Every patient and every operation is unique.
If you have any questions regarding knee arthroscopy in Melbourne, simply book a consultation with Dr Parminder J Singh today.
What is a knee arthroscopy?
Knee arthroscopy is a minimally invasive procedure that involves assessment and treatment of damages to the inside of a knee joint. Knee arthroscopy can be used to treat a number of conditions such as torn meniscus, loose cartilage, damaged cartilage surfaces and anterior cruciate ligament injuries.
What are the typical symptoms?
This will depend on the type of condition you have. Two common conditions Dr Parminder J Singh will treat include meniscal tears and anterior cruciate ligament rupture.
Patients will usually present with a history of loading and or twisting their knee. This mechanism of injury can load the meniscus sufficiently to cause a tear. The patient may experience pain around the knee joint line and some mild swelling of the knee. In the presence of very large tears the knee may become locked in position. An MRI scan will help confirm the diagnosis.
How is the surgery performed?
Patients will usually be admitted as a day surgery procedure and have a general anaesthetic.
Meniscal tears surgery
A tourniquet is inflated around your thigh to maintain a bloodless field during the surgery. Typically, two small incisions are made during a knee arthroscopy. One incision for the arthroscope and one for the surgical instruments to treat the knee damage. The keyhole technique usually allows for a more rapid recovery than open techniques as well as shorter recovery times following surgery. The meniscal tear will be either repaired or trimmed depending on the location of the tear in the meniscus. Generally, tears in the zone where there is still a viable blood supply with be repaired and those that are not will be trimmed. Patients are usually able to fully weight bearing after their surgery unless specified by Dr Parminder J Singh.
Dr Singh will see you after your surgery prior to discharge the same day. A follow up appointment will be arranged for you around day 10-14 for removal of stiches. This is performed in rooms and is not usually painful. Rehabilitation may be facilitated with the supervision of a physiotherapist over the period of the next few weeks. Dr Singh will advise you on return to work time and driving based on his clinical assessment following surgery. Patients however would typically be back to work around 1-2 weeks after their surgery, driving after a similar time and normal activities around 4-6 weeks.
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Anterior Cruciate ligament (ACL) surgery
The ACL is a major stabilising ligament of the knee particularly during movements such as running, twisting and sidestepping.
The function of the ACL is to prevent the femur moving forward and rotating excessively on the tibia. Reconstruction of the ACL will potentially reduce recurrent instability of the knee joint. Usually, patient who are more active and keen to return to sport involving twisting and pivoting will typically proceed to surgery.
Reconstruction of the ACL is performed under a general anaesthetic. A tourniquet is inflated around your thigh to maintain a bloodless field during the surgery. Typically, two or three small incisions are made during a knee arthroscopy. One incision for the arthroscope and the others for the surgical instruments to treat the knee damage. A further 2-3cm incision will be made to harvest your hamstrings.
Your hamstrings will be used to reconstruct the anterior cruciate ligament. Fixation of the ligament will be achieved through a combination of a screw and endo-button. The key hole techniques usually allows for a more rapid recovery than open techniques as well as shorter recovery times following surgery. A check x-ray will be undertaken to endure satisfactory placement of the screw and endo-button prior to your discharge from hospital. An overnight stay is hospital would be typical for ACL reconstruction surgery.
Ice packs used regularly will help with reducing swelling following your surgery. Following your surgery, the physiotherapist will guide you through your rehabilitation. Following your surgery, your ACL graft should be strong enough to put all your weight on the operated leg. You will likely to require crutches and pain killers initially for the first week or two. You may shower providing you have a waterproof dressing over your wounds.
Dr Singh will review your wound approximately 10 days after your surgery and remove any stiches. Patients will need a minimum of 2 weeks of work. Patients who are more active such as labourers may need 2 to 3 months of work. Dr Singh recommends return to competitive sport after 8-12 months following your surgery to reduce the risk of a recurrent injury and it is recommended an experienced physiotherapist helps guide you through your rehabilitation.
What is the process moving forward?
Anterior Cruciate ligament (ACL) injury
Patients will usually present with a history of a low-velocity, non-contact, deceleration injuries and contact injuries with a rotational component. Contact sports also may produce injury to the ACL secondary to twisting, valgus (outward angulation of the leg) stress, or hyperextension (bent backwards or overstretched) all directly related to contact or collision. The knee typically swells immediately following the injuries. The knee will be unstable and give way during simple manoeuvres like turning and twisting. Recurrent instability of the knee can lead to further damage to other structures inside the knee joint such as the meniscus, cartilage and bone. An MRI scan will help confirm the diagnosis and also help identify any other structures in the knee that may be damaged such as the meniscus or cartilage.