Fellowship-Trained · Board Certified (ABOS) · Mako Robotics Certified · Cincinnati Reds Team Physician
Post-Operative Protocol
Arthroscopic Knee Surgery with Subchondroplasty
Post-operative recovery instructions from Dr. Pettit and team
Direct Line to Sandy Evans: 513-441-5639
Your surgical care team: Robert Pettit, MD — Orthopaedic Surgeon · Maria Dodd, PA-C — Physician Assistant, surgical & post-op care
Wound Care
- Remove dressing in 2 days, if sutures in place cover with bandaids
- You may shower in 2 days; be sure to pat the incision dry afterwards.
- Do not scrub the area; just allow water/soap to wash over you.
- Do not bathe or swim until approved by Dr. Pettit.
Ice
- We recommend that you use ice on a consistent basis for the first 24–48 hours. This will help reduce post-operative swelling. After that, use as necessary.
- Use a cloth between the ice and your skin. DO NOT place ice directly on skin as this may cause frostbite. Do not leave ice wrap or cold therapy on for more than 20 minutes without checking your skin.
Braces
- With a Knee Arthroscopy with subchondroplasty, typically, no brace is required. You will have a bulky dressing initially which can be removed after 2 days.
Crutches & Weight bearing status
- Following a Knee Arthroscopy with subchondroplasty, you will be weight bearing as tolerated (placing your foot on the floor using only as much weight as you feel comfortable placing) with crutches, to help with pain management and swelling.
- Be sure that you walk by placing your heel down first, then roll to the toe.
- When you can ambulate without a limp and feel comfortable, you can safely discard the crutches and walk unassisted.
Physical Therapy
- Formal physical therapy will be ordered in the form of a written prescription prior to your surgery. Following a Knee Arthroscopy with subchondroplasty you should start formal physical therapy within 1-5 days.
- Until you begin working with a therapist, you can do some exercises at home, such as: quad sets, leg raises, flexion and extension, and calf pumps (see pictures below). You may begin these exercises the day following your surgery.
Home Exercise Program
Quad Set Exercise
Tighten the muscles on top of the thigh as tightly as possible and hold.
Pull your toes back.
Push the back of your knee down to the floor.
Try to push out and up through the heel.
Pull 10 seconds, trying every second to pull even tighter.
Relax 5 seconds.
Repeat for 2 sets of ten times. Rest 60 seconds between sets.
Straight Leg Raise
Tighten the muscles on top of the thigh as tightly as possible and hold.
Raise the entire leg holding the knee as tight as possible. Hold 5 seconds.
Lower leg and rest 2 seconds.
Repeat for 2 sets of 10 times.
Rest 1 minute between sets.
Flexion and Extension
Sit on something high enough to keep foot off the floor.
Bend the knee as far back as possible.
Straighten knee as far forward as possible and hold it straight.
Then relax. (Like pumping on a swing.)
Repeat for 3 sets of 10 times.
Calf Pumps
Pointing the Feet:- Action
(Keeping your foot strictly in line with the ankle knee and hip joints): Point the foot away from you.
Repeat slowly, five to 10 times each foot.
Flexing Feet:- Action
(Keeping your foot strictly in line with the ankle knee and hip joints): Flex the foot, this time letting the heel push away from you, and the toe end of the foot come toward you.
Repeat slowly, five to 10 times each foot.
Heel Slides
Lie onto your back with both legs outstretched in front of you
Slowly, keeping your heel on the floor, slide your foot towards your backside
Go as close as comfortable, then stop
Keeping your foot on the ground, then slide your foot back out, straightening your leg slowly.
Repeat slowly, 5-10 times
Pain Control and Medications
You have been given a regional anesthetic block prior to your operation. This will wear off in the evening following your surgery.
- Pain Medication: Tylenol 1000mg every 8 hours and, unless discussed otherwise, you have been prescribed a narcotic pain medication (Oxycodone 5mg) to take every 4-6 hours as needed.
- DO NOT drive/use any heavy machinery, drink alcohol, make any life-changing or legal decisions (i.e. sign a will), or participate in activities that require a lot of physical skill, as narcotics may change your mental acuity. On rare occasions they may cause confusion or disorientation, we advise you to discontinue this medication should that occur.
- Narcotics can be addictive. Dispose of any excess medication at a police/fire station.
- Take a stool softener (e.g. Colace) while taking narcotic medication, as narcotics may cause constipation. If this does not help alleviate your constipation, you can try adding miralax or milk of magnesia. Please call our office if this regimen does not alleviate your constipation.
- If you have any questions or concerns about narcotic strength medications, please contact us.
- Journavx (suzetrigine): If Journavx has been prescribed, take it in place of the Oxycodone. Start with a loading dose of 100 mg (two 50 mg tablets), then take one 50 mg tablet twice a day (every 12 hours) for two weeks. If you are not getting adequate pain control with Journavx, you may take Oxycodone instead. Do not take Journavx and Oxycodone at the same time, and avoid grapefruit while taking Journavx.
- Anti-nausea: Zofran (Ondansetron): Take as prescribed if needed for nausea
- Anti-Inflammatory: Unless contraindicated due to other health reasons, you have been prescribed a non-steroidal anti-inflammatory drug (Ibuprofen 800mg) for use postoperatively. If you have no personal history of adverse response to anti-inflammatories (NSAIDs), take as prescribed every 8 hours with food to help reduce swelling and pain. Do not take other NSAIDs (Advil, Aleve, etc) with Ibuprofen.
- DVT prophylaxis: Please take one 81 mg baby Aspirin twice daily for 30 days following surgery to help minimize the risk of blood clot (extremely rare). If you are under age 16, unable to take aspirin for other medical reasons, or currently on anticoagulation, you do not need to take aspirin after surgery.
- Muscle relaxer: Flexeril (Cyclobenzaprine) for muscle spasms in quadriceps muscle. Take this as needed, it will make you drowsy.
Tylenol and Ibuprofen are the foundation for your pain control regimen
Example dosing: 1000mg Tylenol then 4 hours later 800mg Ibuprofen then 4 hours later repeat- every 4 hours alternate between Tylenol and Ibuprofen. Oxycodone as needed for breakthrough pain.
*You should not exceed 3,000mg of Tylenol or 3,200mg of Ibuprofen in 24 hours.
Driving
- In general, you can resume driving after 3-5 days after your operation, when you have full control of your arms and legs and you are pain free. Do not drive if you are still on narcotic medication.
Return to Work
- You may return to work as soon as you are comfortable and able to safely weight bear without crutches. This typically will occur 1–4 weeks post-op, depending on your job type. Return to work notes can be obtained at your first post-op appointment.
Follow-up Appointment
- Your first post-operative appointment will be scheduled 7-10 days following your surgical procedure. Typically dissolvable sutures are used during surgery, and do not need to be removed. If you do not have a post-operative appointment scheduled when you leave following surgery, please call 513-354-3700 confirm the appointment.
****Signs & Symptoms to Immediately Report****
Call 911 and go to the nearest hospital if you are having chest pain or trouble breathing
Call the Office at 513-354-3700 to Report Any of the Following
- Persistent fever (101 or greater)
- Sudden increase in pain and swelling
- Wound redness or drainage
- Increased skin temperature around incision
- Deep calf pain and swelling