Cartilage Treatments FAQ
Will cartilage surgery completely restore my joint surface?
- It is important to know that even with successful surgery, in many cases your treatment will not be able to perfectly restore your joint surface to its pre-injury state
- This is largely due to the poor blood and nutrient supply to the cartilage layer and also because it is not yet possible toexactly replicate the articular cartilage layer, but we can come very close. Instead, often what we aim to achieve is a cartilage-like scar which functions in a very similar way. You could think of this as being like a scar on your skin – the scar forms after an injury and functions much like the surrounding skin but in most cases, the skin does not return to looking, feeling or functioning exactly like normal skin
- The aim of cartilage surgery is to relieve symptoms such as pain, locking and catching and to prevent further damage to the joint surface. The effect may last a long time however, some people may still go on to develop knee arthritis and may even require more surgery in the future
How do I know which cartilage treatmentis right for me?
In this exciting and ever-expanding area of medicine, there are several techniques available to treat cartilage injuries. Choosing the right treatment might seem complicated but your surgeon will discuss with you about your options and what might be best for you. Deciding on the right procedure takes into consideration:
- Where the articular surface is damaged and how big the affected area is
- Whether the cartilage layer alone is damaged or if the defect extends into the subchondral bone
- Other factors such as your age (which may impact on your body’s healing ability) or your activity level
What happens before my surgery?
- The better the knee can move and stronger the muscles are around the knee – the better your recovery will be. Physiotherapy is strongly recommended before surgery
- Once you and your surgeon have decided that a cartilage treatmentis the right decision for you, a plan will be discussed with you regarding your usual medications as some of these medicines (like blood thinners or blood pressure tablets) may need to be stopped before your surgery
- For people with other health conditions, we may arrange for the anaesthetist to see you before your surgery to make sure your surgery is as safe as possible
- We know that smoking increases the risks associated with surgery and reduces your body’s capacity to heal. We recommend that patients stop smoking, both before and after the operation, to reduce the risk of a complication occurring.
What happens on the day of surgery?
There are several steps to take to make your operation as safe and smooth as possible.
- It is very important not to have anything to eat or from 6 hours before your operation although you can have small sips water up until 2 hours beforehand. This is because some of the medicines used as part of your anaesthetic may cause the stomach to relax and if your stomach is not empty, the contents may move into the lungs and cause serious problems with your breathing
- When you arrive at the hospital, our staff will help you change into a hospital gown and will give you stockings to wear to reduce the risk of blood clot
- Your surgeon and the anaesthetist will see you before your surgery to complete your consent form and answer any questions you might have. Your surgeon will also draw an arrow on your leg to confirm the operation and side to be operated on. This is a standard part of our safety checklist for every operation
- At several points before your operation, your identity and surgery will be confirmed along with other important medical information (such as allergies). This is another standard part of our safety checklist for every operation
- When it is time for your surgery, you will be taken through to the operating room. Most people find this a little daunting as there are many people in the room and a lot of specialist equipment. Just remember, everyone in the room is there to look after you, answer your questions and make you as comfortable as possible
- Most patients will require an IV line (drip) to be placed to administer your anaesthetic
What happens after the surgery?
- When your surgery is complete, you will spend some time in the recovery room (PACU) where you are looked after by a specialist team before being transferred to the ward or allowed to go home
- You will be given regular pain relief medication but it is important to let the staff know if you have pain, nausea or other concerns so that we can keep you safe and comfortable
- You will be shown how to use your crutches when you are comfortable and have recovered adequately from your anaesthetic
- Most people will be able to go home the same day of their surgery
- You will be given follow-up appointment details and numbers to call if you have any concerns.
What happens when I leave the hospital?
- Someone should be available to stay with you and provide additional support if needed when you return home from the hospital. This is particularly important in the first 24 hours after your surgery
- You will haveone or morewaterproof dressing(s) on your knee which should stay in place until you see your surgeon, usually two to three weeks after your operation
- There will be a bulky bandage over the top of the dressings. This can come off after 48 hours
- Most people will be advised to use crutches for a period of time after surgery. Depending on the treatment you have had, this may be for 2 – 6 weeks or longer. You might also need to wear a knee brace to control the movements of your knee
- It is important to see your physiotherapist and follow the program carefully to ensure that your operation has the best chance of success. This will be discussed at your first follow-up appointment at approximately 2-3 weeks after the operation
- You will be given more detailed instructions on what to do before you leave hospital
How long does it take to recover from a cartilage treatment?
- This varies significantly depending on the type of surgery you have had and you will need to discuss this with your surgeon before agreeing to proceed
- There may be some restrictions on activities (eg. pivoting sports) for up to six months following your surgery
When can I start walking?
- Provided your pain is well controlled and you have recovered adequately from your anaesthetic, you are able to move your knee the same day. If putting weight through your knee could damage the cartilage repair – you may have to use crutches and keep it off the ground for up to six weeks
- For some procedures, it will be necessary to keep some or all of your weight off the operated leg for a prolonged period of time to allow your joint surface to recover, while sometimes walking will be allowed. Cartilage surgery is very specific for the individual patient and injury, so discussion with you surgeon is important so you understand what you are allowed or not allowed to do.
When can I drive?
- Generally, we advise that patients may not drive anywhere between 2 and 6 weeks after cartilage surgery though again, this is highly dependent on the surgery you have had. You may be advised to refrain from driving for a longer period and usually cannot drive if you are advised to wear a knee brace
- After this period, it is important to be sure you could make an emergency stop if required before resuming driving. We also recommend checking with your car insurance provider to ensure they do not have rules regarding surgery and driving. If you do not comply with these rules, they may not cover you in the event of an accident
When can I return to work?
- This depends on the type of work you do, as well as the type of surgery you have had
- People with a sedentary job might be able to return to work soon after surgery when your pain has settled.However, ifyour job is very active or if you are required to perform dangerous activities, you may require a longer period away from work
- You should talk to your surgeon about what is right for you
When can I return to playing sport?
- This might be different for each patient and depends on the type of procedure performed and on your sport
- As cartilage is very slow to heal, you may need to refrain from training or playing sports six weeks up to six months following some procedures
- You should discuss this with your surgeon before agreeing to surgery
Is my dressing waterproof?
- Immediately after your surgery, you will have a bandage which is not waterproof. This is usually removed after two days and the dressing(s) underneath are waterproof (but you can’t soak it in a bath or pool).
- Your waterproof dressing should stay in place until you see your surgeon to check your wound, two to three weeks after your surgery
When will I see my surgeon again?
- Information about your next appointment will be provided before you leave the hospital
- You will see your surgeon two to three weeks after your surgery to check your wound
Who do I contact if I have a problem after surgery?
- If you have chest pain, shortness of breath or other serious problems, you should seek emergency attention without delay
- If you are there is a problem with your wound or if you have other concerns about your progress, you should contact the hospital or your surgeon who will advise you on the best course of action