physiotherapy knee exercise

Arthroscopic Setup

Arthroscopic Setup

Jatin Jain have 2 screw in Right Knee

Jatin Jain had ACL Operation In 8th January 2009 and still facing problem in Knee Bending
my operation was done in Tagore Hospital Jaipur Dr.Solanki did my operation..


but still till date i am not fit and facing problems in my Right Knee i took Physiotherapy Treatment for 8months still no improvement its costly 200Rs for 45 minutes i used to give now i have stooped it was proving very costaly and i could not affort  .. I took 6months bed rest away from work(job)


Thanks to my boss Dr.Ajay Data Sir (Data Infosys) ..iam back on job

..but still not fit i have showing several doctors in jaipur all suggest my small operation again arthroscopic surgery and 25 days bed rest +  Physical exercise

Jatin Jain
Graphic Designer
Data Infosys Limited
Mobile:9828180603
Jaipur-Rajasthan-India

Important exercises you will begin the day of surgery

These exercises are crucial to your rehabilitation and the following is a general guide for the rehabilitation following knee surgery. Physical Therapy Programs are individualized for each patient by a doctor or physical therapist and a successful outcome is dependent on adequate communication between the patient, therapist and surgeon. Considering those points, these are just guidelines.

Elevate your affected leg, it must be elevated above heart level, usually requiring 4 or 5 pillows. under your leg. Just propping it on the couch, or recliner is not enough, and the more you can elevate and ice, the less pain and swelling you will have.

Squeeze & tighten this muscle tight for 2 seconds, twenty times, and try to do 10 or more sessions each day. Monitor your progress by comparing your muscle contraction to your unaffected leg, and it is wise to do these exercises for both legs.

The Heel Prop is The Most Important Exercise You Will Do. Prop your heel as shown in the photo above. Relax your leg (when you are relaxed, your leg and foot will rotate out slightly and this is good). Allow your knee to straighten as much as possible. This can also be achieved by propping your heel on a chair facing you or on the arm of a couch. as long as nothing is under your knee. Do this every hour for 3-10 minutes.

ACL Reconstruction with Meniscus Repair

Anterior Cruciate Ligament (ACL) Reconstruction Animation

KNEE ARTHROSCOPY

Arthroscopy: What is it?

Arthroscopy is a surgical procedure in which a small fiberoptic telescope (arthroscope) is inserted into a joint. Fluid is then inserted into the joint to distend the joint and to allow for the visualization of the structures within that joint. Usually the surgery is viewed on a moniter so that the whole operating team is aware of the type of surgical procedure that is being performed.

Arthroscopes are approximately 5 mm in diameter, so the incisions are very small (approximately 1/8 inch). During the procedure, which is conducted under anesthesia, the inside of the joint is examined for damaged tissue. The most common types of arthroscopic surgery include removal or repair of a torn meniscus (cartilage), ligament reconstruction, removal of loose debris, and trimming damaged cartilage.

Arthroscopy is much less traumatic to the muscles, ligaments, and tissues than the traditional method of surgically opening the knee with long incisions (arthrotomy). The benefits of arthroscopy involve smaller incisions, faster healing, a more rapid recovery, and less scarring. Arthroscopic surgical procedures are often performed on an outpatient basis and the patient is able to return home on the same day.

While an arthroscope is used in many different types of surgical procedures, the recovery time and outcome of the procedure is related to the type of injury and the type of arthroscopic surgical procedure performed. For example, an arthroscopic surgical ligament reconstruction will take longer to heal and the recovery time will be longer then the patient who has an arthroscopic removal of a loose body.

THIS MATERIAL DOES NOT CONSTITUTE MEDICAL ADVICE. IT IS INTENDED FOR INFORMATIONAL PURPOSES ONLY. PLEASE CONSULT A PHYSICIAN FOR SPECIFIC TREATMENT RECOMMENDATIONS.

POST-OPERATIVE PERIOD

Postoperatively, it is possible to bear weight (partial weight bearing) on the surgically treated leg by using crutches for the first 7 - 10 days after surgery. Patients may stop using crutches when comfortable. Supervised physical therapy often is started by the second to third day after surgery.

Figure 10: CONTINUOUS PASSIVE MOTION - ORTHOLOGIC
In addition, a continuous passive motion device is applied to the injured leg post-operatively. Most patients use this device while sleeping for the first two weeks. This device very slowly moves the knee, thereby decreasing the risk of stiffness and loss of motion. Following an initial 6-10 week period of supervised physical therapy, most patients will progress to a self-directed program that is done in a health club. Typically, it takes the reconstructed ligament approximately 9 months to heal. Until released by your physician, contact sports, racquet sports, skiing, tennis, martial arts, and sports that require rapid direction changes must be avoided.

ARTHROSCOPIC ACL (SURGERY) RECONSTRUCTION

SUMMARY

Figure 1: Right Knee - Frontal View with Patella Removed

The anterior cruciate ligament (ACL) is the major stabilizing ligament of the knee. The ACL is located in the center of the knee joint and runs from the femur (thigh bone) to the tibia (shin bone), through the center of the knee. In this position, it functions to prevent a buckling type of instability of the knee. (For more information on the ACL: KNEE JOINT - ANATOMY & FUNCTION.)

Figure 2: Right Knee - Arthroscopic View of Intact Anterior Cruciate Ligament
Usually the tearing of the ACL occurs with a sudden direction change or when a deceleration force crosses the knee. The patient often feels or hears a popping sensation, has the rapid onset of swelling, and develops a buckling sensation in the knee when attempting to change direction. (Click HERE for an animation of an ACL tear.)

DIAGNOSIS AND TREATMENT

The diagnosis of an ACL injury is usually arrived at by determining the mechanism of injury, examining the knee, determining the presence or absence of blood within the joint, and performing diagnostic studies. These may include x-rays, MRI scans and stress tests of the ligament.
The initial treatment of an acute ACL injury often includes ice, anti-inflammatory medication, and physical therapy which is directed at restoring the range of motion of the injured knee.



Figure 3: Right KneeSurgical treatment of the torn ACL usually involves an arthroscopic surgical reconstruction of the injured ligament.

Figure 4: Arthroscopic Knee Surgery with Instruments in PlaceAlthough a number of different types of tissue have been utilized to reconstruct the ACL, the most common type of ACL reconstruction involves harvesting the central third of the patellar tendon with a bone block at each end of the tendon graft. After performing a diagnostic arthroscopic examination of the knee, the central third of the patellar tendon is harvested. (Click HERE for a computer animation of tendon harvesting (mpg file) courtesy of Rob Kroeger.)

Figure 5: Left Knee - Graft HarvestThe remaining tendon is then repaired. After harvesting the tissue, drill guides are used to place holes into the tibia (bone below the knee)

Figure 6: Left Knee

Figure 7:Intraoperative photo of drill hole in femur for ACLand femur (bone above the knee). By placing the drill holes at the attachment sites of the original ligament, when the graft is pulled through the drill hole and into the knee, it will be placed in the same position as the original ACL. (Click HERE for a computer animation of drilling the holes (mpg file) courtesy of Rob Kroeger.)
After pulling the graft through the drill holes and into the joint to replace the torn ACL, the graft is then held in place with bioabsorbable screws or metallic screws.

Figure 8: Left KneeFastening the graft in this manner allows new blood vessels to grow into the transferred graft and for healing to occur. Typically, the procedure is performed on an outpatient basis.

Figure 9: Lateral Intraoperative X-Ray demonstrating Placement of Metallic Screw for ACL Graft Fixation in the Femur

The anterior cruciate ligament (ACL)

Let's begin with the basics of knee anatomy. The knee joint is made up of three bones and a variety of ligaments. The knee is formed by the femur (the thigh bone), the tibia (the shin bone), and the patella (the kneecap). Several muscles and ligaments control the motion of the knee and protect it from damage at the same time. Two ligaments on either side of the knee, called the medial and lateral collateral ligaments, stabilize the knee from side-to-side.



The anterior cruciate ligament (ACL) is one of a pair of ligaments in the center of the knee joint that form a cross, and this is where the name "cruciate" comes from. There is both an anterior cruciate ligament (ACL) and a posterior cruciate ligament (PCL). Both of these ligaments function to stabilize the knee from front-to-back during normal and athletic activities. The ligaments of the knee make sure that the weight that is transmitted through the knee joint is centered within the joint minimizing the amount of wear and tear on the cartilage inside the knee.
The weight-bearing surfaces of your knees are covered with a layer of cartilage (referred to by doctors as"articular cartilage"). There are also two shock absorbers in your knee on either side of the joint between the cartilage surfaces of the femur and the tibia. These two structures are called the medial meniscus and the lateral meniscus. The menisci are horseshoe-shaped shock absorbers that help to both center the knee joint during activity and to minimize the amount of stress on the articular cartilage. The combination of the menisci and the surface cartilage in your knee produces a nearly frictionless gliding surface. The knee is an incredible joint. It is strong, flexible, and very tough.