Initial Postoperative Knee Care Patella or Quadriceps Tendon Repairs: - Videos are available on Dr. Witty s website: drjeffreywitty.

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1 Initial Pstperative Knee Care Patella r Quadriceps Tendn Repairs: - Vides are available n Dr. Witty s website: drjeffreywitty.cm Imprtant Phne Numbers: - Please see the cntact infrmatin abve fr imprtant phne numbers t call. - If yu have cncerns after hurs, please call the After hurs number t reach ur n-call services. Physician Fllwup: - Appintments fr pst surgery fllwup can be made ne f tw ways. Either call the day phne number abve t make an appintment with the dctr yurself. The nursing staff at ur facility can make the appintment fr yu The time t yur first fllwup will be cnfirmed prir t leaving fr the day. Weightbearing: - Yu may put weight dwn n yur leg. - The leg must remain cmpletely straight, with the brace lcked with the knee in the straight psitin, and the ft shuld be in a level psitin with the flr. Wund Care and Dressing Change: - Yu will typically have a large tan/brwn clred ACE type f wrap arund the leg frm the ft t the thigh. In sme cases yu may have a stcking instead. There will be a brace n yur leg. 1

2 - This can be remved 3 days after surgery. - In rder t get the dressings ff, yu will have t remve the brace. - TO REMOVE THE BRACE: Keep knee straight and the extremity flat n the table r flr. Simply unclick the buckles alng the frnt f the brace. There are usually 4 ttal. See the image abve. Open the brace up. Yu can then slide / push the brace ut frm under the leg while keeping the knee cmpletely straight and withut lifting ff the surface. 2

3 Anther ptin t remve the brace is t have smene lift the leg by the ft t keep the knee cmpletely straight. YOU MUST NOT MAKE ANY ATTEMPT TO HELP THE ASSISTANT. Yur quadriceps muscle (large muscle n frnt f thigh) must be cmpletely relaxed. Yu can lk and feel the muscle t check this. - Mve the leg t a sturdy surface and prp it up by the lwer half f the leg/ankle/ft s that the knee is kept cmpletely straight. Leave enugh rm t remve the brace and unwrap and change dressings. TO UNWRAP DRESSINGS: Nte that any lifting f the leg ff the table r ther surface will activate yur quadriceps muscle which will in turn stress the repair f the quadriceps r patella tendn Yu can either cut the dressings ff by running sissrs directly dwn the frnt f the leg, r yu can take them ff by pushing them underneath the extremity as yu unwrap them. 3

4 - Underneath will typically be sme padding material and underneath that material will be gauze like material. 4

5 - Underneath the gauze will be either small tape like dressings called Steristrips r yu will see the incisin and any sutures / skin clips themselves. - There may be thin, yellw gauze directly n the surgery incisin. 5

6 - Incisins are typically clsed with metal skin clips, nn-absrbable (nndisslving sutures), r absrbable (disslving) sutures. - The first time yu remve the dressings, the Steri-strips r the yellw gauze may be stuck t the skin and d nt peel ff easily. These can be left in place. They will eventually fall ff. Change yur dressing nce a day with 4 inch by 4 inch gauze and re-wrap the ACE bandage r reapply the stcking ver the gauze. - TO REPLACE DRESSINGS: Keep yu extremity flat and straight n the flr r table. Place the new gauze n tp f the incisin. Pull the stcking up the leg and ver the gauze while keeping the extremity still and cmpletely straight. This is t avid activating and tensining the tendn that was repaired during surgery. Yu may als use an ACE bandage and wrap arund leg in a reverse manner frm when yu remved it the first time. 6

7 If yu have prpped the leg (as described abve) with an assistants help, yu shuld have enugh rm t wrk arund the leg with the ACE r t slide n the cmpressin stcking - TO REPLACE THE BRACE: NOTE: G t t see a cmplete vide f the details f the ROM brace. If this is nt yur 7

8 brace, keep in mind that mst braces have similar cmpnents that d the same thing. See general instructins belw. Slide the brace back underneath the leg while keeping the knee cmpletely straight. Re-hk the buckles. Make sure the side supprting bars are directly alng the mid-thigh and leg area Make sure the gears n the dials alng the inside and utside f the brace line up with the knee at abut the level f the kneecap. 8

9 Make sure the brace is then LOCKED in the fully straightened psitin. Nte the clsed lck n the dial f the brace. Yu will be instructed n when t start t pen the brace fr mre mtin. 9

10 Yu will click the switch t unlck when yu have been cleared t start knee mtin. - Yu may stp the dressing changes nce the gauze has n sptting r drainage n it fr a 24-hur perid. Yu may remve the Steri-strips r the yellw gauze at this time. Nerve Blck Infrmatin: - The anesthesia team may have placed a nerve blck prir t surgery - A nerve blck is a prcedure where numbing medicatin is injected arund the nerves that travel t yur knee. - It shuld prvide 6 12 hurs f relief. During that time, the knee may feel numb and yu may even be unable t mve the extremity. - Start taking yur pain medicatin immediately when yu start t feel any pain even if it is minimal. - Mnitr yur skin clsely and place a twel between the skin and any ice pack t avid frst bite. This is imprtant when the blck is wrking because yu will nt be able t feel anything. 10

11 Recvery at Hme: - If yu are discharged the day f surgery, the first meal at hme shuld be clear liquids. Slwly increase t ther easily tlerated meals (ex. rice cakes, sup) t prevent any nausea. Taking yur pain medicatin with sme fd may help. - If yu have received a nerve blck, it will ften begin t wear ff later in the evening. Take the pain medicatin right when yu begin t feel any pain. (See Nerve Blck sectin belw) - Apply the ice pack 30 minutes n and 30 minutes ff t help minimize pain and swelling. Because yu may nt be able t feel hw cld the skin is getting, please remember t check the skin ften while the nerve blck is in effect. It is cmmn t use the ice packs fr the first few mnths after surgery when the knee gets sre, especially after therapy. - Ice therapy has been shwn t be as effective as narctic pain medicatin s it is an imprtant additin t the pst-perative regimen. If yu have a specialized ice and cmpressin machine, use per instructins prvided by the device representative. - Try t get up and mve arund as much as pssible using crutches. - Prp yur leg up by placing a bump f pillws r similar underneath the calf, ankle, r ft area. This will help gravity pull yur knee straight. This can be dne in r ut f the brace. (See belw) 11

12 - If yu begin t have painful swelling, redness, temperature greater than 100.4, r drainage frm yur incisin, call Dr. Witty s ffice immediately. Shwering: - Yu may take yur first shwer nce the wunds have been cmpletely dry fr a 24-hur perid. - Yu may let the water run ver the incisin. Be sure t dry thrughly by lightly pressing with a clean cttn twel. DO NOT RUB the incisin t dry it. - Use f a shwer chair is recmmended after this surgery t yu can sit cmfrtably and prp ft n flr t keep yur knee cmpletely straight. Sit twards frnt edge f chair s that yu whle leg and knee can remain straight. - Only start shwers nce yur dressings have been dry fr a 24-hur perid. D NOT sak in the bath until cleared by physician. 12