I. Postoperative precautions: (excluding meniscus suture)
1. After surgery, cotton is retired, plaster is wrapped and braked, the lower limb is elevated with a quilt or pillow, and after anesthesia subsides, the toes as well as the ankle begin to move to promote blood circulation, prevent swelling, and reduce the formation of deep vein thrombosis in the lower limb. Elevate the affected limb for 2 to 3 days, and try to reduce the time and number of times the affected heel is below the abdomen. If the pain is not obvious, try to contract the quadriceps muscle (i.e. tensing and relaxing the muscles on the front side of the thigh). You can get out of bed with the help of crutches for moderate activities. Be careful of water or objects on the ground and take care to avoid slipping.
2, early should not walk too much, should not be walking as a practice method. Otherwise, it will easily cause bleeding and swelling in the joint, which will affect the functional recovery and tissue healing.
3.The doctor in charge of your bed will usually change your wound 3 to 5 days after surgery.
4.The stitches will be removed 10 days after surgery and you will be discharged from the hospital.
2.Post-operative rehabilitation training precautions: (excluding meniscus suture)
1. The methods and data provided in this plan are formulated in accordance with the general routine, and the implementation should be completed under the guidance of the doctor depending on your own conditions and surgery.
2. A certain degree of pain may exist in the early stage of functional exercises, which is unavoidable. If the pain can subside to the original level within half an hour after the exercise is stopped, it will not cause damage to the tissue and should be tolerated.
3, muscle strength exercises should be concentrated until the muscle has a sense of soreness and fatigue, and then proceed to the next group after sufficient rest. The number of exercises, time, load depending on their own situation, and should be practiced at the same time the healthy side. The improvement of muscle strength is a key factor for joint stability, and must be practiced carefully.
4, in addition to the surgical limb brake protection, the rest of the body parts (such as the upper limb, waist and abdomen, the healthy side of the leg, etc.) should be practiced as much as possible to ensure physical quality, improve the overall level of circulation and metabolism, and promote the recovery of the surgical local.
5, joint mobility (flexion, extension) exercises, only 1-2 times a day, and strive to improve the angle can be. In the early stage, repeated flexion and extension should be avoided and practiced several times to avoid swelling. If the flexion angle does not progress for a long time (>2 weeks), there may be joint adhesions, so great attention should be paid.
6.If the joint is swollen and painful after the exercise, ice should be applied for 20 minutes immediately. If you usually feel swelling, pain and fever in the joint, you can apply ice again, 2-3 times a day.
7. It is not advisable to walk too much in the early postoperative period, otherwise it may cause swelling and affect the functional recovery process.
8.The swelling of the joint will accompany the whole exercise process, and it is normal that the swelling does not increase with the increase of angle exercise and activity, until the angle and muscle strength basically return to normal swelling will gradually subside. The sudden increase of swelling should adjust the practice and reduce the activity, and in case of seriousness, timely follow-up should be made.
III. Postoperative rehabilitation plan: (excluding meniscus suture)
(i) Early period – inflammatory response period (0-1 week)
Purpose: Reduce pain, swelling; early muscle strength exercises; early weight bearing; early mobility exercises to avoid adhesions and muscle atrophy.
1. On the day of surgery.
After the anesthesia subsides, start to move the toes and ankle joint.
①Ankle pump – forceful, slow, full range of flexion and extension of the ankle joint, 5 minutes/group, 1 group/hour
② Quadriceps isometric exercises – i.e. thigh muscle tensing and relaxation. Should be done as much as possible without increasing pain.
③N rope muscle isometric exercise – the affected leg force down the padded pillow, so that the back of the thigh muscle tense and relaxation. The requirements are the same as above.
All exercises are done as much as possible without increasing pain!!!
You can walk on the ground with the help of crutches, but only to go to the toilet and other necessary activities.
2. 1 day after surgery.
①Continue the above exercises.
②change the ankle pump to anti-gravity exercises (can be assisted by others or hold the thigh by hand).
③Start straight leg lift – straight leg lift after knee extension until heel is 15M from the bed, hold until exhaustion.
④Start side leg raise exercise.
⑤ Weight-bearing and balance – Separate both feet under protection and move the center of gravity alternately from side to side within the range of slight pain. 5 min/time, 2 times/day. — Separate both feet back and forth and move the center of gravity. If the pain is not obvious, you can hold a single crutch, or no crutch.
3.3 days after surgery
Start flexion exercises, see notes for method. The pain should be slight, and the angle should be as large as possible.
4.4 days after surgery.
①Continue the above exercises.
②Start single-leg standing balance exercises for 5 minutes/time, 2-3 times/day.
③ Active knee flexion up to 70-80 degrees.
5. 5 days after surgery.
①Continue and strengthen the above exercises.
②Start active extension and flexion exercises in the range of 0-45 degrees in the standing position, but not against the wall. But not against the wall. 30 times/group, 2-3 groups/day, swelling and pain after the exercise, then ice.
6. 1 week after surgery.
① Active flexion greater than 90°.
②Can stand on one foot, can walk without crutches.
③Start half-squat exercises against the wall, 2-5 minutes/time, 3-5 times daily.
(ii) Mid-term: (2 weeks – 1 month)
Purpose: strengthen mobility and muscle strength exercises: improve joint control and stability; start to resume daily activities.
1. 2 weeks after surgery.
① Active flexion to 120-130°.
② Intensive muscle strength exercises. (straight leg lift up to 6 minutes)
③No obvious swelling, pain and instability of the joint, and can walk with normal gait.
④Start each muscle strength exercise under guidance: the load, angle, number of times and time of the exercise will be determined according to your condition. Generally 30 times/group, 2-4 groups/day.
2.3 weeks after surgery.
①Passive flexion to 140°.
②Strengthen muscle strength exercises.
③Start anterior-posterior and lateral striding exercises. Gradually increase the range, and gradually increase the load, 30 times/group, 4 groups/day.
(iii) Mid-term: (1 month-2 months)
Purpose: To strengthen the joint mobility to the same level as the healthy side. Strengthen muscle strength and improve joint stability.
Restore the ability to perform all activities of daily life.
1. 5 weeks after surgery.
①Active flexion up to 150°, and basically pain-free.
②Start single-leg half-squat exercises on the affected side at 45 degrees. 5 minutes/time, 4 times/day.
③Start stationary bicycle exercises. No load to light load. 30 minutes/time, 2 times/day.
2.6-8 weeks after surgery.
①Active flexion and extension angle reaches the same as the healthy side, and there is no pain.
②Can complete daily activities, such as walking up and down stairs, cycling, walking more than 5000 meters without swelling and pain in the joint.
③Start kneeling exercises.
④Start pedaling exercises.
(iv) Later period: (2 months-3 months)
Purpose: To fully resume daily activities, strengthen muscle strength and joint stability, and gradually resume movement.
① Start knee wrapping exercises.
② Start jump-up and jump-down exercises.
③Start lateral jumping exercises.
④Start swimming (breaststroke is prohibited in the early stage). Jump rope and jogging.
⑤ Athletes start special exercises for base movements.
Knee pads may be worn for protection if necessary, but only during strenuous exercise is recommended.
(v) Return to sports period: (after 3 months)
Purpose: Full return to sports or strenuous activities.
① Gradually resume strenuous activities or special training.
②Strengthen muscle strength, and stability of joints in running and jumping.
③Through the test, the affected muscle strength reaches 85% or more of the healthy side, then can fully resume sports.
Remark.
* Exercise methods for flexion.
Choose any one of the following methods. Once a day, strive for a slight increase in the angle can be. If you have any special discomfort during or after the exercise, you should inform the doctor in time.
The doctor. The exercise process should not be straightened to rest, repeated flexion and extension, otherwise it will affect the effect, and is very easy to cause swelling.
1. Patella release (1 week after surgery).
Push and hold the edge of the patella by hand and push the patella slowly and forcefully to the limit position in the up and down direction. 20 times in each direction, 2-3 times/day. This can be done before flexion exercises.
2. Sitting (or supine) leg drop.
Sitting on the side of the bed lying down, below the knee hanging outside the bed. Protected by relaxing the thigh muscles, so that the calf drops naturally, to the limit of protection
10 minutes. If necessary, add load to the ankle joint.
3.Supine leg drops.
Supine on the bed, thighs perpendicular to the bed, under the protection of relaxed thigh muscles, so that the calf drops naturally, the same requirements as above.
4.Sitting position “top wall”.
Sitting on the chair, the affected side of the toe top wall or fixed, slowly move the body forward to increase the bending knee angle, feel the pain and keep still, a few minutes after the pain disappears or lower, and then move forward to the limit. The whole process is controlled within 30 minutes.
5.Active flexion and extension exercises: (performed after passive flexion)
Sitting position, the foot does not leave the bed. Slowly and forcefully, flex the knee to the maximum, hold for 10 seconds and then slowly straighten. 10-20 times/group, 1-2 groups/day.
*Exercise method for straightening.
1.Active stretching: Active stretching straight at the limit hold for 10 seconds, relax for 5 seconds. 20-30 times/group, 1-2 groups/day.
2, passive pressure straight: under the heel pad, appropriate weight of sandbags (or other alternatives) placed above the knee, or slightly bent back after their own hands or ask others to assist with both hands to give appropriate pressure, down above the knee joint, maintain about 5-10 minutes.
If the joint is swollen or painful after the mobility exercise, apply ice immediately for 20-30 minutes. If the joint is swollen, painful or hot, apply ice again 2-3 times a day.