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Incisions for arthroscopy are quite small, usually about 1 centimeter each. The incisions are closed with steri-strips that should remain in place for 7 to 10 days. Your knee will
protected with cotton padding and the cold therapy pad secured with an ace bandage. When you take off the bandages for the first time they may be fairly bloody. When you replace the
cold therapy pad you must place something between your skin and the pad to avoid cold burns.
Phase I: Beginning Day of Surgery
GOALS:
• Decrease Swelling
• Increase Range of Motion
• Initiate Strengthening
1) Apply ice 15 to 20 minutes, 3 to 5 times per day until swelling is diminished, or use cold therapy pad with cooler at 40-50 degrees 23 hours per day for 2-3 days,
then 6-8 hours per day until swelling is minimal.
2) Wear ace wrap until swelling is insignificant.
3) Elevate leg until swelling is insignificant.
4) Use crutches, beginning with partial weight bearing, and progressing to full weight bearing without crutches, as soon as possible, as pain permits, usually within
2-4 days.
5) Do active range of motion (fully straighten and bend as pain permits) exercises while sitting, set of 10, 4 times per day. Discontinue when range of motion is normal.
6) Do straight leg raises, lock knee, two sets of 20, two times per day.
Phase II: To be started after 1 week.
GOALS:
• Continue Strengthening
• Return to Functional Activity
1) When active knee range of motion reached 90 degrees flexion, begin progressive-resistive knee extension exercise with ankle weight or light gym equipment
(knee extension machine).
2) Do short squats, progress to single leg squats (to 30 degrees of flexion).
3) When active knee ROM (range of motion) reaches 100 degrees of flexion, begin cycling for aerobic conditioning and to enhance ROM. Start with 10 minutes of
cycling, and add 5-10 minutes per week.
4) When you can walk without pain, begin step up exercises: start with 4" to 6" steps. Do as many step ups as can be accomplished, up to 50. When goal of 50
is achieved, add 1" to step height.
5) Wall sits (put back against the wall while holding a partially seated position) - three reps, 15 seconds each.
LATERAL RELEASE
A lateral release is a procedure used to realign kneecap. As the knee bends, the kneecap moves up and down in the groove located at the end of the thigh bone. Sometimes, the
kneecap is pulled towards the outside of the groove. When the kneecap does not slide well within the groove, cartilage irritation and pain can result. When the lateral retinaculum
is too tight, it can pull the kneecap out of place. A lateral release is a procedure performed to release this tight retinaculum, and allow the kneecap to sit properly within
its groove.
Patients are advised to weight bear as tolerated but may use crutches for one to three days after surgery. Patients can expect to be swollen for up to two months. It is important
to maintain active range of motion (keep the knee moving) after surgery. It is common to experience stiffness for up to two weeks after surgery. Patients are advised to
avoid stairs and walking downhill for a period four weeks to avoid excess pressure on the kneecap and the groove it tracks in. Physical therapy will be started approximately
four to seven days after surgery. Patients typically return to sports at four to six weeks.
The most common side effect of a lateral release is bleeding into the knee; this can lead to pain and swelling. Other complications include infection, and scar tissue formation.
MENISCUS: GENERAL INFORMATION
The meniscus is a circular piece of cartilage with its blood supply coming from the outer rim. A meniscal repair is only possible if the tear is located in this outer rim where the
necessary blood flow is located to promote healing. Tears located in the central portion of the meniscus will not heal even if a meniscus repair is performed. These tears will be
removed (partial meniscectomy).
MENISCECTOMY
A partial meniscectomy is a surgery performed to remove a piece of torn cartilage in the knee joint that is in a area of poor blood supply.
There is usually mild pain associated with arthroscopic knee surgery. Patients can expect to be swollen for up to two weeks. It is important to maintain active range of motion
(keep the knee moving) after surgery. It is common to experience stiffness for up to one week after surgery. Patients are advised to weight bear as tolerated but may use crutches
for one to three days after surgery for comfort. Physical therapy will be started approximately four to seven days after surgery. Patients typically return to sports at four to
six weeks.
MENSICUS REPAIR
A meniscus repair is an arthroscopic surgery used to place sutures to repair the torn edges. There is usually minimal pain associated with arthroscopic knee surgery. The success
of a meniscus repair is dependent on the patient being non weight bearing for a period of three weeks, avoiding squatting for three months and following our physical therapy protocol.
Physical therapy will be started four to seven days after surgery. It is important to maintain active range of motion (moving the knee) to avoid stiffness. It is common to have
stiffness and pain behind the knee for up to six weeks after surgery. Patients typically return to sports at three to four months.
CHONDROPLASTY
Arthroscopy is performed to clean out bone and cartilage fragments that, may cause pain and inflammation.
There is usually mild pain associated with arthroscopic knee surgery. Patients can expect to be swollen for up to two weeks. It is important to maintain active range of motion (keep the
knee moving) after surgery. It is common to experience stiffness for up to one week after surgery. Patients are advised to weight bear as tolerated but may use crutches for one to three
days after surgery for comfort. Physical therapy will be started approximately four to seven days after surgery. Patients typically return to sports at four to six weeks.
MICROFRACTURE
Microfracture is a surgical option used to treat areas of damaged cartilage. When a patient has an area of damaged cartilage with bare bone, microfracture can be done by penetrating the
bone and allowing stem cells to grow fibro new cartilage. Ideally, the area undergoing microfracture should be less than two centimeters in diameter and have healthy surrounding cartilage.
A small, sharp pick is used to create the small holes in the bone.
This new cartilage is very fragile and needs to be protected. The success of microfracture is dependent on the patient being non weight bearing for a period of six to eight weeks,
using a continuous passive motion machine (CPM) for a period of six to eight weeks for a duration of four to six hours per day and following our physical therapy protocol.
There is usually mild pain associated with arthroscopic knee surgery. Patients can expect to be swollen for up to two weeks. It is important to maintain active range of motion (keep the
knee moving) after surgery. Physical therapy will be started approximately four to seven days after surgery. Patients typically return to sports at four to six months.
OATS (OSTEOCHONDRAL AUTOGRAFT TRANSFER SYSTEM)
OATS is a arthroscopic surgery where cartilage plugs are taken from areas of non weight bearing areas and transferred to the damaged area of cartilage. Over time, the cartilage donor site
will fill with bone and scar tissue. The success of a the OATS procedure is dependent on the patient being non weight bearing for a period of two to six weeks, using a continuous
passive motion machine (CPM) for a period of one to four weeks for four to six hours per day and following our physical therapy protocol.
There is usually mild pain associated with arthroscopic knee surgery. Patients can expect to be swollen for up to two weeks. It is important to maintain active range of motion (keep the
knee moving) after surgery. Physical therapy will be started approximately four to seven days after surgery. Patients typically return to sports at four to six months.
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