A knee injury that requires surgical repair is a tear or sprain of the anterior cruciate ligament (ACL). Sports athletes are those most likely to suffer a torn ACL, but anyone can damage their knee in this area. An injury can occur while running, jumping, or by making sudden contact with a solid or moving object.
Symptoms of an ACL Injury
You may suspect a torn ACL if you hear a “pop” at the time of injury. You might also feel a loss of balance as your knee drops and weakens. Other symptoms you may experience include swelling in the knee joint accompanied by pain, a loss of range of motion, sensitivity in the joint and some soreness while walking. You will likely have to limp a bit to get around because of the stiffness, swelling and pain.
What to Expect at the Doctor’s Office
If you suspect you have a serious knee injury such as a torn or sprained ACL, you should seek out a qualified orthopedic surgeon for a consultation such as the CORE Institute. The physician will ask for your symptoms and details of your injury, and take a patient history. He or she will give you a physical examination, checking your knee structure and comparing your injured and non-injured knees.
Most physicians will be able to diagnosis your injury solely from this physical examination, but may order some imaging tests to verify the diagnosis. You may have an X-ray to determine if there are broken bones and a Magnetic Resonance Imaging Scan to clearly see the soft tissue of the ACL.
Your surgeon will discuss treatment for your knee injury, though a torn ACL will need surgery in order to heal completely. You may be able to wear a brace to insure leg stability and perform physical therapy exercises in lieu of surgery. However the most likely outcome will be a recommendation for knee surgery to rebuild the ligament, since most ACL tears cannot be sewn back together. The surgery is performed using an arthroscopy, which is minimally invasive and uses very small incisions. This surgical option accounts for less pain and a quicker recovery period.
What to Anticipate After Your Knee Surgery
Once your surgery is completed, you will immediately begin exercises while in the recovery room. You will need crutches for about seven to ten days after surgery, until you can comfortably bear your body’s weight. The first couple of weeks after your operation will involve icing and elevating your leg and riding a stationary bike. You can expect to be able to drive by the end of the second week of recovery, when crutches are no longer needed and your muscles are working well.
You will begin a physical therapy regime to regain strength and range of motion in your knee and leg. Your physical therapist will begin your rehabilitation with range of motion exercises, gradually moving on to a program of strengthening the surrounding knee muscles in order to protect your new ligament. By the end of your rehab program, you will be ready to return to your previous level of activity.
Who Needs Knee Replacement Surgery?
You and your doctor may consider knee replacement surgery if you have a stiff, painful knee that makes it difficult to perform even the simplest of activities, and other treatments are no longer working. This surgery is generally reserved for people over age 50 who have severe osteoarthritis.
What Happens During Knee Replacement Surgery?
Once you are under general anesthesia (meaning you are temporarily put to sleep) or spinal/epidural anesthesia (numb below the waist), an 8- to 12-inch cut is made in the front of the knee. The damaged part of the joint is removed from the surface of the bones, and the surfaces are then shaped to hold a metal or plastic artificial joint. The artificial joint is attached to the thigh bone, shin and knee cap either with cement or a special material. When fit together, the attached artificial parts form the joint, relying on the surrounding muscles and ligaments for support and function.
What Are Recent Advances in Knee Replacement Surgery?
Minimally invasive surgery has revolutionized knee replacement surgery as well as many fields of medicine. Its key characteristic is that it uses specialized techniques and instruments to enable the surgeon to perform major surgery without a large incision.
Minimally invasive knee joint replacement requires a much smaller incision, 3 to 5 inches, versus the standard approach and incision. The smaller, less invasive approaches result in less tissue damage by allowing the surgeon to work between the fibers of the quadriceps muscles instead of requiring an incision through the tendon. It may lead to less pain, decreased recovery time and better motion due to less scar tissue formation.
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