Arthroscopy knee surgery is the surgical procedure of choice for removal of loose bodies (cartilage/bone) from the joint space. Arthroscopies are more successful after traumatic knee injuries than for arthritic developments.
With one in four cases of knee arthroscopy going on to further surgery, including knee replacement, it's important to get the best from this procedure. In some cases, further surgery may be unavoidable, but you can optimise the benefits of the arthroscopic debridement by getting back full range of movement as soon as possible after the surgery.
The knee joints suffer massive forces of wear and tear that can be added to through faulty gait patterns. Yes, that means limping! To make sure your knee doesn't continue to deteriorate after arthroscopy it's all about getting the range of joint motion back and getting you walking properly. Walking is the best medicine for knees, but not if you're walking badly!
The opposing bony surfaces of the knee joint are protected by a cartilage buffer that has a shiny friction-free consistency of dense plastic
It's important to remember with all the large weight-bearing joints we must operate with the optimum amount of fluid in the joint, so that we walk on a 'cushion of fluid'.
The synovial fluid lubricates the joint and helps promote friction-free gliding of the opposing cartilage surfaces past one another. If you walk badly, there's more friction from the cartilage caused by the wonky muscle action, which inflames the knee. More fluid then pours into the joint to help filter out little gritty bits of cartilage, with the accumulating swelling causing pain. It's important to empty it out again so that you have just the right amount of fluid in the knee.
Using the thigh (quadriceps) muscles properly gives you proper hydraulic cushioning when you weight bear through the knee
When weight-bearing through the knee, it's essential for the knee to brace back fully to prevent bone-against-bone contact within the joint. Using the quadriceps muscles in the thigh invokes strong hydraulic forces through the knee fluid (contained within the joint capsule) that spring the joint surfaces apart. Bracing pressurises the fluid and provides the critically important off-loading to spare any grinding of the cartilage. By contrast, walking on a collapsed bent knee means you wear the cartilage buffer away. Within weeks, if not days, you can erode down through to the cartilage bed.
Bracing the leg straight is brought about by the vastus medialis muscle of the inner side of your thigh. It straightens the knee through its last 15 degrees until it locks and you can stand on the leg with minimal effort. If the knee stays swollen after surgery - apart from being more painful - it will be more difficult to straighten. Failing to walk properly on the knee after arthroscopy may ultimately cause the procedure to fail.
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