Patient: Simple meniscus barrel shank tear, already had suture surgery, currently reviewed and in good condition, would like to know how many times a day should I practice about exercising greater than 90 degree return bend, how much time is appropriate for each exercise and how much is appropriate to practice the return bend angle? Doctor: Your condition at the time of your review was good, so you don’t need to do too much exercise for bending the knee. Generally, if you can easily reach or exceed 90 degrees of knee flexion the first time you wake up in the morning, your knee flexion is in good condition, so you only need to practice two sets of knee flexion every day, 5-10 times per set, each time reaching the maximum knee flexion angle, one set in the morning and one set in the evening. For post-operative meniscus barrel stem tears, it is important to achieve 90 degrees of knee flexion at 4 weeks post-op and 120 degrees of knee flexion at 12 weeks post-op. If it is easy to reach 120 degrees, then just maintain it at 120 degrees for the rest of the time. Also be sure to pay attention to knee extension and pushing on the patella.? Patient: I would like to know about muscle atrophy related questions. My foot had about a centimeter of atrophy before the surgery, but now the degree of atrophy has not expanded significantly, but the muscle feels a little loose and not as tight as it was. (2) Can the muscles recover completely? (3) Why do the muscles atrophy? (4) What can I do to keep the muscles from becoming loose? Doctor: Muscle atrophy is a common problem with knee surgery, so we have asked you to start doing straight leg raises since the surgery. However, this method will only slow down the rate of muscle atrophy, as your activity level will be much lower than normal or before surgery. But don’t worry too much, the muscles will recover when you can start running and jumping. For now, you can still do straight leg raises and use sandbags on your ankles to increase weight bearing. Patient: My mother would like to see me get off the crutches and resume normal walking. What do you think is the best way to go? Doctor: You had your surgery on December 19, and I think you can start partial weight bearing at 6 weeks post-op, which means you can start stepping on the ground with crutches; you can start walking off crutches at 8 weeks – I think you should have an easy time getting off crutches. It’s 4 weeks now and you can start partial weight bearing in another two weeks, so I think you should be able to get off the crutches by mid-February. Patient: I would like to ask you a few questions (1) I have been on my foot for six weeks, can I take my brace off? If so, I like to move around at night and sleep with my knees bent, how will this affect my foot? (2) When can I run and jump? (3) Do I need to do any more exercises after I take off the crutches and walk normally at 8 weeks? Now I have a new problem and need your help. (1) I have basically learned how to walk, but my body always tilts to the healthy side when I walk, so I walk a little crooked. (2) When I walk, the amplitude of my legs is not the same, but the healthy limb is bigger and the affected limb is smaller, I don’t understand why, what should I do? (3) I feel some pain in my feet when I walk, what is the reason? (4) Why does the skin on my foot appear normal in color when I walk, while the skin on the affected side is a little blue-purple in color, as if the blood is not circulating. But when I sit on the bed with my legs stretched out, the color returns to normal. What is this? (5) Last time you told me to keep my knee flexed at 120 degrees for 12 weeks, when will I be able to reach the normal state? (6) I feel a little weak in my legs when I walk, is it because I am not exercising my quadriceps enough? Is it possible to buy a knee brace to prevent my foot from twisting? (7) I got an electronic scale, how many pounds do I need to step on the affected limb? Doctor: The questions you asked are all questions that arise at the beginning of the weight-bearing period, because when the affected limb is not weight-bearing for a long time, symptoms such as weakness, small walking stride, color change when sagging, pain in the palm or heel after weight-bearing, etc. will naturally improve with more walking. Currently your affected limb can bear 1/4 to 1/2 of your body weight. Patient: I would like to ask: 1. Last time you told me that I could start partial weight bearing after six weeks, but I only started walking in the seventh week, will this have any effect on the full eight weeks of deconditioning? 2. How should I go up and down the stairs? 3. Will I be able to walk steadily after deconditioning? 4. How long should I practice every day now? In addition to that, should I keep my knee flexion at 120 degrees for 12 weeks like you told me last time? Doctor: There is no contradiction between the two since you can start walking only after starting partial weight-bearing. The exercise for walking up and down stairs starts with crutches or handrails and gradually progresses to independent walking up and down stairs. There is no requirement for the duration of the exercise, as the exercises you perform are necessary for daily life, and you can gradually transition to performing these movements without crutches. 12 weeks or more before further knee flexion exercises. Patient: I feel much better after the last few days of exercises, but I am still using the crutches. During the exercises, I have occasionally experienced a “giggling” sound in my foot, but I do not feel any pain in my foot, so I wonder if this is normal physiologically or pathologically. I will be eight weeks old tomorrow. 1. I’ll be able to take off my brace after tomorrow, so can I turn over as normal? What else should I pay attention to? 3. Can I practice going up and down stairs now? Doctor: Don’t be nervous, the process of getting out of the crutches may be easier than you think. You can try to walk directly off the crutches, you can walk a little slower, but you must try to control not to limp. You can turn over in your sleep and it won’t be a hindrance. You will also be able to practice going up and down stairs and you can start trying to move around normally. Patient: I am now walking without a cane. But I still have some questions that I need your answers. First: I occasionally hear a “clucking” sound in my joints when I walk, I wonder if this is normal? Second: every time I am tired of walking, I will sit down and lift my feet up, and then straighten, but when I put my feet down slowly, sometimes there will be a feeling that the bin bone there as if there is something stuck to that, can not be put down, but when you put down, you will hear the sound of ‘card’ inside, really do not know what is going on? I’m scared, very upset!!!! Third: I’m going back to school in a few days, I want to ask, what should I pay attention to at school? I feel a slight bend in my leg when I walk, I don’t know if it’s normal or not? Doctor: It’s not a big deal to feel a little stuck in the joint, but it’s important to do exercises to move the patella and inhibit the formation of scarring in the joint, because this stuck symptom and the sound in the joint can be relieved by exercises. However, if the knee is not fully straightened, it is very important to press the leg and straighten the knee joint. Patient: The straightening of the knee joint means that it can be straightened like a good leg and returned to its normal state. What is intra-articular scarring? I haven’t moved my patella for so long, has it formed a scar and how will this affect the recovery of the knee and my life in the future? Will the scarring have any serious consequences? Thank you! I would also like to add that what should I do to prevent the stitches from breaking? Why do I have pain on the outside of my leg when I press? And what is the level of my leg press to pass? Now I can’t go down the stairs with both legs alternating, how should I practice this? Doctor: 1, to strengthen the quadriceps muscle strength exercise, so that going down the stairs will not be a problem. 2. Be sure to move your patella more often so that you can effectively prevent scar formation in the joint. Scarring in the joint may cause ringing in the joint. 3, You are completely correct in your understanding of the role of knee joint extension. 4, The sutures we use are very strong and will not break taut.