INTERVENTIONAL PROCEDURES

KNEE SURGERY (ARTHROSCOPY)

The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia). The smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) are the other bones that make the knee joint. Tendons connect the knee bones to the leg muscles that move the knee joint. Ligaments join the knee bones and provide stability to the knee. There are two types of ligaments, namely, ACL (Anterior Cruciate Ligament) and PCL (Posterior Cruciate Ligament). When either one or both these ligaments are injured due to a fall or twisting injury, reconstruction of the torn ligament will be done. The procedure, Arthroscopic Ligament Reconstruction, is a minimally invasive procedure, also called as a keyhole procedure as the incision made during the surgery is very small or minimal.

The injured knee is marked, and two holes over the knee joint are made. Through one hole, the camera is used to visualize, and the other will be used to perform the procedure. There is another cut made over the leg bone to harvest the graft. This harvested graft will then be prepared into a ligament which will be inserted by making drill holes on the leg bone and the thigh bone from the direct vision of the camera. The graft taken will be inserted through the tunnels made in the bone. There will be a small button holding the graft over the thigh bone and a bioabsorbable screw will be holding the graft in the leg bone.

Six hours after the surgery, the patient will be in a condition to walk, provided there is not much damage noticed in the joint. During the walk, the patient is required to put on the knee brace/ knee splint in order to ensure the stability to walk.

REHABILITATION PROTOCOL

During the first fifteen days after the surgery, the patient will be asked to bend the knee from 0 to 30 degrees, and walking just from the bed to the washroom is advised. At the end of two weeks, the patient will be required to visit the doctor for the removal of stitches. During this visit, the patient will be assessed and further knee movements, that is, bending movements up to 90 degrees will be advised. Further exercises for the thigh muscles will be advised by the concerned doctor. Also, ice packs to be kept over the knee joint every three hours will be suggested.

Further protocol measures to be taken by the patient would be to visit the doctor on a monthly basis and commence physiotherapy sessions. By the end of the sixth month, the patient should be able to get back to regular physical activities and sports, provided that he/ she has adequately strengthened the thigh muscles.