Transcript Anterior Cruciate Ligament Reconstruction

Knee Arthroscopy
University Orthopaedics & Sports Medicine
Presentation designed for patient education
Updated 2/11
University Orthopaedics &
Sports Medicine
Offices
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Clifton (Medical Arts
Building)
Westchester
www.ucortho.com
513-475-8690
University Orthopaedics &
Sports Medicine
Surgery
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Holmes Hospital (Clifton)
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Mercy Fairfield
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Outpatient Surgery Center
Main
Outpatient Surgery Center
Westchester Medical Center
University Pointe Ambulatory Surgical Hospital (ASH)
University Hospital
What is Knee Arthroscopy?
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Simply looking
around the joint with
a camera
A complete inventory
of the knee can be
performed
Many pathologic
conditions can be
addressed.
Indications (Reasons) for Knee Arthroscopy
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Meniscus Tears
Articular cartilage injuries
Ligament repairs and reconstruction
(i.e. ACL reconstrucion)
Removal of loose or foreign bodies
Lysis of adhesions (cutting scar tissue
to improve motion)
Debridement
Irrigating out infection
Lateral Release (cutting tissue to
improve patella pain)
Fixation of fractures or osteochondral
defects (bone/cartilage defects)
Diagnostic
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Meniscus Tear
Debrided and Repaired Meniscus Tear
Arthroscopic Instruments
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Camera
Probe
Shaver- “shaves and
debrides” loose or torn
tissue
Baskets- “nibble away”
damaged tissue
Scissors
Cautery-coagualates
small bleeding vessels
How is surgery done?
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The surgery begins with
an examination of your
knee while you are asleep
This allows for testing of
your knee ligaments to
make sure they are stable
without the resistance of
your muscles
“Examination Under
Anesthesia”
Arthroscopic Examination
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A camera is inserted into your knee thru a tiny poke
hole in the front of your knee called a portal
The doctor moves the camera around your joint while
looking at a monitor
A complete inventory of your knee will be performed
looking at all the structures inside your joint
A second portal is created for the insertion of working
instruments
Usually only two portals are necessary, but occasionally
additional portals are needed to get the job done
effectively
Normal Arthroscopic Anatomy
Knee Cap
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Thigh Bone
Thigh Bone
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Shin Bone
Meniscus
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Anterior Cruciate Ligament (ACL)
Addressing Pathology
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Instruments can be
used to inspect the
knee structures
Other instruments
can be used to
debride or repair
structures
Probe used to evaluate torn meniscus
Shaver used to debride a bone
tunnel for ACL reconstruction
Pathologic conditions
Meniscus Tear and Arthritis
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Loose Bodies
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Scar tissue and adhesions
Torn ACL
Various Pathology
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An infinite number of
problems can be treated
with arthroscopy and we
are continually expanding
the array of diseases that
can be effectively treated
with the camera
Tibial spine fracture with pulled off ACL
Arthroscopically assisted fracture repair
and restoration of ACL anatomy
Post Operative Rehabilitation
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Usually you can go home the
same day
Ice and elevate your leg as
much as possible for the first
72 hours
You may or may not have a
brace depending on what
surgery was done
Your doctor will tell you how
much weight you can put on
your leg
Post Operative Rehab
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You can usually take your
dressings down on the third
post op day and shower
Do not scrub or submerge
your wound
No soaking, swimming or
hot tubs
Do not apply any ointments
to your wound—this
includes polysporin or other
antibiotic ointments
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Other than bathing keep your
wound clean and dry
After your shower you can
leave your leg open to air if
nothing is draining
If your knee is draining then
apply a clean dry dressing
and notify your doctor
You will be given pain
medications and a pill for
nausea
Please take an Aspirin 325
mg per day until your follow
up appointment
Post op
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You will usually see your
doctor 5-7 days post op
At that point you will get into
physical therapy
You will work on range of
motion
The thigh muscle
(quadriceps) goes to sleep
after many knee injuries and
after surgery. Thus, much of
your rehab will be aimed at
quadriceps strengthening
exercises
Physical Therapy
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The amount of physical
therapy that you will
need depends on what
was done in surgery
The rehab is quite
different for different
arthroscopic knee
surgeries
Please make sure you
understand the expected
rehab goals
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Physical therapy is very
important in optimizing
your outcome
It is critical to do
exercises at home on
your own as well
Your therapist will give
you a home exercise
program that should be
done every day
Return To Work or Sport
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Desk job—3-5 days
Prolonged standing or
heavy lifting—usually
about a month
This is highly variable
depending on surgery
and rehab and most
importantly what kind of
work you do or what
sport you play
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This is also very much
dependant on your rehab
progress
It is best to anticipate the
expected length of
recovery before surgery
Sometimes the recovery
is shorter or longer than
expected but often can
be estimated before
surgery
When Can I Drive?
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Must be off all narcotics
Should be able to hold a straight leg raise for 10
seconds
Ask you doctor before you drive?
Practice in a parking lot first
Conclusions
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Knee arthroscopy is a very useful tool of the
orthopaedic surgeon
We are constantly getting better and better to expand
the types of procedures that can be done
The recovery is variable, but you should be able to get a
ballpark estimate based on the anticipated procedure
Your doctor or therapist can be a useful resource for
any and all questions. Do not hesitate to ask questions
at your appointment or call the office when questions
arise
513-475-8690
Thank You