During treatment there are many questions that immediately come to mind, most of which,
especially those regarding the actual surgery that has taken place are very dependent
on each individual patient and the circumstances surrounding that patient.
However over the many years of experience the Yorkshire Knee Clinic has in this area
we have been able to compile the following three lists of more generalised,
but equally important questions, and their associated answers.
You will be admitted on the day of surgery. You will be advised prior to admission the time up to when you can eat and drink. This will allow you to arrive fasted and prepared for surgery.
The vast majority of arthroscopies are performed under a general anaesthetic. Occasionally, for medical reasons, a spinal anaesthetic may be given. This is normally decided with the anaesthetist. Local anaesthetic is also injected into the knee at the time of surgery to provide post operative pain relief.
Surgical time varies according to the complexity of the problem. Most procedures are completed within 30 mins.
The surgical incisions used are small (5-7mm) and do not normally require stitches.
Arthroscopy of the knee is normally performed as a ‘day-case’ procedure with patients going home the same day. In some circumstances, however, there may be an overnight stay. It is important to have a responsible adult at home for 24 hrs following a general anaesthetic.
These are provided by the hospital and advice will be offered prior to leaving hospital.
The large wool and crepe bandage is usually removed 24-48 hrs following your operation. The small dressings over each wound should be left on for 5 days and then removed providing all leakage has stopped. Re-apply a fresh dry dressing or plaster if there is still any leakage from the wound.
Simple exercises will normally be demonstrated by the physiotherapists prior to leaving hospital. These must be performed regularly to be effective. However, it is possible to over-exercise which can cause increased swelling and pain. If in doubt consult your physiotherapist.
Most patients require additional physiotherapy following discharge. Patients will be advised on an individual basis prior to discharge.
You will normally be admitted on the same day as surgery. You will be advised prior to admission the time up to when you can eat and drink. This will allow you to arrive fasted and prepared for surgery.
The vast majority of ACL Reconstructions are performed under a general anaesthetic. Occasionally, for medical reasons, a spinal anaesthetic may be given. This is normally decided with the anaesthetist. Local anaesthetic is also injected into the knee at the time of surgery to provide pain relief in the post-operative period.
Surgical time varies according to the complexity of the problem. There may be associated injuries to the knee such as a meniscal or cartilage tear that was sustained during the initial injury or at a later date as a secondary injury. The majority of ACL reconstructions are completed within 60 mins.
The majority of patients are fit to be discharged home within 24hrs and some patients go home on the day of anterior cruciate ligament reconstruction. Your surgeon will advise a plan for discharge based on the specific surgery and physiotherapist recommendations.
It is important to have a responsible adult at home for 24 hrs following a general anaesthetic.
Painkillers and/or anti-inflammatory tablets are provided by the hospital for the first few days following ligament reconstruction and advice will be offered prior to leaving hospital. Regular painkillers and/or anti-inflammatory medication are important to allow early mobilisation.
The large wool and crepe bandage should be removed 24-48 hrs following your ligament reconstruction. The small dressings over each wound should be left on for 5 days and then removed providing all leakage has stopped. Re-apply a fresh dry dressing or plaster if there is still any leakage from the wound.
For the first few days, try to keep the leg elevated when sitting down and rest as much as possible. Do your exercises frequently. You can put as much weight through the knee as comfortable but the muscles around the knee will be weak and therefore crutches are encouraged for support for a few days. The hospital physiotherapists will give you specific advice prior to discharge from hospital.
You may take a shower or bathe from the day after ligament reconstruction providing you keep the wound areas completely dry. Provided the wounds have healed, they can be soaked from day 5.
In order to drive safely you must have regained good muscle control of the operated leg. This is normally at least 2 weeks following surgery. Advice can be sought from your surgeon or physiotherapist. . You should be confident you are in full control of the car and be able to perform an emergency stop with no hesitation.
Out-patient physiotherapy will normally start within a week of your ligament reconstruction. This must be with an experienced knee physiotherapist and will follow a structured program in order to get the best results from your ligament reconstruction surgery. There are important activity restrictions over the first few months following ACL reconstruction and these will be explained fully by your physiotherapist. If these restrictions are ignored there is a significant chance that the surgery will fail.
This depends on the recovery from surgery and the type of work. Some patients have more complicated surgery which may require extra restrictions. The majority of office workers can return within 2 weeks, whilst those patients who need to stand for long periods may need 2-3 weeks off work. Heavy manual work or patients whose jobs require carrying or lifting may not return to work until advised by their surgeon or physiotherapist.
Simple exercises will normally be demonstrated by the physiotherapists prior to leaving hospital. These must be performed regularly as well as frequent ice application to reduce swelling etc.. Further exercises will be explained by your physiotherapist. The success of anterior cruciate ligament (ACL) reconstruction surgery depends upon complying with the rehabilitation programme which must be supervised by your physiotherapist.
Serious complications are uncommon following knee ligament reconstruction but can occur. These include infection, blood clots (or DVT – deep vein thrombosis), excessive swelling, bleeding and damage to blood vessels or nerves.
There is always a small risk that the reconstructed graft can rupture, in a similar way to the original injury to your ligament. This risk is greatest in the first 3 months following surgery. It is therefore important an experienced physiotherapist supervises your recovery.
Warning signs following surgery you should look out for are:
If you experience any of the above please contact the Hospital for advice.
You will normally be admitted on the same day as surgery. You will be advised prior to admission the time up to when you can eat and drink. This will allow you to arrive fasted and prepared for your operation.
Knee Replacements are performed under either general or spinal anaesthetic. Nerve blocks are sometimes also used. This is normally decided with the anaesthetist.
Surgical time varies according to the complexity of the problem. On average the surgery takes 60 minutes for a first time joint replacement. However you will be away from the hospital ward for longer than this to allow for your anaesthetic and initial recovery.
The majority of patients are discharged home within 2-5 days. Some patients are safe to go home earlier whilst others may need longer.
Painkillers and/or anti-inflammatory tablets are provided by the hospital for the first few days following surgery and advice will be offered prior to leaving hospital. Further pain killers may be required from your doctor.
Advice on dressings (if still required) will be given before leaving hospital.
Exercises will need to be done frequently each day to build muscles and recover range of movement. It is important to remain active at home and regular walks are encouraged. When resting it is best to elevate the leg to reduce swelling. Most knees, however, remain swollen and warm for many weeks.
You may take a shower or bathe when you get home once you can get safely into and out of the bath/shower and providing wounds have healed.
In order to drive safely you must have regained good muscle control of the operated leg and pain must be controlled. Remember you are not allowed to drive whilst taking some types of pain killers. Driving is normally possible 3-6 weeks after surgery depending on which leg and whether the car is manual or automatic. Advice can be sought from your surgeon or physiotherapist.
This depends on the recovery from surgery and the type of work. Some patients have more complicated surgery which may require extra restrictions.
The majority of office workers can return within 3-4 weeks, whilst those patients who need to stand for long periods may need 6-8 weeks off work.
Simple exercises will normally be demonstrated by the physiotherapists prior to leaving hospital. These must be performed regularly to be effective. However, it is possible to over-exercise which can cause increased swelling and pain. If in doubt consult your physiotherapist.
Most patients require additional physiotherapy following discharge. Patients will be advised on an individual basis prior to discharge.
The majority of patients have an uncomplicated recovery but knee replacement is a major operation which carries risks of complications. The main risks associated with knee replacement are:
Warning signs you should look out for are:
If you experience any of the above please contact the Hospital for advice.
