Arthroscopic knee surgery has revolutionized the surgical process on the knee. In cases where large incisions used to be the norm, most surgeries can now be performed using arthroscopic tools and with minimal incision and shorter recovery times. Despite the fact that there might only be three small incisions on the outside of the knee, the work that the surgeon may have done on the inside of the joint might be quite extensive. Pain from the surgical work on the inside of the knee might be much more severe than the small incisions indicate. This article will give you some information on arthroscopic knee pain.
Arthroscopic knee surgery is an improvement over open knee surgery for many reasons. By creating smaller incisions, the surgeon is lowering the risk of infection. In addition, the patient's body has less to recover from and the shock to the body is less severe. Blood loss is held to a minimum, and damage to surrounding tissue is also minimal. The improvement in technology makes more complicated procedures possible in smaller spaces, and everyone benefits. Patients do not need to spend time in the hospital in most cases, and rehabilitation is quicker.
Using the arthroscopic procedure, surgeons can do everything from trimming torn cartilage to repairing complex ligament tears and even, in some cases, performing bone repairs that require insertion of hardware. There are some procedures that still require an open incision--knee replacement being the main one--but many knee surgeries can be performed using the arthroscopic method. In this procedure, three small incisions are made around the knee and instruments are inserted into the knee joint. One is used to fill the joint with sterile saline in order to keep the tissues expanded and allow the surgeon to get a good view of the knee's interior. The other two incisions are used for the insertion of a camera and tools that the surgeon will use to repair and work on the knee itself. While the pain of this surgery is minimal compared to large, open knee surgeries where the incision is much bigger and the tissues more traumatized, pain will still result from the surgery itself.
The most common type of arthroscopic knee surgery is a meniscus repair. This is where the cartilage around the knee has torn or is damaged, causing pain and swelling, as well as grinding in the knee, and the surgeon goes in and "trims" the damaged cartilage, smoothing out the rough spots and helping alleviate pain and poor function. Another common arthroscopic surgery is a torn ACL repair. This is where the Anterior Cruciate Ligament has been torn or ruptured, and the surgeon must use the tools to repair, drill, insert and secure a ligament repair in the joint. Moving up on the complexity level, there is a knee chondroplasty, which is where tools are inserted to scrape the bone of spurs, and essentially create scar tissue that can function as makeshift cartilage in cases where bone is already exposed and grating. There are many other types of surgeries, too many to list. As mentioned before, in most knee surgeries, arthroscopic incisions and tools are the first method used to try and repair the damage. Depending on the amount of work done by the surgeon, the pain resulting from the surgery can be minimal to severe.
There are various types of pain resulting from arthroscopic surgery. The incision pain is usually minimal, as the incisions are most often less than an inch long and the damage to the skin and tissue moderate. There may be some bruising, but bleeding should not be an issue from a standard arthroscopic surgery. Joint pain is more common, and usually more severe. The pain of having surgical instruments being pushed around the joint, and having things cut, shaven or repaired is usually much more irritating than the surgical incisions themselves. If a chondroplasty was performed, bone pain can be quite severe and medication will be necessary for a couple of weeks. The same applies for an ACL repair, as the bone has been drilled and the tendon repaired with sutures. A rule of thumb is the more extensive the work the surgeon has to perform, the more pain will be involved during recovery.
In most cases of arthroscopic surgery, pain is controlled with oral prescription--usually narcotic--medication for the first few days, and then the patient is weaned onto over the counter medications such as Ibuprofen, Tylenol, Aleve and Aspirin. In the more complex cases, the narcotic medication may be extended for 10 to 14 days. Rarely, in the case of an overnight hospital stay, pain medication may be given by intravenous line directly into the bloodstream. As with any pain medication, the idea is to use it to get you past the first few critical hours and days, then to begin to taper it off and use standard medication. Pain medication is no joke, and can be addictive and cause all kinds of problems, so it is important to follow the directions given to you by the doctor. In most cases, pain from arthroscopic knee surgeries should not be expected to last more than a few weeks.