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POSTOPERATIVE INSTRUCTIONS – PATELLAR REALIGNMENT

Post- op

– Ambulation locked at 0 for 6 weeks

– Early PROM with CPM up to 90 deg.

– MPFL: limit CPM flexion to less 20 deg.

– Early Quad sets and SLR

– Weight bearing as tolerated

7 weeks
– Shields brace
– Zero ROM restrictions
– Quad sets/SLR
– Wean off brace / crutches
 
BRACE/MOVEMENT
You can walk with the brace locked in extension with full weight.  Have the brace locked in extension while ambulating until your follow-up visit.  Use your crutches for stability.  Do not go for long walks or stand on your feet for extended periods of time.  This will cause swelling and pain. Wear the brace at all times when not icing or bathing.  While at rest you can bend your knee as tolerated with assistance.
 
ICE
An ice machine will be provided to you prior to your surgery.  This will help decrease swelling and pain after your surgery.  Use the ice machine as much as possible when you get home at intervals of 20 minutes on and off.  You should keep the ice machine for approximately two weeks.  Do not use the ice machine while you are sleeping.
 
If you did not receive an ice machine – you should use ice packs over the surgical site regularly throughout the day.
 
In addition to icing your knee, elevate your knee so that your toes are above your nose.  This elevates your knee above your heart and will help reduce swelling.
 
MEDICATIONS
If you were given a nerve block for anesthesia, it will wear off over 18-24 hours. During this time you will have little to no feeling in the body part where you had surgery (i.e. leg).  To control your pain during this transition while the nerve block is wearing off, you are to eat first and then begin taking the pain medication (e.g. Vicodin, Percocet, etc) immediately when you get home from surgery.  This will prevent you from having severe pain. Take the pain medication every 4 hours until you go to bed.
 
You have been given an antibiotic medication – please take this as prescribed until completion of the medication.
 
Please take 325mg of Aspirin daily for the first two weeks after surgery.
 
A sleeping medication (e.g. Ambien) is also provided to help you sleep at night. Take one tablet 30 minutes before you plan to sleep.
 
DRESSING/BANDAGES
Keep your surgical dressing clean and dry.  Do not remove your dressing until your first post-operative visit. You may take a shower with a plastic bag over your leg to keep the dressing clean and dry.
 
Do not take a bath or submerge your knee in water until your incisions are checked at your first post-operative visit.
 
TEMPERATURE
It is normal to have an elevated temperature during the first 2-3 days post-operatively.  Please call our office if your temperature is above 101oF, if there is increased redness around the incision sites, or if there is increased drainage from the incision sites.
 
APPOINTMENT
Please call the office prior to, or immediately following, your surgery in order to schedule a post-operative appointment.  This should be scheduled 7-10 days after surgery.  At that visit your stitches will be removed and you will be given a prescription for physical therapy.