Patients are given a complete physical examination which provides an assessment of the patient's overall health.
An examination is given of the range of movement in both the injured and uninjured knee.
Strength and walking (gait) ability is measured and analyzed.
Expectations for Recovery
Surgically treated cartilage damage, if rehabilitated properly, will allow the patient to eventually regain some strength, stability, motion and control of the knee.
Patients with more severe symptoms that require surgery can expect a lengthy recovery. The knee may be gradually re-introduced to activity after a month, but only to moderate capacity. Ongoing physical therapy combined with modifications made to athletic activities will likely be required for more than three months.
To help maintain a healthy knee, continued gentle use of the knee will be required, running or other impact producing activities should be kept to a minimum.
In all cases, physical therapy is required to restore the muscle strength, flexibility and stability lost after any surgical procedure associated with the knee.
Post Operative Recovery
Immediately after surgery, as anesthesia wears off, patients will usually feel tired and slightly disoriented, although the effects of anesthesia can vary greatly from patient to patient.
The knee will remain tender and painful after surgery. The most intense discomfort is felt in the first 24-48 hours, after which the pain generally steadily decreases.
At the first post-operative visit to the doctor, the sutures are removed, motion is examined, and the patient may be directed to a physical therapist.
Braces are usually prescribed when patellar malalignment is present, to provide the patient greater control of the knee.
Close examination of the knee during the following four to six weeks is needed to ensure that the knee is healing correctly.
Some athletic activities like jogging are occasionally allowed after three months, though often only in a controlled environment such as on a treadmill.
Sport-specific exercises are allowed according to their intensity level and strain on the recuperating knee.
Post Operative Instructions
If the surgeon has prescribed a brace, wear the brace at all times, except when bathing or showering.
Bear weight as tolerated in the brace with the knee locked in full extension.
Use crutches as needed.
Ice the knee three times a day for 20 minutes.
Keep the wound dry. The dressing can be removed for showering (with the knee wrapped in plastic kitchen film) as directed by your surgeon.
Three times a day, for 30 minutes each time, sit with a large towel roll under the heel with the brace locked in full extension.
It is normal to have some discomfort and swelling, as well as some blood-tinged drainage, following surgery. If this becomes severe or the patient develops a fever, calf pain, shortness of breath or chest pain; contact a doctor immediately.
Medication and Medical Products
NSAIDs NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
Pain resulting from inflammation or swelling.
Pain after injury.
Joint pain and arthritis.
Knee: Cold Therapy Cold therapy is used to reduce pain and swelling and is a convenient method to apply cold to an injured or rehabilitating extremity, such as a knee or shoulder. A cuff fits like a sleeve around the extremity and utilizes cold water supplied by a connected thermos or canister to chill the extremity. Water flow into the cuff can be controlled by different mechanisms. The simplest way is gravity; elevating the canister fills the cuff and controls the amount of pressure against the extremity. Water flow may also be controlled by a pump which will automatically circulate the cold water to and from the cuff. After surgery or immediately following an injury, the canister should be refilled with cold water every one to two hours to maintain a proper temperature. The cold therapy may also be used during rehabilitation, especially after physical activity, reducing the inflammatory heat from exercise.
Cold therapy can be used to treat:
Knee, Shoulder, Elbow, Wrist and Hand, Back, Hip, and Foot & Ankle Injuries.
Knee Examples include:
Pre-operative ACL/PCL injuries.
Non-surgical ACL/PCL injuries.
General knee pain or swelling.
Soft tissue injuries.
Possible Complications and Risks
Risks during and after surgery include the possibility of infection and reactions to anesthesia.
Re-injury to the cartilage is possible if physical therapy or other activities during rehabilitation are overly strenuous, causing further damage to the area surrounding the cartilage defect.
The repaired cartilage structure is not as durable or long lasting as the body's natural cartilage.
