Post Operative Discharge Instructions for Knee Arthroscopy
Including All Arthroscopic Knee Procedures. Click here for printable ‘Post-Op Knee’ instructions.
Please use the information below as a general guide. If you can not find the answer to your question or concern, call the office.
First Postoperative Day/Evening
Begin specific instructions from Dr. Glashow or his team at the hospital. A few consistent recommendations are as follows. You will be given a cane for support but may put weight on the leg. Surgery produces swelling in the knee joint. You should also understand that during the procedure, fluid is instilled into the knee, which also contributes to the swelling of the joint. Elevation is the single most effective way to help alleviate swelling. In order to effectively elevate the knee, you must be lying down on your back. You must have the knee joint 1 to 2 feet higher than the level of your heart. One pillow will not suffice. You should use either several couch pillows or a box covered with several pillows. You may have the knee bent while elevating the leg. You must remember that for every hour of walking around, you need 2 to 3 hours of elevation to negate the accumulation of swelling. While it is not necessary to be on another device. You must tighten the sling band when standing up, or walking about. You may come out of the sling and bend and straighten the elbow at your side immediately after surgery. The arm goes back into the sling for sleeping. You may remove the pillow support during the day, but it is important to wear for sleep. Care must be taken not to lift the arm away from the side particularly in procedures involving reconstructive surgery or harm can be done to the operative repair.
Pain Medication
You should expect some pain following any operation. You will be given a prescription for pain medication and instructions for using it. You need to know that in most cases Dr. Glashow will instill local anesthetic into the knee, which will slowly wear off in the ensuing 8 to 12 hours. You should start taking the pain during the early onset of pain. In some cases, it may be acceptable to take Advil or Aleve, but please check with Dr. Glashow if it is permissible in your case (see cover sheets).
Ice Machine/Cold Packs
Most patients will go home with a “game ready.” The reservoir portion will be in place after your surgery. You will be given the instructions on how to use it. Please familiarize yourself with this prior to leaving the hospital. You will need a large supply of ice at home for the next several days in order to effectively use this device. The “game ready” pad is applied at the time of surgery. When the bandages are removed, you should reapply the “game ready” pad. The “game ready” device should be used as much as possible during the first two weeks after surgery while you are sedentary. This means you can use it continuously. The device has a setting for compression; this should be set on medium/moderate. This is effective in reducing pain and swelling. Thereafter, it becomes less effective and you may discuss with your doctor, the specifics of your case. If you have elected or prefer not to use the “game ready”, you may use reusable cold packs or ice. Cold packs should only be on the knee for 20 to 30 minutes to prevent skin damage. While it is okay to use the “game ready” continually, it is not okay to keep ice or frozen packs on your skin continuously.
Dressings
The knee will be covered with an Ace bandage and cotton gauze and web roll. You should take this bandage off between 24 and 48 hours after surgery unless you are told otherwise. The small wounds on your knee will be covered with WHITE STERI-STRIPS, WHICH SHOULD NOT BE REMOVED. If in your particular case Steri-Strips were not used, you will see the sutures directly on the skin. After bandages are removed, you may shower and get the areas around the wound wet, but you may not submerge them in a bathtub, pool, hot tub or other. You should clean the wounds off the first day with a solution of hydrogen peroxide or rubbing alcohol. Afterwards, you may rewrap the Cryocuff over the knee being sure to keep a thin cotton cloth between the plastic cold pack and your skin. Keep the wounds dry until you go back to see the doctor except for brief periods of showering. If you do not have the Steri-tapes directly over the small wounds, place a Band Aid directly over the sutures for the first two postoperative days.
Do not touch, remove or apply ointment to the Steri-Strips that are over the portal sites. You may remove the Steri-Strips after 7-10 days. If they fall off before, please reapply with the extra ones supplied.
Activities after surgery depend upon what has been done to your knee. You will be given crutches or a cane after the surgery and be allowed full weight bearing on the knee*. You should try to bend and straighten the knee between 0 degrees (fully straight) and 90 degrees (right angle) during the first few days postoperatively. Once the bandages have been removed, this will become easier. It is helpful in obtaining full extension (straightening) by placing a pillow underneath the heel and nothing behind the knee to ensure full straightening. Full extension is the most important range of motion in the early postoperative phase.
* Micro-Fracture
If your surgery included a micro fracture it is important to understand what your weight bearing status is. Depending on the location the micro fracture was done in the knee will depend if you will need crutches to put no weight on the operated side. In some cases a brace is used and full weight bearing is allowed.
Physical Therapy: Each case is somewhat different. You should contact the doctor’s office regarding specific instructions with physical therapy often which is arranged ahead of time prior to the surgery.
Follow-Up Appointments
You will be given a follow-up appointment to see the doctor between 5 and 14 days after the surgery.
Driving
You may drive when the bandages have been removed and you have control of the leg, usually within a few days after the surgery.
Exercise/Bicycle
Exercise bicycle is an integral part of most rehabilitation programs and the doctor often encourages this within a few days of surgery. Consult with him regarding the specifics of your case. Treadmill: In most cases, the treadmill should be avoided for exercise immediately following surgery.
