Post Operative Instructions
Now that you have just finished your surgery, you and your loved ones may be wondering what you should be doing to help you in your recovery. Listed below are a few tips and instructions for your post operative care.
The first 24 hours
For the first 24 hours after your surgery:
- Do not drive a car or operate any machinery that requires your full concentration.
- Do not drink any alcohol or take any recreational drugs.
- Do not sign any legal papers or make any major decisions.
- Have someone stay with you and help you with some of your daily activities.
Manage your discomfort after surgery — the first 48 hours
To reduce your discomfort after surgery
- Elevate
Keep you're your leg elevated above your heart continuously for the next 48 hours. Please see the enclosed picture for an idea of how to accomplish this in your own home. One of the best methods we have found is to use the larger cushions from a couch and place this on your bed. Place your leg on the top of this cushion while you lie flat on your back. Your leg must be higher than your heart. Sitting up in a lazy-boy type chair is counterproductive since your leg is now lower than your heart.
Proper and Improper Elevation Techniques - Ice
Keep your leg cool. This means icing the leg down continuously for the next 48 hours. Our patients report that one of the easiest methods to accomplish this is to purchase 4 large bags of frozen peas from your local grocer. Use one or sometimes two of these bags (depending on the size of your leg) at a time over the top of your leg directly over the dressing. The cold from the peas will gently cool through your dressing and/or cast and keep swelling and pain down to a minimum. The bags need to be rotated back into the freezer about every 90 minutes depending on the outside temperature. You can rotate the already chilled bags back onto your covered leg to keep your extremity continuously cooled. If you have loss of feeling or notice significant blanching of the skin, please discontinue the ice. However, if you keep the ice over the dressing and it does not touch your skin, this should not be a problem. Another option is to use the blue gel packs used in coolers or to purchase a cryotherapy unit such as the Polar Care Cub or the Iceman from a medical supplier. All of these works equally well ands the choice is yours. Another useful tip provided by one of our patients is to place a cooler next to your bed at night filled with the frozen peas or blue packs. Place one or two of the bags over your knee and set your alarm for approx 2 hours later. When the alarm sounds, just reach over and pull out one or two more of the peas and place them on to your knee and place the others back into the cooler. This method keeps your extremity cool and free from inflammation and allows you to have a more restful night. - Medication
Take your medication continuously for the first 48 hours. When you first arrive home, take the pain medication prescription according to the instructions so when the anesthesia wears off, your pain is minimal. Repeat the dosing according to the directions for the first 48 hours and than you may want to take the medication only when you need it.
Taking Care of your incision(s)
It is very important to take care of your incision(s). Please follow these tips below:
- Keep your dressing dry and clean.
- We recommend a good old-fashioned sponge bath if possible to keep the dressing dry and clean.
- If you need to use a shower, we recommend that you first wrap the area with an absorbent terry cloth towel. Cover this with a large plastic bag and tape the top well. Keep the spray away from the extremity and never submerse the extremity. Dry your entire body off first before taking the bag off. If you are interested, you can purchase a protective bag from our office.
- Unless you are instructed otherwise, after 72 hours you can remove the dressing around your extremity.
- Some bloody drainage in and around the dressing is very normal. Wash the area down with some warm soapy water and blot dry.
- Cover the incision with a very small film of antibiotic cream such as Neosporin or Bacitracin (these can be purchased at any pharmacy without a prescription).
- Place some band-aids over the incisions.
- Report any abnormalities around the incisions to our office. It is normal to have some mild to moderate redness around the incisions and you may notice some clear or even some blood tinged drainage from the area for up to one week. However, please report the following to our office:
- Increasing drainage from the incisions.
- Increasing redness.
- Foul odor.
- Increasing swelling accompanied by pain.
- Fever over 101 degrees (take your temperature twice to ensure accuracy).
- Increasing pain not relieved with rest, elevation, ice and the pain medication.
When to call
Please notify us of any of the following symptoms. Call our office anytime. If your symptoms are increasing suddenly and you do not here from us right away, report to the nearest emergency room for evaluation and treatment.
- Increasing drainage from the incisions.
- Increasing redness.
- Foul odor.
- Increasing swelling accompanied by pain.
- Fever over 101 degrees (take your temperature twice to ensure accuracy).
- Increasing pain not relieved with rest, elevation, ice and the pain medication.
- Coldness, numbness or a sustained blue color to your extremity.
- Sudden onset of calf pain.
- Sudden onset of shortness of breath.
- Chest pain.
Frequently asked questions (FAQs)
Some of most frequently asked post operative questions are listed below:
How long of a recovery can I expect?
The answer is not universal, since each person is a unique individual with varying degrees of severity of their condition and each person responds differently to treatment. However, on average, most of our patients recover from a scope of the knee between seven (7) to ten (10) days. Some people take longer and others shorter, but this is just an average. If you have a high demand job, you may require a longer recovery period. During your first post-operative visit, your return to your full activities will be discussed.
When can I drive?
Once again, this is not a universal answer, and each person recovers at different rates. However, most of our patients can drive within one week from the surgery. We do not recommend that you attempt to drive while under the influence of narcotic medication or during the first 72 hours when you have the large bulky dressing on your leg. Once this is removed, you can take a short test drive with someone else by your side. It is recommended you have someone drive you to an empty parking lot and take a short test drive to determine if it is safe for you to drive. Remember, that your decision not only affects your safety, but the safety of your passengers, and the other people on the road.
How long do I need the crutches?
If you had a normal arthroscopic procedure, crutches are optional. Unless you are instructed otherwise, you may only need to use the crutches or a cane until your muscle strength is strong enough to safely ambulate. For most of our patients this is within the first 24 hours. We have provided you with a prescription for a pair of crutches and, if needed, crutch training. We suggest you use them for your own safety and wean yourself off them when you feel confident and safe in your ambulation.
Will I need physical therapy?
Below, you will find a set of easy to complete exercises recommended to help you regain your strength and stability. An overwhelming majority of our patients easily complete these exercises in the comfort and convenience of their own home without the need for a visit to a physical therapist. On your first post-operative visit with us, we can discuss your progress and make further recommendations.
Quadriceps Sets
Quadriceps Sets
Quadriceps sets help rebuild your front thigh muscles, which help give your knee its greatest stability. "Quad sets" can be done anywhere, anytime, lying down or sitting. Simply tighten your quadriceps to press your knee toward the floor or bed. Hold for five (5) to 10 second, then relax. It may help to rest your hand on your knee cap and feel it move upward slightly as you tighten your muscles. You may begin doing "Quad sets" 24 hours after surgery. Do 10 to 12 repititions, and two (2) sets per day.
Heel Slides
Heel Slides
Heel slides help you regain range of motion in your knee and hip. Start by lying down or sitting on a firm surgace (e.g., a bed, floor, or firm couch). Bend your bandaged knee and slowly slide your heel up the bed or floor, as far as possible, toward your buttocks. Hold for four (4) to six (6) seconds, then slowly slide your heel back down and repeat. You may begin doing heel slides 24 hours after surgery. Do 10 to 12 repititions, and two (2) sets per day.
Toe Presses
Toe Presses
Toe presses help rebuild your calf muscles. Simply press up on your toes with both feet, hold for five (5) to 10 seconds, and slowly lower your heels. Use a support for balance. You may begin doing toe presses 24 hours after surgery. Do 10 to 12 repititions, and two (2) sets per day.
Ankle Circles
Ankle Circles
Ankle circles help you regain range of motion in your ankle. Simply circle your foot slowly, five (5) times in each direction, making each circle as large as you can. You may begin doing ankle circles the same day of surgery. Do 10 repititions, and six (6) sets per day.
Straight Leg Raises
Straight Leg Raises
Straight leg raises help rebuild all of the muscles that support your knee.
To the Front: Lie on your back and do a "quad set" as described above. Lift your leg eight (8) to 12 inches. Hold four (4) to five (5) seconds, then slowly lower and repeat.
To the Back: Lie on your stomach and lift your leg straight behind you eight (8) to 12 inches. Hold four (4) to six (6) seconds, then slowly lower and repeat.
To the Outside: Lie on your side, and lift your bandaged leg 12 to 24 inches. Hold four (4) to six (6) seconds, then slowly lower and repeat.
To the Inside: Rest your leg on a low support as shown. Lift your bandaged leg up to touch ankles. Hold four (4) to six (6) seconds, then slowly lower and repeat. You may begin doing straight leg raises 24 hours after surgery. Do 10 to 12 repititions, and two (2) sets per day.
What about notes for work/school or my disability insurance?
All of the paperwork needed to document your disability can be completed by discussing this with our staff prior to your surgery. For some disability carriers, we have to do make some phone calls, research your chart, and find the appropriate codes. Because this requires a tremendous amount of time and effort from our staff, we will require a small fee. Please make sure you give all of these requests directly to our staff, since paperwork given to the physician just delays the process. A simple form is also required to complete your request. This can be obtained through any of our staff members.
We appreciate the opportunity to help you in your recovery. We are always available for any questions or comments you may have since our primary objective is to provide you with the best of care. Feel free to talk with any of our staff. We are here to help.
