Individualized postoperative rehabilitation is particularly important, and the specific program should be developed under the guidance of the surgeon; the following is for reference only.
If microfracture is performed in the weight-bearing area, the affected leg should not be weight-bearing for 8 weeks; the non-weight-bearing area can be weight-bearing under the protection of a straight leg splint at an early stage.
On the day of surgery.
After the anesthesia subsides, start moving the toes and ankle; if the pain is not obvious, try to contract the quadriceps muscle. That is, tensing and relaxation of the anterior thigh muscles.
One day after surgery.
24 hours after the operation, you can hold the double crutches and walk on the foot without touching the ground (only to go to the toilet!)
1, ankle pump – forceful, slow, full range of flexion and extension of the ankle joint, as much as possible while awake. (Important for promoting circulation, decreasing swelling, and preventing deep vein thrombosis)
2, quadriceps (anterior thigh muscle group) isometric exercises – that is, thigh muscle tensing and relaxation. Do as many as possible without increasing pain. (More than 500 times / day)
3, N rope muscle (posterior thigh muscle group) isometric exercise – the affected leg force down the padded pillow, so that the posterior thigh muscle tense and relax. Requirements as above, more than 500 times / day.
4 . Correct position placement DD affected leg elevated on the pillow, toe to the top, not crooked to the side, below the knee joint should be empty, not to use the pillow to cushion the leg into a slightly bent position. If the pain is unbearable, place in a comfortable position under the guidance of a doctor.
5 .CPM exercises: 4-8 hours/day
Or perform flexion exercises on your own: sit, remove the splint, relax the affected leg completely, hold the knee joint with both hands, lift and lower the joint to make passive flexion and extension (the angle range varies according to the cartilage injury site), 8 hours/day. This exercise was continued until 8 weeks postoperatively. Immediately after the flexion exercise, apply ice for about 20 minutes. If there is usually a significant feeling of heat and swelling in the joint, apply ice again 2-3 times/day.
2 days after surgery.
Withdrawal of drainage or no drainage
1 . Continue the above exercises.
2 . Change the ankle pump to anti-gravity exercises (can be assisted by others or hold the thigh by hand). This can be done after each time you get out of bed to effectively prevent swelling.
3.Start side leg raise exercise, 30 times/group, 2-4 groups/day, 30 seconds rest between groups.
4.Start posterior leg raising exercise, lying prone (face down on the bed), lift the affected leg straight backward until the toe is 5 cm above the bed surface for one time, 30 times/group, 2-4 groups/day, rest 30 seconds between groups.
2-4 weeks after surgery.
1.Continue and strengthen the above exercises.
2. Daily small passive flexion with a range of motion not exceeding 45°.
5-8 weeks postoperatively.
1.Passive flexion up to 120-130°.
2.Start weight bearing and balance exercises at 8 weeks postoperatively: 5 minutes/time, 2 times/group, 2-3 groups/day.
8-10 weeks postoperatively.
1.Start front-to-back and side-to-side striding exercises: slow, controlled movements and no swaying of the upper body are required. After the strength is increased, you can lift heavy objects with both hands as a load or add sandbags at the ankle joint as a load. 20 times/group, 30 seconds between groups, 2-4 groups in a row, 2-3 times/day.
2, static squat exercises: squat to a pain-free angle, adjust the distance of the foot from the wall, so that the knee has been perpendicular to the tip of the foot squat angle less than 90 °. In the painless and controllable maximum angle to maintain two minutes 1. 2 minutes / time, 5 seconds interval, 5-10 times / group, 2 groups / day.
3. Aim to achieve normal gait walking.
10 weeks-3 months after surgery.
1.Start single knee squat exercises: squat in the range of 0-45°, requiring slow, controlled movements and no swaying of the upper body. If necessary, lift weights with both hands to increase the difficulty of the exercise. 20 times/group, 30 seconds interval, 2-4/consecutive groups, 1-2 exercises/day.
2. Patients who are able to do so and whose joint swelling and pain are not obvious can start stationary bike exercises to improve joint flexibility. No load to light load. 20-30 min/time, 2 times/day.
3. Seated resistance knee extension: use sandbags, etc. as a load exercise, 30 times/group, 30 seconds rest between groups, 4-6 consecutive groups, 2-3 exercises/day.
After 3 months postoperative
1, daily prone position flexion so that the distance from heel to hip is the same as the healthy leg, continuous stretching 10 minutes / time.
2.Step front down exercise: 20 times/group, 30 seconds interval between groups, 2-4 groups continuously, 2-3 times/day.
3.Protected under full squat: 3-5 minutes / time, 1-2 times / day.
4.Start swimming, jumping rope and jogging.