In recent years, with the development and popularization of arthroscopic technology, the number of patients with middle-aged and elderly knee osteoarthritis (mild to moderate degeneration) undergoing arthroscopic cleaning is increasing, and most of them have good results. There are also a few patients who feel that the outcome is worse or even inferior to that before surgery. The reason for this is that they have not received systematic treatment and follow-up rehabilitation measures after surgery. Knee cartilage wear and meniscal degeneration is more common in middle-aged and elderly patients in China due to years of work or repeated minor injuries in their youth. However, arthroscopic cleaning can only partially relieve the symptoms and cannot fundamentally restore the cartilage and meniscus to normal, so it should be clearly explained to the patient before the procedure and the patient should not have too high expectations for the procedure (just as worn teeth cannot be rejuvenated after treatment at a dentist). However, after arthroscopic debridement, systematic treatment and rehabilitation can reduce or eliminate most of the knee discomfort and maintain the knee in a more “youthful” state for years to decades. The importance of this procedure cannot be overstated. The main rehabilitation treatment after arthroscopic cleaning of knee osteoarthritis is as follows: a. Oral medications 1. Because of the stimulating effect of these drugs on the mucous membrane of the gastrointestinal tract, patients with more serious gastric ulcers and gastrointestinal bleeding should use them with caution or change to other drugs. 2, central analgesic drugs, such as: tramadol extended-release tablets, amfepramine hydrocodone, etc.. Some patients have symptoms such as dizziness and nausea after taking them, so they can reduce the dosage or take them only before going to bed. 3, proprietary Chinese medicine, such as: paralysis, paralysis Qi, Tiger Power, rheumatism pain relief, Zhengqing wind pain Ning, rheumatism pain relief liquid, …… (numerous varieties, ingredients are not known, the efficacy varies from person to person, you can choose one according to your own experience) 1.4 nourishing joint cartilage drugs, mainly: glucosamine sulfate (domestic and imported can be), glucosamine hydrochloride is the second Glucosamine hydrochloride is the next best thing. It can be taken in reduced doses for 2-3 months, and then stopped for 1 month, according to personal experience and gastrointestinal reactions, to decide whether to continue taking. Second, the topical drugs 1, the applicator, such as: Fotalin, ketoprofen, orthopedic water, safflower oil, etc. 2, creams, such as: wound and damp pain relief cream, joint pain relief cream, dog skin cream, Qizheng pain relief paste, etc.. Skin allergies are used with caution. Personal experience, the role of the above drugs accounted for 30% – 40%. The following rehabilitation exercise measures account for 60% – 70%. Functional exercise 1, quadriceps muscle strength exercise after surgery can be carried out quadriceps functional exercise, contract the quadriceps, tense the patella, for 10-15 seconds, relax; repeated more than 100 times a day; straight leg raising exercises, lying down, standing, sitting posture can be, tense straight knee joint, raised about 30 degrees, for 10-15 seconds, relax; daily morning and evening exercises three groups, each group repeated more than 50 times; 1 After 1 week, 1-2 pounds of sandbags can be added and fixed to the ankle for straight leg raising exercises. In the exercise, the toes are turned to the outside, focusing on exercising the strength of the medial femoral muscle. 2, joint mobility exercises after surgery can be gently knee mobility exercises: ① straight leg press, can be their own pressure, relatives pressure, sandbag pressure, knee straight, with about 4-5 pounds of pressure placed on the upper edge of the patella (do not directly press on the patella, so as not to cause severe pain), for 3-5 minutes / time, 5-6 times / day. Adjust appropriately according to individual condition and pain level. The goal is to fully straighten the knee joint, and after 3-4 weeks of exercise, the N-fossa can be easily attached to the bed surface. ②Flexion of the knee joint, again, sitting at the edge of the bed, at the edge of a high stool, the knee joint on the operated side drops to the maximum angle and then hooks backwards with slight force. You can hold your own hands near the calf or ankle joint and perform functional exercises for knee flexion. Again, this lasts 3-5 minutes/time, 5-6 times/day. Adjust appropriately according to individual condition and pain level. The goal is full knee flexion. After 3-4 weeks of exercise, the knee joint can be easily flexed and the heel can reach a fist distance from the hip. Prepare for smooth squatting later. 3, foot and ankle pump exercise: active dorsiflexion, plantar flexion of the ankle joint and toes, moderate strength, each time for 10-15 seconds; practice more than 100 times a day. Promote blood circulation in the lower limbs. 4.Patellar massage and nudge exercises After knee arthroscopy cleaning, patellar activity exercises are also very important. Sitting on the bed or sofa, with the knee straight and the patella relaxed, use the palm of the same side to slightly press the patella and push it medially, it is normal to feel slight pain and friction; the movement gradually transitions from slow to fast, and finally it is possible to push the patella easily and feel that the patella can be pushed inside and outside, up and down by about 2cm. Massage 3-4 times a day, lasting 5-10 minutes each time. Combine with patellar tightening exercises for better results. 5, cold compress Some time after knee arthroscopy, 3 months to 6 months, swelling will occur after functional exercises of the knee joint; it can be reduced after rest. If the pain and swelling is more obvious after the exercise, cold compress measures can be used; the method is to use a water bag or rubber handbag with more than half a bag of water, frozen in the refrigerator into half ice and half water, wrapped in a towel with 2 layers, and applied to the inside and outside of the knee joint after exercise for 10-15 minutes. Note to avoid placing directly on the skin to prevent frostbite. 6, gait exercises Knee arthroscopy cleaning after the operation generally does not require crutches, daily down to the ground for walking exercises, efforts to walk normally, can not limp, play bent leg. Try to land on both feet at the same time. Practice time and number of times gradually, just after surgery can be 3-4 times / day, 10-15 minutes / time; 2 weeks later gradually increase. After 4 weeks of surgery, you can walk for 30 minutes, pedal a bicycle for 20 minutes, or swim for 30 minutes. 3 months later, if the knee swelling has completely subsided and the mobility of the joint has improved significantly, you can perform half-squat exercises and jogging exercises. Half squat is not standing horse stance, both knees and both hips are slightly flexed about 20 degrees, both feet are separated by shoulder width, half squat standing for 5-10 minutes, 2-3 times a day, for knee stability exercise. Climbing mountains, stairs, standing horse stance and repeated squatting exercises are not recommended. Joint injection After 4-6 weeks after surgery, or in late autumn or early spring when the seasons change, knee pain is slightly aggravated; you can go to the hospital for joint injection treatment. The vast majority of injections are given with sodium vitrate, 3-5 injections a course, 1-2 courses per year. Even so, there are still a few patients who cannot adhere to the above rehabilitation exercise program, or experience increased pain and swelling during the exercise process; it should be continued after 2-3 days of rest. Otherwise, the previous work is abandoned. It is quite important to review in hospital 3-4 weeks after surgery, mainly to check the adherence to functional knee exercises and improvement of knee mobility after discharge from hospital; whether the scheduled exercise plan can be completed. It is important to check whether the patient can complete the exercise program. Other review time: after 3 months, 6 months, 1 year, mainly to check the recovery of knee function and whether it can achieve the expected purpose. If severe pain, redness, swelling, interlocking, generalized fever, drug allergy, gastrointestinal reaction, etc. occur during the rehabilitation exercise, you should contact the surgeon of the operation team or review in time. Tip: “Joint disease is not well nourished, but well practiced” has some truth, but it is necessary to exercise properly.