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Microfracture of Patella / Trochlea

 

1. DIET

  • Begin with clear liquids and light foods (jellos, soups, etc.)
  • Progress to your normal diet if you are not nauseated

2. WOUND CARE

  • Maintain your operative dressing, loosen bandage if swelling of the foot and ankle occurs
  • It is normal for the knee to bleed and swell following surgery – if blood soaks onto the ACE bandage, do not become alarmed – reinforce with additional dressing
  • Remove surgical dressing on the third post-operative day – if minimal drainage is present, apply band-aids or a clean dressing over incisions and change daily – you may then shave as long as the wounds remain sealed with the band-aid
  • To avoid infection, keep surgical incisions clean and dry – you may shower by placing a large garbage bag over your brace starting the day after surgery – NO immersion of operative leg (i.e. bath)

3. MEDICATIONS

  • Pain medication is injected into the wound and ankle joint during surgery – this will wear off within 8-12 hours
  • Most patients will require some narcotic pain medication for a short period of time – this can be taken as per the directions on the bottle
  • Common side effects of the pain medication are nausea, drowsiness, and constipation – to decrease the side effects, take medication with food – if constipation occurs, consider taking an over-the-counter laxative
  • If you are having problems with nausea and vomiting, contact the office to possibly have your medication changed
  • Do not drive a car or operate machinery while taking the narcotic medication
  • Ibuprofen 200-400mg (i.e. Advil) may be taken in between the narcotic pain medication to help smooth out the post-operative ‘peaks and valleys’, reduce overall amount of pain medication required, and increase the time intervals between narcotic pain medication usage

4. ACTIVITY

  • Elevate the operative leg to chest level whenever possible to decrease swelling
  • Do not place pillows under knees (i.e. do not maintain knee in a flexed or bent position), but rather place pillows under foot/ankle
  • Use crutches to assist with walking – you are not to bear more than 50% of your weight on the operative leg unless otherwise instructed by the physician. No squatting >90°
  • Do not engage in activities which increase knee pain/swelling (prolonged periods of standing or walking) over the first 7-10 days following surgery
  • Avoid long periods of sitting (without leg elevated) or long distance traveling for 2 weeks
  • NO driving until instructed otherwise by physician
  • May return to sedentary work ONLY or school 3-4 days after surgery, if pain is tolerable

5. BRACE (IF PRESCRIBED)

  • Your brace should be worn fully extended (straight) at all times (day and night – except for exercises) until otherwise informed by the physician after first post-operative visit
  • Remove brace for flexion (bending) and other exercises done in a non-weight bearing position (i.e. lying or sitting)

6. ICE THERAPY

  • Begin immediately after surgery
  • Use icing machine continuously or ice packs (if machine not prescribed) every 2 hours for 20 minutes daily until your first post-operative visit – remember to keep arm elevated to level of chest while icing

7. EXERCISE

  • Begin exercises 24 hours after surgery (straight leg raises, quad sets, heel slides, and ankle pumps) unless otherwise instructed
  • Discomfort and knee stiffness is normal for a few days following surgery – it is safe and, in fact, preferable to bend your knee (unless otherwise instructed by physician)
  • Complete exercises 3-4 times daily until your first post-operative visit – your motion goals are to have complete extension (straightening) and 90° of flexion (bending) at your first post-operative visit unless otherwise instructed
  • Do ankle pumps continuously throughout the day to reduce the possibility of a blood clot in your calf (extremely uncommon)
  • Formal physical therapy (PT) will begin after your first post-operative visit

8. EMERGENCIES

Contact Dr. Waterman or his nurse at 336-716-8091 if any of the following are present:

  • Painful swelling or numbness
  • Unrelenting pain
  • Fever (over 101° – it is normal to have a low grade fever for the first day or two following surgery) or chills
  • Redness around incisions
  • Color change in wrist or hand
  • Continuous drainage or bleeding from incision (a small amount of drainage is expected)
  • Difficulty breathing
  • Excessive nausea/vomiting
  • **If you have an emergency after office hours or on the weekend, contact the same office number (336-716-8091 and you will be connected to our page service – they will contact Dr. Waterman or one of his fellows if he is unavailable. Do NOT call the hospital or surgical center.

**If you have an emergency that requires immediate attention, proceed to the nearest emergency room.Post-Op Instructions

PT Protocols

 

At a Glance

Dr. Brian Waterman, MD

  • Chief & Fellowship Director, Sports Medicine, Wake Forest
  • Team Physician, Wake Forest University, Chicago White Sox
  • Military affiliation/Decorated military officer and surgeon
  • Learn more

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