Arthroscopic Knee Ligament Repair

What is an Arthroscopic Knee Ligament Repair

Arthroscopic knee ligament repair is a procedure to repair a tear in one or more of the tough, cord-like tissues that connect bones (ligaments) in the knee. This procedure is done by placing a thin tube with a light and camera on the end (arthroscope) through a small incision in the knee.

The arthroscope sends images to a monitor in the operating room, and the images are used to help perform the surgery. This procedure is less invasive than open knee surgery.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding or blood clot.
  • Allergic reactions to medicines or dyes.
  • Damage to blood vessels, nerves, or other structures of the knee.
  • Stiffness.
  • Failure to relieve symptoms.
  • Buildup of pressure and swelling in spaces in the leg (compartment syndrome). This is rare.

What happens before the procedure?

Medicines

Ask your health care provider about:

  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

General instructions

  • You may have a physical exam of your knee.
  • You may have some imaging tests of your knee, such as X-rays or MRI.
  • Do notuse any products that contain nicotine or tobacco for as long as directed before your procedure. This includes cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • You may be asked to shower with a germ-killing soap.
  • Ask your health care provider how your surgical site will be marked or identified.
  • Plan to have someone take you home from the hospital or clinic.
  • If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

  • To lower your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
  • Small monitors will be put on your body. They are used to check your heart, blood pressure, and oxygen levels.
  • An IV tube will be inserted into one of your veins.
  • You may be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to make you fall asleep (general anesthetic).
  • A breathing tube will be placed down your throat and into your lungs to help you breathe during the procedure.
  • A cuff may be placed around your upper leg to slow bleeding during the procedure.
  • Several small incisions will be made in your knee.
  • Your knee joint will be flushed and filled with a germ-free saltwater solution (sterile saline). This expands the knee joint and clears any blood, which lets your surgeon see your knee more clearly.
  • An arthroscope will be inserted through one of the incisions to examine your knee.
  • Surgical instruments will be inserted through the other incisions to repair injured tissue. Injured tissue will be stitched (sutured) together, and in some cases tissue may be removed.
  • Sterile saline will be removed from your knee.
  • Your incisions will be closed with absorbable sutures and covered with bandages (dressings).
  • Your knee may be placed in a brace or immobilizer at the end of the procedure or right after the procedure.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate and blood oxygen level will be monitored until the medicines you were given have worn off.
  • You may be given medicine for pain.
  • You may get crutches to help you walk without supporting your body weight on your knee.
  • You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
  • Do notdrive until your health care provider approves.
  • You will work with a physical therapist to determine the best course of rehab (rehabilitation) for you. Rehab is very important after this procedure.

Summary

  • Arthroscopic knee ligament repair is a procedure to repair a tear in one or more of the tough, cord-like tissues that connect bones (ligaments) in the knee. This procedure is less invasive than open knee surgery.
  • Plan to have someone take you home from the hospital or clinic.
  • Do not use any products that contain nicotine or tobacco for as long as directed before your procedure. This includes cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • You will work with a physical therapist to determine the best course of rehab (rehabilitation) for you. Rehab is very important after this procedure.

Arthroscopic Knee Ligament Repair, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

  • Pain in your knee.
  • Bruising and swelling on your knee, calf, and ankle for 3–4 days.
  • Fatigue.

Follow these instructions at home:

If you have a brace or immobilizer:

  • Wear the brace or immobilizer as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the splint or immobilizer if your toes tingle, become numb, or turn cold and blue.
  • Keep the brace or immobilizer clean.

Bathing

  • Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers.
  • Keep your bandage (dressing) dry until your health care provider says that it can be removed. Cover it and your brace or immobilizer with a watertight covering when you take a shower.

Incision care

  • Follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.

Check your incision area every day for signs of infection. Check for:

  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

  • If directed, put ice on the affected area.
    • If you have a removable brace or immobilizer, remove it as told by your health care provider.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag or between your brace or immobilizer and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Move your toes often to avoid stiffness and to lessen swelling.

Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Driving

  • Do notdrive until your health care provider approves. If you have a brace or immobilizer on your leg, ask your health care provider when it is safe for you to drive.
  • Do notdrive or use heavy machinery while taking prescription pain medicine.

Activity

  • Rest as directed. Ask your health care provider what activities are safe for you.
  • Do physical therapy exercises as told by your health care provider. Physical therapy will help you regain strength and motion in your knee.
  • Follow instructions from your health care provider about:
    • When you may start motion exercises.
    • When you may start riding a stationary bike and doing other low-impact activities.
    • When you may start to jog and do other high-impact activities.

Safety

  • Do notuse the injured limb to support your body weight until your health care provider says that you can. Use crutches as told by your health care provider.

General instructions

  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
  • To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
    • Drink enough fluid to keep your urine clear or pale yellow.
    • Take over-the-counter or prescription medicines.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have more redness, swelling, or pain around an incision.
  • You have more fluid or blood coming from an incision.
  • Your incision feels warm to the touch.
  • You have a fever.
  • You have pain or swelling in your knee, and it gets worse.
  • You have pain that does not get better with medicine.

Get help right away if:

  • You have trouble breathing.
  • You have pus or a bad smell coming from an incision.
  • You have numbness and tingling near the knee joint.

Summary

  • After the procedure, it is common to have knee pain with bruising and swelling on your knee, calf, and ankle.
  • Icing your knee and raising your leg above the level of your heart will help control the pain and the swelling.
  • Do physical therapy exercises as told by your health care provider. Physical therapy will help you regain strength and motion in your knee.
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