Please see immediate post-op instruction sheet that Dr Borque will give to your family member or whomever is accompanying you the day of surgery. This will give you your weight bearing status, motion restrictions, brace parameters, and date of your first therapy visit.
Dressing and Wound Care
- It is not uncommon to have a small amount of bloody drainage on the dressing within the first 48 hours after surgery. This typically does not require treatment and should not cause concern unless it is expanding.
- You may remove your dressing in 24 hours, unless instructed otherwise. Please leave the Steri-Strips in place and do not place any antibacterial ointment over the wounds. You may cover with regular band aids if desired. No further dressings are necessary unless there is persistent drainage. Please bring thigh high TED stockings to your first PT visit. Your physical therapist will help you put these on. You will wear this for 2 weeks to help keep the swelling down and protect against developing blood clots.
- For the first 3 days, in the shower please cover your wounds with a plastic bag in order to keep it dry. You may get the wounds wet after 3 days, but do not scrub the wounds for 2 weeks and do not submerge underwater in a bath tub, hot tub, or swimming pool for at least 3 weeks. Pat dry with a towel afterwards.
Achieving Full Extension / CPM Machine
- Achieving full extension is the most important goal immediately after surgery. Beginning the night of, or the day after surgery, begin knee extension exercises by firing the quad muscle to drive the back of the knee into the bed and hold it or 3 seconds. Do sets of ten and do as many of sets daily as you can.
- Physical therapy will start within 3 days of surgery, ideally post op day 1. This will be arranged when your surgery is scheduled. If 3 days before your surgery, you have not been notified of your physical therapy appointment, please contact Dr. Borque’s office.
- If Dr. Borque thinks you would benefit from a CPM machine, it will be ordered and it will be either given to you at the hospital or the technician will deliver it to your home. The technician will have instructions from Dr. Borque and will teach you how to use it. You should start using it the first day after surgery at the specified settings for a goal of 8 hours per day. You should increase the flexion 6 to 10 degrees each day, as tolerated. A representative will contact you at least 24 hours prior to surgery to set this up.
- At your first therapy session, your therapist will teach you how to mobilize your patella (knee cap). You should perform these daily to prevent scar tissue developing under the knee cap.
Swelling Control
- Swelling is common after any injury or surgical procedure. Decreasing swelling through elevation ABOVE your heart, AND avoidance of activity is the key to success.
- Swelling control is also very important for muscle (quadriceps) and motion recovery. Minimizing quadriceps atrophy is very important for the recovery of your knee.
- We recommend use of a Game Ready cold compression machine. This is what is typically used by professional athletes after ACL surgery to help minimize swelling and stimulate recovery. A representative will contact you prior to surgery to get this to you. It is normally not covered by insurance but is a good investment. If you decide not to get this the representative can guide you to other cryotherapy options.
- You may begin elevating your surgical site ABOVE your heart with pillows and use an ice pack if you decide against the other cold therapy options mentioned above. If using ice please be careful not get your dressing wet. When elevating, please try to keep the pillows under your heel (rather than your knee) as much as possible while this is less comfortable, it helps achieve full extension of the most important goal in the first 2 weeks post-operatively.
- If the swelling becomes so large that the dressing begins to become tight, then please loosen the outer layer covering your wound so you can fit at least two fingers underneath it.
- If your swelling is still not decreasing with the instructions listed above and you are experiencing severe pain at the site of swelling then please call us immediately.
Diet
- There are no specific restrictions on your diet after surgery, however, it is prudent to start with clear liquids and advance to solid food as you are able.
- Be sure to drink plenty of liquids and avoid alcohol the evening of surgery.
Activities
- Your knee was injected with numbing medicine at the conclusion of your surgery, this will last 8-12 hours, please rest the first 2-3 days after surgery.
- You will be in a brace for a minimum of 6 weeks after surgery. The brace should be worn to bed for at least the first four weeks.
- For the first 4 weeks, the brace must be locked straight any time you are walking around.
- You can weight bear as tolerated (with crutches), but only with the knee fully straight.
- Do not engage in activities which increase pain or swelling in you affected joint.
- Return to school 2 to 3 days after surgery; return to work depends on your type of employment.
Additional factors
- PLEASE GO TO EMERGENCY ROOM IF: you experience shortness of breath, chest pain, loss of consciousness, severe pain that cannot be controlled with the medication given to you, excessive bleeding that cannot be controlled, or inability to urinate.
- Some people do experience a sore throat after surgery along with a minor form of laryngitis, this is most likely due to anesthesia using a tube to help you breathe during surgery. If you do become concerned about your sore throat or feel as though this might be a new sickness please inform your primary care physician.
For any questions or concerns please contact Ashley, Dr. Borque’s assistant, at 281-275-0580.