Scott A. Rodeo, M.D.
POST-OPERATIVE INSTRUCTIONS – MICROFRACTURE
BRACE
□ The post-operative ROM brace should be locked in full extension and worn at all times except when you are using the motion (CPM) machine or doing your home PT exercises. It is necessary for even the simplest tasks such as going to the restroom to protect your knee while your muscles are recovering.
□ Home CPM – please use for 2 hrs at least 3 times per day ROM: _____
▪ The motion machine should be used without your brace for 6-8 hours a day.
▪ Start at 0-40 degrees and advance as tolerated. If this becomes too painful, you may decrease the flexion to a tolerated degree.
AMBULATION
□ You will be ambulating with your brace. You must use your crutches.
_____ Non Weight-bearing (NWB)
_____ Toe Touch Weight-bearing (TTWB) – 20%
_____ Partial weight-bearing (PWB) – 50%
□ You may place the above stated amount of weight on the involved leg unless instructed otherwise after surgery to help with balance and stability with your brace on.
□ Crutches will be needed until your physical therapist and Dr. Jones deem them unnecessary. This decision will be based on strength in the involved leg and your ability to walk with a normal gait (heel to toe walking without a limp).
COLD THERAPY
□ Ice or cryo-cuff machine (if covered by insurance) should be used for comfort and swelling. Use it at least 20 minutes every hour as often as possible.
□ Never apply directly to exposed skin. Place a towel between your skin and the ice or cryo-cuff machine to avoid cold injury.
□ After the first 14 days, use 20-30 minutes every 3-4 hours if possible.
EXERCISE
□ Following surgery, three main goals exist:
▪ Full knee extension
▪ Quadriceps contraction and activation
▪ Control of pain and swelling.
□ To help gain full knee extension, place a small rolled up towel under your ankle and push the back of your knee down to the floor by contracting your quadriceps muscle.
□ Depending on your limitations after surgery, several exercises will be beneficial for you at home: quad sets, ankle pumps, and straight leg raises should be performed.
□ DO NOT put pillows under the knee while sleeping. This can lead to a flexion contracture. Instead place the pillows under your heel which will help ensure full knee extension.
□ Elevate your leg for several days if you are sitting to help with swelling. Remember it must remain fully extended (straight).
□ Being up and around after surgery will help diminish the risk of blood clots.
BRUISING
□ The lower leg may become swollen and bruised, which is normal. This is from the fluid and blood moving down the leg and should resolve in 10-14 days.
□ If you experience severe calf pain and swelling, call the office immediately.
WOUND CARE
□ Immediately after surgery, if you feel your bandages are too tight, you may loosen the ace wrap only.
□ You may remove the Operative Dressing on Post-Op Day #3
□ Keep the incisions clean and dry.
□ Do not remove the steri-strips (small pieces of white tape) covering the incisions. If they fall off, cover incisions with water proof band-aids.
□ Apply Band-Aids or gauze/tape to the wounds. Change the dressing daily. Please do not use Bacitracin or other ointments under the bandage.
□ An ace wrap may be used to help control swelling. Do not wrap the ace too tight.
□ There may be a small amount of bleeding and/or fluid leaking at the surgical site. This is normal. The knee is filled with fluid during surgery, sometimes causing leakage for 24-36 hours. You may change or reinforce the bandage as needed.
□ There will actually be more swelling on days 1-3 than you had the day of surgery. This is normal. The swelling is decreased by using Ice or the Cryocuff. The swelling will make it more difficult to bend your knee, but once the swelling goes down, it will become easier to bend your knee.
□ You may shower on Post-Op Day #3. Do not get the wound wet. To protect the incisions and keep them from getting wet, wrap the leg in a large plastic garbage bag or saran wrap with tape at both ends. Pat dry if knee gets wet.
□ Do not soak the knee in water. Do not go swimming in the pool or ocean until instructed. Incisions may not get wet until after your first postoperative visit. NO soaking of wounds until approved by Dr. Jones.
POST-OP
□ Pain medications will be prescribed to you. Take as instructed and as needed.
□ Pain medication may cause constipation. You may take an over the counter stool softener (Colace, etc) to help prevent this problem.
□ You should take these medications with food or they may cause nausea.
□ DO NOT take any anti-inflammatory medication such as Advil or ibuprofen for two weeks after surgery as this may impair graft healing.
□ Resume all home medications unless otherwise instructed.
□ Call immediately to the office if you are having an adverse reaction to the medicine.
DRIVING
□ You may not drive or operate heavy equipment while on narcotics.
□ If your Right Knee is the operative side, you MAY NOT DRIVE FOR 4-6 WEEKS. It is important to regain adequate Quadriceps control before operating a motor vehicle.
□ If your Left Knee is the operative side and you drive an Automatic Transmission vehicle, you may drive a few days AFTER you finish taking your pain medication. It is important that you feel very confident in your ability to respond efficiently before attempting to drive.
SLEEP
□ Nighttime will probably be the most uncomfortable time. You should use the narcotic pain medication as prescribed to assist you in resting well.
□ You should sleep in your post-op brace until your first post-op visit where you will get additional instructions depending on your progress.
EMERGENCIES
□ Contact the office if you notice any of the following:
▪ Uncontrolled nausea or vomiting, reaction to medication, inability to urinate, fever greater than 101.5 (low grade fevers 2-3 days after surgery is normal), severe pain not relieved by pain medication, redness or continued drainage around incisions (a small amount is normal), calf pain or severe swelling.
□ If you are having chest pain or difficulty breathing, call 911 or go to the closest emergency room.
FOLLOW-UP
□ At your post-operative visit, Dr. Jones will go over your surgery, show you arthroscopic photographs from your surgery, and outline your rehabilitation.
IF YOU HAVE ANY QUESTIONS, PLEASE FEEL FREE TO CALL OUR OFFICE AT (310) 825-6095.
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Place label here
NAME OF PATIENT: _______________
MRN: _______________________
Kristofer J. Jones, M.D.
Sports Medicine, Shoulder Surgery and Cartilage Restoration
UCLA Department of Orthopaedic Surgery
David Geffen School of Medicine at UCLA
10833 Le Conte Avenue, 76-143 CHS
Los Angeles, CA 90095-6902
Phone: (310) 825-6095
Fax: (310) 825-1311
CA License: A126262
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Kristofer J. Jones, M.D.
UCLA Department of Orthopaedic Surgery
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