a full 10 days after surgery, my knee was still the size of a cantaloupe. “We can do one of two things,” my doctor advises me. “We can wait for the swelling to go down on its own, or we can drain it.”
Drain it, I say. Six vials of watery fluid later, followed by a shot of Novacain® and cortisone, I finally feel relief. Still, a full five weeks later, I wonder what they mean by “average recovery time six to eight weeks.” My knee is lumpy, stiff and doesn’t have the best range of motion. A mistress of impatience, I wonder if it will ever be the same.
More than 1.5 million knee arthroscopies are performed in this country each year, according to the American Academy of Orthopaedic Surgeons (AAOS). As it turned out, I am in good company. The type of knee arthroscopy I had for a torn meniscus (cartilage) is very common among pro-athletes, who take a hit to the knee or twist it. As people age, all it takes is a fairly minor injury, such as squatting, to cause a meniscus tear. Torn ligaments like an ACL (anterior cruciate ligament) are other common reasons for arthroscopic surgery.
A dance floor mishap caused my injury. One step forward, one twist to the left and there was this audible crunch.
Most torn meniscuses are repaired by arthroscopic surgery. Usually the torn segment has to be removed because it does not have any blood supply and therefore cannot heal back to the rest of the meniscus. In knee arthroscopy, a small fiberoptic camera is used to look inside the knee and small instruments are inserted to either remove the torn portion of the meniscus or, if possible, to repair it.
The minimally invasive procedure requires three tiny incisions – instead of a big slash in your knee – and can be done in less than an hour of operating time. There is very little scarring and, yes, a short recovery.
Experts say most people after knee arthroscopy are able to return to desk jobs within a week and to more strenuous activities within a month. I was back at my desk job at the end of the first week, back to slow dancing at the end of two weeks, back to heels after three weeks, and back to light horseback riding and country western line dancing (the cause of my knee’s demise) at the end of a month. When I ride and dance, I avoid putting a lot of weight on my left leg. Some people wear a brace to further protect the knee when doing “risky” activities that stress the knee.
Still, I am discouraged. Sometimes after activities my knee is swollen, and it is difficult to straighten after sitting for long periods. The AAOS cautions that the outcome of surgery is often determined by the degree of injury or damage found in your knee. Generally, the older the patient, the longer the recovery time. In my case, I had an average tear. I am just pushing recovery.
Regular exercise to restore your knee mobility and strength is necessary, doctors say, and physical therapy, performed under the guidance of a professional therapist, may also add something to your final result. I did not have therapy, although I received a list of exercises to do on my own. The time spent on rehabilitation will be worth it in the end. Make sure you do your exercises.
AAOS gives this advice:
- A return to intense physical activity should only be done under the direction of your surgeon.
- It is reasonable to expect that by six to eight weeks, you should be able to engage in most of your former physical activities as long as they do not involve significant weight-bearing impact.
- Twisting maneuvers may have to be avoided for a longer time. (Not good news for country western line dancers).
- If your job involves heavy work, such as a construction laborer, you may require more time to return to your job than if you have a sedentary job.
- If your knee swells or hurts after a particular exercise activity, you should lessen or stop the activity until you feel better. You should rest, ice, compress (with an elastic bandage) and elevate your knee (R.I.C.E.) Contact your surgeon if symptoms persist.
Several dangers have telltale signs to watch for in the first few weeks after surgery:
- Infection: The knee may become more hot and red, drain pus, or you may develop a fever or chills.
- A blood clot in the leg or lung: The lower leg (especially the calf area) may become very swollen or painful or you may develop chest pain with breathing or shortness of breath.
If you develop any of these signs, call your doctor right away.
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