Rehabilitation after knee surgery

Restoration of the functional state of the knee after surgery is impossible without high-quality rehabilitation. A complex of restorative measures, which are divided into several stages, is prescribed by the doctor individually, which depends on the age of the patient, the nature and extent of the operation, as well as the severity of anatomical changes.

Types of knee surgery

Surgical intervention on the knee joint is prescribed to correct changes in the anatomical ratio of components, forced removal of tissue fragments that are not subject to plastic surgery. There are several groups of indications for the operation:

• Inflammatory pathology, accompanied by necrosis (death) or damage to various components of the knee.
• Degenerative-dystrophic processes - against the background of impaired nutrition of the tissues of the joint, arthrosis of the knee (gonarthrosis) develops, which leads to the destruction of cartilaginous surfaces, menisci. Pronounced changes require replacement of the joint with a special endoprosthesis.
• Past injuries - meniscus tear, sprain or cruciate ligament rupture require surgical recovery with the operation.

Depending on the severity of the changes, surgical intervention on the knee involves the use of several techniques:

• Arthroscopy is the least traumatic intervention, after which rehabilitation takes a relatively short time. The bottom line is the introduction of special micro-instruments, a camera and lighting into the joint cavity. The doctor performs manipulations under visual control on the monitor screen.
• Open reposition (restoration of the anatomical ratio) of bone fragments.
• Suturing for torn or sprained ligaments, which is performed by open access or with the help of arthroscopy.
• Arthroplasty is the restoration of articular surfaces.
• Removal of a cyst (limited pathological cavity filled with fluid) or menisci of the joint.
• Resection is the removal of a part of the knee joint, namely, non-viable tissues that cannot be restored and pose a danger to human health.
• Prosthetics - replacement of the knee joint. Rehabilitation after surgery is the longest, as it requires a change in the functional state of muscles and ligaments in new conditions. Recovery is usually carried out in the conditions of specialized medical institutions in which the replacement of the knee joint was carried out. Rehabilitation is appointed by the attending physician.

The most complete functional recovery of the knee can be achieved after low-traumatic manipulations, which include arthroscopy.

Stages of rehabilitation

Rehabilitation after knee surgery is a complex event that includes several areas, the purpose of which is to maximize the functional recovery of the knee. Conventionally, there are several stages:

• postoperative period;
• early healing phase;
• late regeneration phase;
• stage of functional recovery.

At each stage, recovery after knee surgery includes individual measures.

Postoperative period

Regardless of the nature and extent of knee surgery, the patient must remain under medical supervision for a certain period of time. All manipulations are accompanied by tissue damage of varying severity, so postoperative measures are aimed at speedy tissue healing and prevention of complications. These include:

• Dressings with antiseptics - gauze bandages are applied to the area of ​​​​postoperative sutures (sterile bandages are used), moistened with antiseptic solutions. This makes it possible to prevent the penetration of a bacterial infection with a subsequent inflammatory reaction. If during the surgical intervention a drainage was introduced into the joint cavity (a sterile tube for the outflow of contents), then it is washed with antiseptic solutions through it.
• Ensuring functional rest - for several days the patient is forbidden to move in the knee, as there is a risk of suture divergence and the development of complications.
• Drug treatment - during the postoperative period, if necessary, the attending physician prescribes drugs of several therapeutic groups. These include non-steroidal anti-inflammatory drugs (relieve inflammation, pain, swelling), hemostatic drugs (prevention of bleeding), antibiotics (fight against secondary bacterial infection). To stimulate the regeneration (healing) of tissues, multivitamin preparations are prescribed with the obligatory observance of dietary recommendations (the diet includes foods with a sufficient amount of protein compounds).

The duration of the postoperative period depends on the nature and extent of the surgical intervention. Rehabilitation after knee replacement surgery in a medical hospital can last more than a month. After conventional operations, including meniscus manipulation, the postoperative period is about 10-14 days.

Early healing phase

The rehabilitation phase begins even in a medical hospital. It is characterized by the fact that against the background of tissue regeneration in the area of ​​the manipulation, there is a need to ensure a minimum functional activity of the joint. At the same time, there is still no tone of the quadriceps femoris muscle (quadriceps), therefore, passive movements are carefully performed, the volume of which should not exceed 90 ° C (passive movements are performed by the attending orthopedist or rehabilitation specialist). Exercises after knee surgery are performed once a day for 10-15 minutes. Gradually, as tissues regenerate, the duration of classes and the range of motion in the knee increase.

The early healing phase continues after the sutures are removed and the patient is discharged home from the hospital. Preliminarily, the attending physician talks in detail about the proper nutrition of the patient, gives recommendations regarding the further implementation of passive movements in the knee. In general, the stage lasts about a month.

late healing phase

Rehabilitation after knee surgery in the late healing phase is aimed at gradually increasing the functional load on the joint. The patient gradually recovers the tone of the quadriceps femoris muscle, the severity of pain and inflammation decreases. The complex of rehabilitation measures includes:

• passive knee flexion, increased range of motion up to 120°C;
• active flexion of the leg in the knee joint, range of motion up to 90°C;
• short sessions on exercise bikes with a gradual increase in load;
• walking outdoors for 10-15 minutes;
• swimming 1-2 times a week for 20 minutes;
• cycling once a week for 15 minutes.

To improve blood circulation in the tissues, it is recommended to perform a special massage by a specialist. The late healing phase can take place at home. At the same time, it is important to fulfill all appointments in a disciplined manner and follow the recommendations of the doctor. The necessary measures are also carried out in the conditions of special sanatorium-resort institutions, where there are conditions for additional physiotherapy (mud baths, ozocerite, laser therapy). On average, the stage lasts several months, which depends on the volume and nature of the operation (if a knee replacement was performed, rehabilitation in the late healing phase can last up to six months).

Functional recovery stage

The development of the knee joint after surgery is necessary for the most complete functional recovery. Usually, six months after surgery, complete tissue healing occurs. Joint components (connective tissue ligaments, tendons, capsule, cartilage) acquire the necessary strength, which makes it possible to gradually increase the load. The following activities are included in the period of functional recovery:

• ensuring sufficient static load;
• a gradual increase in physical activity of a person (the duration of classes on an exercise bike, swimming, walking increases);
• performance of special functional exercises (squats, vertical static loads on the leg, flexion and extension of the lower leg in a sitting position, walking over rough terrain, running).

The duration of rehabilitation depends on the goals. For professional athletes, the stage of functional recovery lasts from 1 year. Recovery after knee replacement is characterized by less stress, performing special exercises, which are primarily aimed at increasing muscle tone, including quadriceps, as well as strengthening the ligamentous apparatus of the knee.

The knee joint is a complex structure of the human musculoskeletal system. After an operation, including plastic surgery, a comprehensive rehabilitation is required, which is prescribed by a doctor. The process takes place in several stages. You should not try to restore the knee after surgery on your own, as in most cases it leads to complications, including complete loss of mobility in the joint. Rehabilitation after knee replacement can last more than a year.