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ARTHROSCOPIC SURGERY

Dr Gallagher may be unable to see you before you go home, as he may still be operating when you are ready to depart the hospital. The physiotherapist though will see you before you leave hospital to determine whether you need crutches or not and explain in general terms what was found and done during your surgery. The physiotherapist will also instruct you on what you will be allowed to do with your operated leg before seeing Dr Gallagher back in two weeks time.

Crutches MAY be used until you feel you can safely walk without them (unless advised otherwise)

  • You will be taught some important exercises – start them today and do them daily
  • Rest and elevate the limb when not doing your exercises – this is important for healing
  • Your day of surgery is considered DAY 0, and the first day after is DAY 1
  • Keep your wound and Steristrips dry until DAY 7

Wound Dressings

  • After surgery you will have a bandage around your operative knee – leave it on until DAY 3
  • On DAY 3 – remove bandages, wool & first layer of dressings but LEAVE STERISTRIPS ON
  • You will be given TWO waterproof CUTIFILM DRESSINGS – put on over top of steristrips
  • Once Cutifilm dressings are on, if they are well adhered, you may lightly shower the knee
  • Steristrips and Cutifilm dressings are left intact until the evening of DAY 7

Exercises

  • Straight Leg Raises – tighten your quadriceps & lift leg off bed & hold it straight for 10secs
  • Knee Bends – bend your knee by moving your heel towards your bottom (within pain limits)
  • Knee Extensions – push the back of your knee down into the bed & hold it straight for 10secs
  • Ankle Pumps – bend your foot & ankle up and down (like pushing on the accelerator pedal)

 Physiotherapy Rehabilitation

The physiotherapist will visit you in the hospital prior to discharge to show you the above four exercises & teach you the correct use of crutches & discuss your physiotherapy rehabilitation. The goals of rehabilitation are:

  • Relieve the post operative pain & swelling in your knee
  • Regain your full range of bending movement in your knee
  • Regain the strength and power of your thigh and calf muscles

Pain and swelling are your guides to the effectiveness of your rehabilitation program. Increasing pain and/or swelling may be because you have done too much too soon or that there is another problem. If this occurs, ensure you have been taking your pain relief medications, slow down your activities, elevate the leg and apply ice packs to the knee. When applying ice to the knee – the ice should be placed in plastic bag first, then in a wet towel or pillow slip before placing upon your knee for 30 minute periods every 3 – 4 hours.

Prolonged pain and swelling have been shown to limit the effectiveness of your muscle control and therefore slow your ultimate recovery, but a little pain whilst you are doing exercises after your surgery is not unusual, it is only if you have significant pain which continues long after you have finished exercises that may be a concern warranting review.

 DAY 1

  • When standing and walking – only put as much weight through your operated knee as pain allows
  • Do all four exercises (see above) 20 times each, both before & after each meal (ie. 6 times a day)
  • Take your analgesia tablets REGULARLY, even if pain is minimal – to avoid sudden severe pain

 DAY 2

  • Mobilise at home only as necessary eg. going to the toilet, getting to dining table for meals etc
  • Continue with above exercises – before and after meals
  • Slowly increase weight bearing with crutches as tolerated

DAY 3

  • Remove outer bandages & wool & primapore dressing but leave steri-strips on
  • Put fresh water proof cutifilm over steri-strips
  • As above with exercise program
  • Slowly wean off crutches

DAYS 4 – 7

  • Hamstring curls standing/lying
  • Side leg raises
  • 3 way leg swings
  • Inner range quads
  • Calf raises
  • ¼ squats
  • 1 leg standing

SECOND WEEK

  • Continue rehabilitation program as shown
  • Continue to ice regularly if swelling persists
  • Post op visit to Dr Gallagher at The Queensland Knee Surgery Clinic

THIRD WEEK

  • You should have full or near full range of motion
  • Minimal to no swelling
  • Good quadriceps strength
  • Correct walking pattern

Remember if pain or swelling increases cut back in the exercise program.

Resume crutch walking and partial weight bearing and ice regularly.

 

Report to Dr Gallagher or your local doctor if:

  • Pain is not relieved with rest and the analgesics with which you are supplied
  • The wound or knee gets excessively red or hot
  • There is excessive bleeding through the dressings
  • If there is an onset of fever, chills or sweats
  • Your calf muscle gets tender and painful on foot movement