POST-SURGICAL GUIDELINES: GENERAL


Icing & Elevation:

•    Ice and elevate above the level of the heart regularly throughout the day and night
     Can use the ice machine or other icing agents 20 mins. on/ 40 mins. off,  with a
     pillow case or other thin barrier between skin and ice pack to avoid skin irritation
•    Immediately post-op with gauze dressing still on: OK to leave ice machine on
     constantly as the dressing will provide a strong buffer against the cold


Weight Bearing:

•    Progress to weight bearing as tolerated.  Use the crutches to assist your walking and
     wean off after one week or longer when you can walk without a limp
•    Use crutches (or crutch) for 1 week post-op to control swelling and inflammation no
     matter how well you’re walking


Activity Level:

•    Minimize walking and standing for the first week to minimize swelling and
     inflammation.  Swelling will lead to pain, stiffness, muscle shutdown and increased
     scar tissue formation.  Spend more time icing and elevating
•    Take it easy; you just had surgery
•    Avoid impact and twisting of the knee for 4 weeks


Stretching and Strengthening Exercises:

•    See the illustrated exercise handout from your Physical Therapist for these.
•    Should have full knee extension equal to opposite side by Day 3 post-op
•    Make sure that you are on the prescribed pain medication schedule in order to better
     tolerate the exercises
•    Can perform upper extremities training and abdominal/back/trunk training
     immediately as tolerated
•    Can start well leg stationary biking immediately as tolerated
•    If you continue to improve each day and have no problems with swelling, you can
     ride a stationary bike with both legs beginning 1 week after surgery.  Start easy with
     light to no resistance for maximum 10 minutes and gradually progress day-by-day if
     your knee does not swell much and does not have increased pain by the next
     morning


Clinic Visits:

•    Day 8-10: for check-up and any suture removal
•    Month 1: check-up with Dr. Stone

Physical Therapy appointments should be initiated within 3 days post-op.



POST-SURGICAL GUIDELINES: EXERCISE

All exercises are to be done without increasing pain or swelling.

Week 1:

•    Open-chain exercises including leg raises
•    Well-leg biking
•    Upper body and trunk training
•    Gait training to normalize patterns
•    Standing calf raises
•    Weight shift in mutiple planes
•    "Seated or standing trunk mobility exercises (trunk rotation, sidebending)"
•    Single leg balancing
•    Bridging


Week 2-3:

•    Mini and split squats
•    Wide-based walks with theraband loop around ankle (Monster Walks)
•    Light 2-legged stationary biking with light or no resistance
•    Mini step-ups with perfect knee biomechanics
•    Single leg balancing with perturbation
•    Deep water work-outs. Flutter kicks
•    "Elliptical cardio machine (light resistance, no more than 20 minutes)"


Week 4:

•    Low impact lateral agility work
•    Functional squatting and lunging
•    Outdoor road biking--avoid steep hills
•    Moderate step-ups
•    "Train for components of sport-specific activities (e.g., lateral lunges for skiers)"
•    Progress intensity of exercises per patient and symptom tolerance
•    Versa climber cardio machine


Week 6 and Beyond:

•    Progressive return to sports activities
•    Avoid cutting and pivoting until week 8