Preparation for arthroscopy

Memo for the patient.

Arthroscopic surgery has many advantages over traditional joint surgery. Arthroscopic surgery is performed with minimal skin incisions (up to 1 cm), while traditional joint surgery involves a much larger tissue incision. The consequence of arthroscopic intervention is much less pain for the patient. The patient can move without additional devices on the same day. Rehabilitation (recovery) is much faster. The next day after the operation, the patient can be released from the hospital, and a week later - to be discharged to work. There are cases when professional athletes (football players, paratroopers, skiers) two weeks after arthroscopic resection of the meniscus began active performances.


Your doctor believes that for one reason or another you need to perform an arthroscopic revision of the knee joint. Reasons for this: damage to the menisci, damage to the intra-articular ligaments of the knee joint, damage or disease of cartilage and synovial membrane, the presence of free intra-articular bodies, synovitis, instability of the patella and more. Well, everything will look something like this.


The day before the scheduled operation, you must come to the clinic in the morning on an empty stomach, perform an electrocardiogram, pass tests (blood and urine) and get a medical history in the admission department. For this purpose it is necessary to have with itself the passport and all results of additional researches (roentgenograms, data of ultrasonic inspection and in the presence - results of magnetic resonance inspection). After you have been examined by an anesthesiologist and your doctor, you can leave the clinic. You must not eat after 20.00 on this day. In the evening it is necessary to make a cleansing enema (Normocol).


In the morning on the day of surgery it is also necessary to make a cleansing enema (drug Normocol), it is strictly forbidden to eat, drink water, smoke. If you have hair on your legs - you need to gently shave the leg on which surgery will be performed, from the foot to the upper third of the thigh. At 8.30 you should come to the clinic and settle in the ward. It is advisable to have a clean T-shirt, change of underwear, sports suit (or bathrobe, or shorts), toiletries, cutlery, changeable shoes and 2 liters of mineral water. In the ward you need to change into a clean T-shirt, wear a sports suit (bathrobe, shorts). After the anesthetist gives you an intramuscular injection (premedication), you will be taken to the operating room. You will be given an intravenous catheter, an intradermal test for antibiotic sensitivity and an intravenous medication. Then the anesthesiologist will give you a spinal anesthesia (injection into the spinal canal with a syringe and a special very fine needle of anesthetic). After that, you will begin to feel warmth in the lower extremities, and anesthesia will soon follow. This condition is temporary - sensitivity and mobility are fully restored in 3-5 hours. After anesthesia of the extremities, doctors will begin their own surgery - arthroscopic revision of the knee joint. Thus in the field of a knee joint, as a rule, two cuts-punctures of skin on 5-10 mm become. Through one - the optical system with the video camera is entered into a joint cavity and sterile liquid is pumped, and through another - the special working tool. The image from the joint is displayed on the monitor. At the first stage of surgery, the diagnosis is performed: the joint is fully examined, and all intra-articular injuries and diseases are identified. In the second stage, the actual medical manipulations on the menisci, ligaments, cartilage, synovial membrane are performed. At the end of the operation, the joint is thoroughly washed with sterile fluid under pressure, a drainage tube is installed in the joint cavity, to which a container with a vacuum ("accordion") is attached. Several sutures are applied to the punctures of the skin, on them a sterile bandage. Operation complete. If necessary, the knee is fixed with a special standard tire. After that you are taken to the ward, where the intravenous administration of drugs is continued, the knee is covered with ice for 2-3 hours. In case of discomfort or pain, as well as when filling the drainage tank with fluid from the joint, it is necessary to call the nurse on duty using the call button (on the wall). After the operation, you can not get up in bed, especially to walk for 24 - 48 hours. It is necessary to lie down and drink mineral water (2 liters a day). This is done to prevent headaches and nausea. If it is necessary to use a toilet - the nurse is called. As a rule, 2 intramuscular injections of a solution of an antibiotic are made after operation. Painkillers are administered by a nurse intramuscularly as needed (at your request). However, these drugs should be used for pain of medium or high intensity, as well as for any night pain.


The next day, the attending physician performs a bandage, during which, as a rule, the drainage tube is removed from the joint, postoperative wounds are treated, and sterile wipes are changed. In each case, the attending physician gives recommendations on the need to walk on crutches, the frequency of dressings, the need to use an immobilization splint, the possible level of mobility in the joints of the operated limb. In some cases, you can leave the hospital on this day (subject to strict compliance with the prescriptions of the attending physician).
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