Arthroscopy is minimally invasive surgery. A range of procedures can be performed from simple debridement to more involved procedures like meniscal repair, cartilage restoration (microfracture), and lateral release. This protocol provides general advice on simple debridement surgery such as partial menisectomy and chondroplasty.
The “Rules of 3’s and 4’s” is used to generally outline the recovery from arthroscopic debridement as follows:
- It takes 3 – 4 hours from the time you arrive at hospital to the time you are ready to go home
- You should take it easy for 3 – 4 days following your surgery
- Return to activity generally takes 3 – 4 weeks (large meniscal debridements or surgeries involving the lateral meniscus will take longer to return to full activity, especially high impact and advice regarding return to full activity should be gained from the surgeon).
Post op exercises (0 – 2 weeks)
- Circulation drills – foot pumping, static quads and glutes
- Static quad drills with small rolled towel behind the knee – get VMO firing (do this regularly)
- Straight leg raise / inner range quads
- Calf raises
- Range of motion drills – calf and hamstring stretches for extension and active / assisted foot slides for flexion
- Icing the knee once the bandage is removed and smaller dressings applied – usually day 3 – 4
Following the first week and provided that the knee is settling well (minimal pain and swelling) then you could commence some closed chain drills such as mini squats and some single leg balance drills. Some glute work- clams, bridges, side leg raises, standing 3 way leg swings could also be added.
All progressions of exercises and activity should be guided by knee pain and swelling.
Review by Dr Gallagher at 2 weeks
- A graduated progression of exercises / activity over next 2 – 4 weeks or as advised.
- Graduated sports specific rehab for those patients returning to sports.
- Knees should have regained ROM with minimal or no swelling, have good hip and knee control and have successfully completed a progressive return to sport program before full participation.
The following Physiotherapy interventions may be useful in restoring the joint:
- Patellofemoral mobilisation
- Release / soft tissue massage lateral thigh and ITB
- Massage of arthroscopy portals – care with depth until 4 weeks and portals healed
- Use of NMS (Neuromuscular stimulators) for VMO activation