Dr. Abene's Postoperative Knee Instructions

Your operation was performed through two or three small incisions. The interior of your joint was visualized with a small telescopic device/camera. Either a repair or removal of the meniscus cartilage if appropriate was performed. You may experience fluid or swelling in the joint. This is usually due to fluid used during your surgery or mild bleeding into the joint. This fluid normal and is usually reabsorbed by your body over time. Hopefully this handout answers all of your questions. Don’t hesitate to call me if you have any questions. You can e-mail me as well. You can also visit me on the web at my Kaiser web site www.permanente.net/doctor/anthonyabene or at my American Academy of Orthpaedic Surgeons (AAOS) site http://orthodoc.aaos.org/abene/ Dressing: There is a soft compression dressing around your knee. This dressing should feel comfortable and will absorb any drainage from your knee. The dressing may become moist from blood or arthroscopic fluid; this is not a cause for alarm. If the area in question is exceptionally large or continues to bleed, please call the office. You can remove the dressing two days after surgery. You may use Band-Aids to cover the incisions.

Wounds: There may be small stitches in the incisions. The incisions may be sore and may bruise. Keep the incisions clean and treat them like any small cut in the skin. If you have Steri-Strips over the incisions, leave them on until instructed to remove them. Activity: Crutches or a cane may be necessary during the first 24-48 hours days or longer following surgery until you are able to walk without limping. To relieve pain and reduce swelling, keep your leg elevated above your heart. Perform ankle range of motion frequently. Other exercises you should be working on include quadriceps-setting exercises (“quad sets”): With your leg straight in front of you, contract your thigh muscle and try to press the back of your knee against the underlying surface; hold it for 5 seconds and release. Do at least 3 sets of 10, 3 times per day. The exercise will be limited by the amount of pain and swelling you experience. Gentle exercise will reduce swelling, increase motion and help prevent stiffness and weakness. Use your crutches, and put as much as weight as is comfortable on the operative leg. Ice and elevate the knee as much as possible for the first several days. Apply ice 20 minutes on and 40 minutes off as needed. Icing helps to reduce the pain and swelling. Do not run, jog, or engage in any sports activities until you receive permission and instructions from me. Return to work/school/sport: Return to work will depend on your job and the procedure that was done. Generally, you should plan on taking two days completely off and having some restrictions for a few weeks. If you have a desk job, you could return to work within one week. At work, try to keep your foot elevated initially to prevent swelling. Get up for a short walk at least every hour for the first few weeks. Some types of work may require further time off. For example, if your job requires heavy lifting or climbing, then return may be delayed several weeks. Full recovery and return to pre-injury athletic activities usually occurs in 3-6 weeks for a partial meniscectomy and 8-12 weeks for a meniscal repair.

Bathing: Do not get your operative site wet for 3 days after the date of surgery. At that point you may shower but don't bathe or swim until two weeks after surgery. Do not swim, submerge the knee or scrub the incision. Pain: Marcaine(a type of numbing medication) was placed in your knee after the surgery, which will significantly reduce your discomfort during the first night. When this wears off, you may feel increased discomfort. Upon discharge you should have a prescription for pain medication. Please take the pain medication with food. Do not drink alcoholic beverages or drive if you are using pain medications. Cryo/Cuff (if applicable): The Cryo/Cuff is worn for the first 3 days. Wear the cuff for 3 hours and take it off for 2-hour intervals. Change the water in the Cryo/Cuff hourly. You may remove the Ace wrap on your lower leg when the Cryo/Cuff is off. Rewrap the Ace when you reapply your Cryo/Cuff. The Cryo/Cuff is yours to keep. Physiotherapy: YOU MUST CALL TO SCHEDULE YOUR PHYSICAL THERAPY APPOINTMENT ASAP. If you are going to do your physiotherapy at Kaiser San Jose, please call 408-972-6400 to schedule an appointment in the next two days. You should begin physical therapy sometime in the next 1-2 weeks. If you wish to do your therapy at Gilroy (inform me so I can forward the referral), call 408-848-7040. Postoperative visit: I will see you in 7-10 days. At this time I will probably remove your sutures. We will also go over your arthroscopic pictures and discuss in further detail what I saw and did inside your knee. When to call 408-972-3030 or 408-362-4788 (after hours and weekends): •Excessive bleeding •Excessive non-bloody wound drainage beyond the first 3-4 days •Poor pain control •Fever > 101.5 after postoperative day #3 •Increased redness along incision •Calf pain or swelling •Any other concerns / questions.

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