Post-operative recovery related questions?
Hello Doctor: Three years ago, I injured my knee while playing basketball, and after initially undergoing conservative treatment, I chose to have surgery for reconstruction due to persistent weakness in my leg.
This year, I have been experiencing pain on the right side of my right knee, which escalates to weakness, swelling, and severe pain that prevents me from bending my knee.
Initially, I would go to a small clinic for aspiration and physical therapy with heat treatment and pain medication.
However, in the past six months, the frequency of these issues has increased, affecting my daily life and work, so I went to Cheng Kung University Hospital for an examination.
The doctor determined that there is instability in the lateral collateral ligament of my knee, which is causing these symptoms.
I am scheduled for surgery at the end of this month, and I would like to ask the doctor how I can prepare myself to be able to walk independently after the surgery, as I have a very important job in March.
What rehabilitation exercises should I follow, and how should I care for my knee in the future? Thank you, Doctor.
Mr. Wang, 20~29 year old female. Ask Date: 2021/01/22
Dr. Shi Guozheng reply Orthopedics
Before the surgery, it is advisable to perform strength training for the right knee joint, typically focusing on the quadriceps through flexion and extension exercises to enhance muscle strength.
After the surgery, it is essential to follow the physician's instructions for rehabilitation therapy, while also taking care to avoid re-injury.
Reply Date: 2021/01/22
More Info
Post-surgery recovery after knee reconstruction, particularly following an ACL (anterior cruciate ligament) injury, is a critical phase that requires careful planning and adherence to rehabilitation protocols. Given your history of knee instability and the upcoming surgery, here are some comprehensive tips and guidelines to help you navigate your recovery effectively.
Immediate Post-Surgery Care
1. Rest and Elevation: After your surgery, it is crucial to rest your knee and keep it elevated to reduce swelling. Use pillows to prop your leg up while sitting or lying down.
2. Ice Therapy: Apply ice packs to your knee for 15-20 minutes every few hours during the first few days post-surgery. This will help manage pain and swelling.
3. Pain Management: Follow your physician's recommendations for pain management. This may include prescribed medications or over-the-counter pain relievers. It’s important to manage pain effectively to facilitate participation in rehabilitation.
4. Wound Care: Keep the surgical site clean and dry. Follow your surgeon's instructions regarding when to change dressings and how to care for the incision.
Rehabilitation Timeline
1. Initial Phase (Weeks 1-2): Focus on gentle range of motion exercises. You may start with passive movements, where you or a therapist help move your knee. Aim for flexion and extension within a pain-free range.
2. Weight Bearing: Depending on your surgeon's advice, you may begin partial weight-bearing activities using crutches or a walker. Gradually increase your weight-bearing as tolerated.
3. Physical Therapy: Engage in physical therapy as soon as it is safe to do so. A physical therapist will guide you through exercises tailored to your recovery stage, focusing on regaining range of motion, strength, and stability.
Key Exercises
1. Quadriceps Sets: Tighten your thigh muscle while keeping your leg straight. Hold for a few seconds and release. This helps strengthen the quadriceps without moving the knee.
2. Heel Slides: While lying down, slide your heel towards your buttocks, bending your knee as much as possible. This promotes flexibility.
3. Straight Leg Raises: While lying down, keep one leg bent and the other straight. Lift the straight leg to the height of the bent knee, hold for a few seconds, and lower it back down.
4. Balance Exercises: As you progress, incorporate balance exercises to enhance stability. This can include standing on one leg or using a balance board.
Long-Term Care and Maintenance
1. Continued Physical Therapy: After the initial recovery phase, continue with physical therapy to build strength and improve function. Your therapist will introduce more advanced exercises as you progress.
2. Home Exercise Program: Develop a home exercise program to maintain strength and flexibility. Consistency is key to preventing stiffness and promoting healing.
3. Listen to Your Body: Pay attention to pain signals. If you experience increased pain or swelling, it may be a sign to modify your activities or consult your healthcare provider.
4. Gradual Return to Activities: Once cleared by your surgeon and therapist, gradually return to sports and physical activities. Start with low-impact exercises and progressively increase intensity.
5. Long-Term Joint Health: Maintain a healthy weight, engage in regular low-impact exercise (like swimming or cycling), and consider dietary supplements that support joint health, such as glucosamine and chondroitin, if recommended by your healthcare provider.
Conclusion
Recovery from knee reconstruction surgery is a gradual process that requires patience and dedication. By following these guidelines and maintaining open communication with your healthcare team, you can optimize your recovery and return to your daily activities, including basketball, with confidence. Remember, every individual's recovery timeline may vary, so it's essential to tailor your approach based on your specific circumstances and medical advice.
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