Postoperative Anterior Cruciate Ligament Reconstruction Care WITH meniscus repair:

Transcription

1 Pstperative Anterir Cruciate Ligament Recnstructin Care WITH meniscus repair: 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: - D nt put weight n yur leg until ntified by physician. Brace: - Please refer t handut r website fr hinged knee brace use. - Yu will be prvided a hinged knee brace either befre r after surgery - The brace shuld be left n and LOCKED with knee in full extensin until yur appintment with Dr. Witty. This includes sleeping. - The brace may be remved nly fr shwers. Keep the knee straight while in shwer. - The brace may have the straps released (see image belw) t let the knee breathe, but the knee shuld remain straight while ding this. - 1

2 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 8 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. 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 an ice pack as much as pssible fr 3 days t help minimize pain and swelling after surgery. After 3 days, try t apply the ice pack fr abut 30 minutes t an hur when yu experience pain. 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) 2

3 - If yu begin t have painful swelling, redness, temperature greater than 100.4, r drainage frm yur incisin, call Dr. Witty s ffice immediately. 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. Yu may r may nt have a brace applied. 3

4 Jeffrey B. Witty, M.D. - - This can be remved 3 days after surgery. Simply unwrap the bandage. Underneath will typically be sme padding material and underneath that material will be gauze like material. Yu may see sme bld n the bandages. 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 a 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 left in place if they are stuck t the skin and d nt peel ff easily. 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. Yu may als use absrbent adhesive dressings and re-wrap with the ACE r the cmpressin stcking. 6

7 - 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 even if it is stuck t the skin. 7

8 Exercises: Refer t drjeffreywitty.cm under Patient Educatin Vides t see demnstratins f the exercises belw. - The fllwing simple exercises can be started immediately (same day) after surgery. These shuld be dne while lying n a bed r seated n the flr. Heel prp Twel stretch fr extensin Quad sets Ankle pumps Calf stretches 1) Heel Prp a. Prp blster/bump underneath ankle t allw gravity t pull knee straight b. Blster/bump can be made f anything sft, but shuld allw the ankle t be high enugh t allw the knee t fall int extended (straight) psitin c. This may be perfrmed as much and as alng as patient cmfrt allws i. Gal fr at least 5 10 times per day fr abut 5 minutes each time ii. In additin, whenever the patient is sitting, the patient shuld be perfrming the heel prp as described abve. 8

9 2) Twel stretch fr extensin a. Use a twel r sheet that is lng enugh t reach the sle f the ft b. Place a hand just abve the knee cap c. While the hand hlds dwnward pressure stabilizing the knee, pull back n the twel t stretch the knee straight d. Mst peple will have sme degree f hyperextensin. This exercise allws the patient t regain that mtin e. Perfrm at least 10 sets f 10 repetitins 5 10 times per day and hld fr 5 10 secnds each time 9

10 3) Ankle Pumps a. Drsiflex (pull ankle and ft tward yur head) and plantarflex (push ankle and ft away frm yur head) b. Hld fr a few secnds befre mving ft the ther directin. c. D this exercise whenever yu are perfrming the ther exercises 4) Quadriceps sets a. Perfrm in seated psitin b. Keep perative leg straight and tighten thigh muscles s that the back f the knee is pushed dwn int the flr, bed, r table. c. Perfrm 4 5 times a day and wrk up t 100 repetitins by the end f the day 10

11 Jeffrey B. Witty, M.D. Crutches r ther assistive devices: - Please review the fllwing resurce regarding the apprpriate use f crutches and walking aids. This dcument is als available t dwnlad frm ur website. Shwering: - If weight-bearing is restricted, a shwer chair r similar will be necessary. - If nt, a chair r similar may be needed fr safety if yu are still unsteady with yur balance. - Only start shwers nce yur dressings have been dry fr a 24 hur perid. D NOT sak in the bath until cleared by physician. 11