Knee pain may be the result of a variety of causes, from an accident to arthritis. Whatever the reason for knee pain, surgery is always the last option. An off-the-record definition for surgery has been described by some as 'scheduled trauma'. However, if knees continue to cause pain or to hinder daily life, arthroscopic surgery may be necessary. Know the facts before invading the body's natural ability to heal.
The first course of action with knee pain is to reduce inflammation, which is usually the cause of pain due to overuse. Athletes struggle with this. The good old-fashioned ice pack is known to work wonders. If running, biking, or even walking causes swelling or pain, simply apply an ice pack immediately after the activity. Friction in the knee joint causes blood to gather around the joint; ice reduces the amount of blood to the area, giving the knee a chance to get back to normal operating procedure. Remember to apply ice only in 20 minute increments with a 20 minute relief in between. Many pharmacies carry ice packs that strap around the knee for under $15 dollars, a small price to pay for repeated relief.
In more serious cases, a ligament (along the side of the knee) may be strained, or the meniscus torn. The meniscus is the padding between the thigh bone (femur) and the shin bone (tibia). While a strained ligament can be quite painful; it does not require surgery. However, a torn meniscus usually gets worse rather than better because it's in a frequent movement area that has applied pressure. Arthroscopic surgery may be recommended by an orthopedist, or sports medicine physician.
What happens after the diagnosis?
When a physician has determined that surgery is the best option for knee pain, the preparation for surgery is the same as any other day surgery. There should be no eating or drinking after midnight before the surgery. Surgeons usually like to take small children earlier in the morning, so be prepared to wait up until 11:00am in some cases. Prepared patients are sent to a surgical waiting area where an anesthesiologist will usually appear to explain his or her job to you. This can be a very peaceful experience when the patient is relaxed and confident.
How is the surgery performed?
When the patient is fully anesthetized, the doctor makes three small incisions in the around the kneecap. Each incision is for a specific instrument; one is for the light, one is to pump air, and the other is to repair the damaged area. The knee cap is raised out of its position and the area beneath is carefully repaired and cleaned. Sometimes, excess cartilage is cleaned away from behind the knee cap from the build-up of arthritis. To prevent further build-up after surgery - believe it or not - frequent movement is the remedy. Arthritis occurs when joints are stiffened and not moved. Walking is the best movement; it is low impact on the knee, but good for circulation and minimal movement of the knee.
What is recovery like?
Recovery from arthroscopic knee surgery is remarkably fast. Depending on the amount of work done to the knee, the doctor may opt to wrap the knee and have the patient gently walk out of the hospital. Of course bed rest is recommended, but frequent and immediate movement to prevent stiffening is usually the doctors' orders. Although there is some swelling from the surgery, and a bit of discomfort from the incisions, the relief from knee pain is immediate. The doctor or attending nurse will send home instructions for each particular case, but most are common with 20 minute intervals of icing and perhaps an anti-inflammatory or mild pain reliever. Another important part of recovery is to follow the doctors' instructions for exercise. Simple, non-strenuous exercises will help the area to heal well.
What kind of medications will be prescribed?
Immediately after surgery, if the patient is experiencing and undue amount of pain, the doctor will prescribe a moderate pain reliever like Vicodin or Percocet. Different pain medications have different base ingredients - Vicodin has hydrocodone and the base in Percocet is oxycodone; both medications are narcotic and both medications also are combined with acetaminophen. This is why doctors and nurses need to know patients' allergies to medications. Usually, a day or two of one of these medications is sufficient; afterwards, Tylenol works fine. Most often, a regimen of anti-inflammatory medication will be given over a period of a few months to keep the swelling down while the knee completely recovers.
While surgery is always the last option for treatment in any medical condition, it is an option. If trying every other method to relieve pain is ineffective, or pain and swelling increase and persist, or if pain is at a level that wakes the patient in the night, it may be time to consult a sports medicine physician. Recuperation time is minimal and relief is almost immediate. Scheduling surgery over a long weekend or close to a secondary holiday is sometimes advised to get the extra day of rest. Whatever the decision, always follow the advice given by your doctor.
