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Knee Surgery Follow up Care and Exercises - by Vic Goradia, M.D.

After surgery, your doctor will have told you whether you should wear a brace and when to wear it. Icing is recommended for the best recovery and can be applied using the cryocuff device, ice man, a regular ice pack or any other cooling or passive cooling device. Ice should be applied over bandages for a period of time several times a day until your follow up appointment in most cases. Pay attention to instructions on whether you should or should not take a shower.

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Pain control is important!

You should NOT wait until your pain is unbearable before taking your pain medications. Your knee is usually injected with medications during the surgery in order to help with pain relief. These medications typically wear off 4-6 hours after surgery.

Most patients are given prescriptions for pain and Phenergan (Promethazine) to take as needed for nausea; as nausea is a common side affect of the pain medication. You can help prevent nausea by making sure you eat when you take lightheaded. Make sure you increase your fluid intake.

The pain medication and ice should help to "control" your pain, however, it will NOT take away all of the pain.

Swelling and Stiffness is normal.

Swelling and Stiffness about the knee are expected for the first several weeks following your surgery. Continuing to ice, use anti inflammatories, and exercise will help this. This can also be achieved by propping your heel on a chair facing you or on the arm of a couch. Your foot may swell or feel cool because you are lying around without moving the leg. It should become warmer as you move around more.

Side effects that should NOT be ignored! Call your doctor.

• Difficulty breathing, a severe rash, extreme drowsiness, nausea. If your side effect is life threatening, dial 911. If it is not life threatening call your doctor for further instructions.
  
  
• If you notice your bandages are completely saturated with blood. Some blood on the bandages is okay, however, persistent bleeding is not normal.
  
  
• If you have a temperature above 101 degrees. Many patients will have an elevated temperature for the first few days after surgery. However, a temperature above 101 degrees is not normal, especially if associated with chills or severe pain.
  
  
• If you have pain that is not "controlled" with pain medication and ice and/or if your toes are cold, numb or purple. A purple, cold, numb foot that does not get better with movement or loosening the bandages is NOT normal.
  
  
• Call your doctor if you have any other concerns or questions.

Important exercises you will begin the day of surgery

These exercises are crucial to your rehabilitation and the following is a general guide for the rehabilitation following knee surgery. Physical Therapy Programs are individualized for each patient by a doctor or physical therapist and a successful outcome is dependent on adequate communication between the patient, therapist and surgeon. Considering those points, these are just guidelines.

Elevate your affected leg, it must be elevated above heart level, usually requiring 4 or 5 pillows. under your leg. Just propping it on the couch, or recliner is not enough, and the more you can elevate and ice, the less pain and swelling you will have.

Squeeze & tighten this muscle tight for 2 seconds, twenty times, and try to do 10 or more sessions each day. Monitor your progress by comparing your muscle contraction to your unaffected leg, and it is wise to do these exercises for both legs.

The Heel Prop is The Most Important Exercise You Will Do. Prop your heel as shown in the photo above. Relax your leg (when you are relaxed, your leg and foot will rotate out slightly and this is good). Allow your knee to straighten as much as possible. This can also be achieved by propping your heel on a chair facing you or on the arm of a couch. as long as nothing is under your knee. Do this every hour for 3-10 minutes.