Post-op Instruction for Cartilage Restoration Procedures

Diet

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

Wound Care

Maintain your operative dressing, loosen bandage if swelling of the foot or ankle occurs
It is normal for the knee to bleed and swell following surgery – if blood soaks onto the bandage, do not become alarmed – reinforce with additional dressing
You may shower on postoperative day #3. Remove the ACE bandage and all of the gauze pads. Place waterproof band-aids over incision areas. Be careful not to slip and fall – try and keep the knee straight. Do not scrub over the surgical incisions – use soap on your thigh and let the soapy water run over your knee. Pat the knee dry with a towel and apply new waterproof bandaids over the surgical incision. Reapply the ACE bandage (snug not tight) – no need to reapply the gauze pads.

DO NOT submerge the incision in water (i.e. NO bath, hot tub or pool, etc) *Brace may come off to shower

Medications

Pain medication is injected into the wound and knee 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
Primary Medication = Percocet
- Take 1 – 2 tablets every 4 – 6 hours as needed
- Do not take more than 10 pills per day
- Plan on using it for 2 to 5 days, depending on level of pain
- Do NOT take additional Tylenol (Acetaminophen) while taking Norco, Vicodin or Percocet
For larger surgeries, some patients will also be prescribed Oxycodone (5mg) to be used for breakthrough pain
- Take 1 – 2 tablets every 4 – 6 hours as needed
- If given Oxycodone, this should be used as a supplement during the first few days after the Surgery. As the pain level improves you should transition to just Percocet medication for residual pain.
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 such as prune juice, Senekot, Colace (or Periocolase), or Miralax
For nausea, take the prescribed Zofran as needed
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 400-600mg (i.e., Advil, Motrin, Aleve) may be taken in between the narcotic pain medication to help smooth out the postoperative “peaks and valleys”, reduce overall amount of pain medication required, and increase the time intervals between narcotic pain medication usage

Activity

DO NOT PUT ANY WEIGHT on the Operative Leg
Elevate the operative leg to chest level whenever possible to decrease swelling
Place pillows under foot/ankle to elevate leg (i.e., do not maintain knee in a flexed or bent position)
Use crutches to assist with walking
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
May return to sedentary work ONLY or school 10-14 days after surgery, if pain is tolerable

Ice Therapy

Begin immediately after surgery
Use icing machine continuously or ice packs (if machine not prescribed) every 2 hours for 15 to 20 minutes daily until your first postoperative visit
Motion Medical Ice Machine “Gameread”/Vasothermic device may be used.
- Use unit as frequently as tolerated x 14 days
- Unit is programmed hour on/hour off continuous of compression and ice alternating
- If braced* – Loosen brace to avoid added pressure
- If issues with Vasothermic device, please contact the distributor or Dr. Campbell’s office at NYU Langone Seaport Orthopaedics or at the NYU Center for Musculoskeletal Care at 646-356-9407 based on the location that you have your regular office visits.

Exercise

Begin exercises 24 hours after surgery (Quad sets and ankle pumps) unless otherwise instructed
Range of Motion Continuous Passive Motion (CPM) Machine for 6-8 hours per day for 6-8 weeks
- Set CPM to 1 cycle per minute – starting at 40°of flexion
- Advance 10° per day until full flexion is achieved (should be at 100° by week 6)
Discomfort and knee stiffness is normal for a few days following surgery
Complete exercises 3-4 times daily until your first postoperative visit
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 postoperative visit and you will be given a script for this at that time

Emergencies

Contact Dr. Campbell’s office at NYU Langone Seaport Orthopaedics ; or at the NYU Center for Musculoskeletal Care at 646-356-9407; or the HJD Sports Medicine Clinic on 23rd Street at 212-598-6321 or 212-598-6322 based on the location that you have your regular office visits, if any of the following are present:

Painful swelling or numbness
Unrelenting pain
Fever (greater than 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, hand or lower extremity
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, call for Seaport Office or 646-356-9407 for NYU Center for Musculoskeletal Care office and you will be connected to our page service – they will contact Dr. Campbell. Please Do NOT call the hospital or Surgicenter.

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

Follow-Up Care/Questions

Dr. Campbell will call you on your first day after surgery to address any questions or concerns. If you have not been contacted within 48 hours of surgery, please email Dr. Campbell or call directly (NYU Langone Seaport Orthopaedics ; or at the NYU Center for Musculoskeletal Care at 646-356-9407; or the HJD Sports Medicine Clinic on 23rd Street at 212-598-6321 or 212-598-6322 based on the location that you have your regular office visits)
If you have additional questions that arise at any time, please send an email to Dr. Campbell for the fastest reply [javascript protected email address] . If email is not an option please call the office.
If you do not already have a postoperative appointment scheduled, please contact the scheduling office during normal office hours to make a follow-up appointment.