Arthroscopic Knee Surgery Post-Operative Information
Weight Bearing and Recovery Time for:
- Meniscectomy, Chondroplasty, Loose Body Removal, Diagnostic Arthroscopy, Synovectomy, Debridement, Articular Cartilage Biopsy, and Arthroscopic Lateral Release: You will be “weight bearing as tolerated” immediately after surgery until your recovery is complete. This means that you may put as much weight on your operated leg as is comfortable for you immediately after surgery. Most patients will use a cane or crutches to take some of their weight off their operated leg while attempting to walk with a normal gait. Over the next few days or weeks, you will increase the amount of weight on your leg until you are full weight bearing, with no crutches or cane. Full recovery may occur as quickly as five weeks after surgery and may take as long as six months, depending on the severity of your problem, your age, and the procedure performed. In most patients, the complete recovery process takes several months. During this time, your activities and function will gradually increase according to your condition. Return to a sedentary office job may be possible as soon as one day after surgery, but may take longer if your pain is severe. Return to a physical job may take weeks or months, depending on your condition and the nature of the job.
- Drilling or Microfracture: If you have had drilling of your femoral condyles or tibia, you will be 25% weight bearing for the first six weeks, gradually increasing your weight over the next two weeks until you are full weight bearing. Be conservative. A walker is safer than crutches. Do not hesitate to rent a wheelchair from a local medical supply store and use it for moderate distances. This will decrease your risk of falling and save wear and tear on your hands and arms. Be very careful not to fall. You should go up and down stairs on your buttocks.
If you have had drilling of your patella or trochlea (patellar socket) you will have a knee immobilizer, and may walk weight bearing as tolerated immediately after surgery. Full recovery may take four to nine months as the newly regenerated fibrocartilage grows in and matures. If insufficient new cartilage grows in, your knee may stop improving and further surgery may be necessary. Return to work will be dictated by your ability to function with your weight bearing restrictions.
- Lateral Release: You will have a knee immobilizer on your operated leg. You may remove it to shower, but keep it on at all other times, including sleeping.
If you feel comfortable driving, you may do so on the first post-operative day, if you have an automatic transmission and your right leg has not been the one operated on. If your right leg has been operated on, you should delay driving until at least your first post-operative visit. Some patients after right knee surgery will be able to drive relatively soon, when their knee feels strong enough to operate the gas pedal, if they are comfortable braking with their left leg. In all cases you should practice driving in a relatively empty parking lot before getting on the road. In particular, you should practice braking hard to make sure you can make an emergency stop. If in doubt, do not drive. If you have a clutch you must be especially careful not to drive prematurely.
You will have three roughly (1)-centimeter arthroscopic punctures and no incision. The post-surgical dressing will be moist or wet and may appear bloody on the night of surgery as the fluid used to inflate your knee seeps out tinged with blood. Do not worry that you are bleeding excessively unless the dressing becomes saturated with bright red blood. In seventeen years of practice I have never had this occur to an arthroscopic knee surgery patient. On the first day after surgery, remove this dressing after washing your hands. Usually you may apply a simple band-aid to each puncture. If one or more of the punctures is still draining, then apply sterile gauze with tape until it stops. You may shower on the second day after surgery and should reapply band-aids afterwards.
You will probably have hydrocodone with acetaminophen. If you are allergic, you will have another medicine. Take these as per the instructions on the bottle as needed. Do not take aspirin, ibuprofen (Advil), or glucosamine after surgery without discussing it first with Dr Prodromos, as these medications may slow healing. You may also apply crushed ice in a plastic bag over your dressing.
Swelling is normal after arthroscopic knee surgery.
You may eat whatever you wish. Do not push yourself to eat if you feel nauseated. It is important to drink a moderate amount of fluid. Many patients do not have much of an appetite for 24 hours after the surgery. As long as you are consuming fluids (Gatorade, clear non-caffeinated soda or chicken broth are best) this is not a problem. Your appetite should gradually return.
Knee motion is encouraged to help prevent post-operative stiffness. Up and down movement of your foot as if “pumping” your ankle is also beneficial. A CPM (continual passive motion) machine is used for the first six weeks for six to eight hours per day. Most patients prefer to use the machine while they are sleeping to maximize time and comfort.
Elevating your foot when seated to a level just below waist level, with the knee slightly bent, helps decrease foot and ankle swelling. If you elevate your foot to waist level with your knee perfectly straight, your foot may experience numbness from the stretching of your sciatic nerve. Bending the knee alleviates this problem.
Call our office to schedule a follow-up appointment about one week after the surgery. The exact timing is not critical, but it should be more than three days, and less than 11 days, after the procedure. We will remove your stitches or staples at that time and review your surgical findings.
Body Temperature – Fevers:
Your normal body temperature of 98.6 degrees may increase normally by one degree in the evening. Thus a true fever is usually over 100 degrees. Fevers are normal after surgery due to chemicals released by bleeding. Fevers in the first four post-operative days do not indicate the presence of an infection. Fevers over 100 degrees after the first four post-operative days may indicate infection. Infection is exceedingly rare after arthroscopic surgery. If your fever is over 101 degrees you may wish to take Advil or Tylenol, if you are excessively hot, but in general the Tylenol in your pain prescription will provide sufficient temperature control. If your temperature is over 100 degrees on or after the fifth post-operative day, call me.