Knee Surgery Options: Insights on Recovery and Rehabilitation - Orthopedics

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Dr.
Li: Thank you for your detailed response to my questions.
I have already gone for a consultation at the Veterans General Hospital with Dr.
Ma.
He used a patellar tendon graft and informed me that this method is stronger, but the recovery time is longer, and the scar may be more noticeable after healing.
There is also another option using a lateral graft combined with an absorbable reinforcement material (not covered by insurance), which allows for quicker wound recovery.
As for the collateral ligament, he suggested letting it heal on its own.
Additionally, he advised me to continue strengthening my biceps and improving my knee flexion, and I will have surgery in a week.
After returning home, I remembered some questions and would appreciate your advice: (1) During arthroscopic surgery, can the meniscus be examined and repaired if there are any issues? (2) Can I walk confidently now and do more knee flexion exercises? (3) I still feel some swelling and mild pain in the medial collateral ligament.

JK, 30~39 year old female. Ask Date: 2004/11/05

Dr. Li Wenlin reply Orthopedics


Hello: In response to your questions...
1.
During arthroscopic surgery, the condition of the meniscus can be clearly assessed, and if possible, it can be addressed simultaneously (for example, partial tears can be treated with partial meniscectomy).
2.
You should currently be wearing a brace.
Under the protection of the brace, you can walk and bend your knee, but avoid excessive activity.
At the same time, you should strengthen your quadriceps and increase knee flexion, which should also be done postoperatively.
3.
Mild swelling and soreness of the medial collateral ligament is reasonable.
If it does not cause any walking difficulties, it is likely a normal change following the injury and should not be a cause for alarm.
Department of Health, Keelung Hospital, Executive Yuan, Li Wen-Lin.

Reply Date: 2004/11/05

More Info


Understanding knee surgery options and the subsequent recovery and rehabilitation process is crucial for patients who have undergone significant knee injuries or surgeries. Based on your inquiry, here are detailed insights regarding your situation and general recommendations for recovery.

1. Arthroscopic Surgery and Meniscus Repair: When undergoing arthroscopic surgery, it is indeed possible for the surgeon to assess the condition of the meniscus during the procedure. If any tears or damage are identified, the surgeon can often repair them at the same time. This is one of the advantages of arthroscopic surgery, as it allows for a comprehensive evaluation of the joint and the opportunity to address multiple issues in one procedure. If you have concerns about the meniscus, discuss them with your surgeon prior to the operation to ensure they are aware and can plan accordingly.

2. Walking and Range of Motion Exercises: After knee surgery, it is generally encouraged to begin walking and performing range of motion exercises as soon as it is safe to do so. However, this should be done under the guidance of your healthcare provider or physical therapist. Engaging in gentle bending exercises for the knee can help improve flexibility and prevent stiffness. It’s important to listen to your body; if you experience significant pain or discomfort, you should consult your healthcare provider. Gradually increasing your activity level while monitoring your pain is key to a successful recovery.

3. Inner Ligament Discomfort: Feeling some swelling and discomfort in the inner collateral ligament (MCL) area post-surgery is not uncommon. However, persistent pain or swelling should be evaluated by your physician. It may indicate that the ligament is still healing or that there is some inflammation. Ice therapy, elevation, and rest can help manage swelling. If the discomfort continues, your doctor may recommend further imaging or adjustments to your rehabilitation plan.

4. Rehabilitation Process: Rehabilitation following knee surgery is vital for restoring function and strength. Your physical therapist will likely develop a tailored program that includes strengthening exercises for the quadriceps and hamstrings, as well as flexibility exercises for the knee. It's essential to adhere to this program and communicate any concerns or difficulties you encounter during your rehabilitation.

5. Long-term Considerations: Depending on the severity of your injury and the specific procedures performed, recovery times can vary significantly. While some patients may return to full activity within a few months, others may require a longer rehabilitation period. It's important to set realistic goals and be patient with your recovery process. Regular follow-ups with your orthopedic surgeon will help monitor your progress and make necessary adjustments to your rehabilitation plan.

6. Alternative Surgical Options: As you mentioned, there are different surgical options available, such as using a patellar graft versus a lateral graft with absorbable materials. Each option has its pros and cons, including recovery time and potential outcomes. Discuss these thoroughly with your surgeon to understand which option aligns best with your lifestyle and recovery goals.

In conclusion, your recovery from knee surgery will involve careful monitoring, consistent rehabilitation, and open communication with your healthcare team. By following their guidance and being proactive in your rehabilitation, you can optimize your recovery and work towards regaining full function of your knee. If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice.

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