Physiotherapy After Keyhole Surgery
Definition: Keyhole surgery (also known as arthroscopic surgery) is a surgical technique where the surgeon operates through a very small (usually no larger than 5 mm) incisions. A telescope with a video camera is introduced through one incision and operating instruments are introduced through one or more other incisions nearby – the operation will be performed by the surgeon who will watch the image on a television monitor. Advantages: small incision means less discomfort, less pain, quicker recovery and more cosmetic results.
In this article we will make references to physiotherapy after a knee surgery for ease of sharing, but arthroscopic surgery is not limited to knee operations – shoulder, back, elbows and hands are too frequently operated arthroscopicly.
Following arthroscopic surgery
Keyhole knee surgery is commonly done for patients with cartilage problems although there are other knee conditions which can also be treated this way.
Physiotherapy following keyhole surgery is a very important part of the healing process regardless of the diagnosis and preferably should be done under the supervision of a registered physiotherapist.
When you wake up after the procedure you will normally be put in a sling/brace to help support and protect the structure that has been operated on. The type of sling/brace depends on the type of procedure that you had undergone. Usually, before operation, your surgeon would have discussed with you, or you had a pre-surgical physiotherapy session, so you may know how to use it. If not, no worries, there is usually instructions that come with the brace, if not, ask for a nurse or a physiotherapist to help you.
Depending on the surgery and the surgeon’s preferences, the brace may be needed for a few days to about six weeks. Generally, for surgical repairs, the brace is worn between 4-6 weeks. If you’re required to stay overnight, do remember to bring overnight clothing and toiletries before you come to the surgical centre. A physiotherapist will be assigned to teach you pre-operative exercises (research had shown that pre-operative exercises helps to accelerate healing, decrease pain and increase mobility post-operatively).
You will need physiotherapy after the surgery and should return to your own physiotherapist. If you don’t have a local therapist and if you’re in Singapore, you can connect with us for our registered specialist physiotherapists to serve your therapy needs.
Aims of Rehabilitation Post operatively
Most of the time a simple keyhole surgery will be undertaken as a day case which means that you will come into the day surgery centre, undergo the surgery and go home on the same day itself. You will usually be able to fully wear bear without the use of crutches.
It is also common to experience some pain in the knee because of the swelling within the joint and the kneehole surgery treatment itself. Swelling can cause pressure on the surrounding structures which can affect and impair muscle function and decrease one’s range of motion within the joint that is affected.
That is why early mobilization and physiotherapy of the operated joint helps to activate the muscles, which in turn helps to increase the circulation to the knee and helping it to accelerate healing. Exercises with the leg raised will also help the reduction of swelling as you begin to move the joint and strengthen the knee muscles. Your physiotherapist in charge will teach you post-keyhole surgery exercises, and they should be done in moderation during the initial first few days.
Wherever possible, elevate the limb when you’re sitting or when you’re applying the cold compress. Ice/cold compress helps to decrease the swelling in the knees and is often good for pain relief (check more with your physiotherapist who will be able to teach you more on this)
After the initial stage, you will get a customised exercise rehabilitation program according to your needs. Often, the goals are to encourage normal movement and will gradually move to a more functional strengthening program. For knee repairs, this may include ski squats, lunges, knee dips, balance exercises etc.
Physiotherapy following keyhole surgery usually takes from four to six weeks.