Message from your doctor…
Whether you or one of your family members or friends is considering prochondrix knee cartilage transplant, or are scheduled for surgery, I understand this can be a stressful time. You may have forgotten some of the information we discussed during our last visit, or forgot to ask me a specific question about what to expect. This site is designed to help us stay connected, and to answer some of the most common questions patients ask me about cartilage transplantation.
I want to make sure that both you and your family members have timely information at your fingertips during the days, weeks, and months following your surgery…so you can get back to enjoying the activities you love.
Please take your prescription pain medication for the first 24 hours as directed. After the first day or two, as the pain lessens, you may decrease the frequency with which you take the medication. Remember, the medications are not necessarily meant to completely eliminate your pain, only to make it more bearable. Narcotic pain medications can cause constipation; you may wish to use an over-the-counter stool softener to help prevent this.
If you are having minimal pain and would like to switch to a milder medication, please take Tylenol/acetaminophen (extra strength or regular). Do not take Tylenol and norco together (this would be too much acetaminophen). Do not exceed more than 4000mg of Tylenol/acetaminophen in a 24 hour period.
Please try to avoid anti-inflammatory medications (NSAIDS) for 3 months post-op. Some studies show that these medications can slow the healing process. Some NSAIDS include Advil/Ibuprofen/Motrin, Aleve/Naproxen, Celebrex/Celecoxib, Mobic/Meloxicam, and Diclofenac. If you occasionally need an NSAID (for example, if you get a headache), it is ok to take.
It is helpful to use ice or a cold therapy unit to decrease pain and swelling. If you have been given an ice therapy unit, you are encouraged to keep the ice unit on as much as possible for the first 48 hours. After 48 hours, please continue to ice at least 5 times daily for 20 min each time. You may also elevate your leg on a few pillows while laying down to decrease pain and swelling. To elevate, place a few pillows under your foot and at least 1 pillow under the operative knee for support.
Underneath your knee brace, you will have a soft dressing and ace wrap applied over your incisions. It is meant to absorb any leaking blood or fluid from the joint, and to protect from infection. Mild leakage immediately after surgery is normal and actually helps to drain some of the fluid that accumulates in the joint during surgery. The dressings may become slightly moist or blood-stained; this is normal and usually not a cause for alarm.
The hinged knee brace should remain on, locked in extension, anytime you are up with your crutches. If you are sitting or laying down resting for an extended period of time, the brace may be removed. Please try to sleep with the brace on, at least for a few nights. This will help to better stabilize the knee and prevent any twisting type motions.
The brace will typically remain locked for 1 month total, then will be unlocked (allowing bending) for an additional 2 weeks. Your Physical Therapist will help determine when the brace may be unlocked. This is dependent on quadriceps strength and other factors.
You may put full weight on your operative leg immediately after surgery with the brace on, locked in extension. You will be given crutches and taught how to use them. Wean off the crutches whenever you are comfortable walking without them.
You may remove your surgical dressing 2 days after your surgery to take a shower. You will have absorbable sutures under steri-strips. Please leave them in place until they fall off on their own or until they are removed at your first post-op appointment. You may let soap and water gently wash over your incisions, but do not scrub them. Pat them dry with a towel, then you may leave the steri-strips uncovered if you’d like. Or, you may cover each of the steri-strips with band-aids if there is still any drainage. Please reapply the large ace wrap to protect the incisions. The ace wrap is also helpful underneath the knee brace (stops the brace from rubbing on skin).
You may not soak in a bathtub or go in a pool until your incisions are healed (usually 3-4 weeks).
Your first post-op visit will be scheduled 10-14 days after surgery. You will see Cassie Mandala, Physician Assistant on the first visit. At this visit, we’ll check your incisions and answer any questions you may have.
WHEN TO CALL
Please call our office at (630)584-1400 if you develop a fever greater than 101°F, increasing pain that is not responding to pain medication, redness, increased swelling, persistent bleeding or drainage, or drainage other than clear fluid or blood.
Please do not attempt driving until you are off the pain medications. You should wait to drive until you can comfortably and safely operate the vehicle (get from gas to brake).
PLEASE DO NOT DRIVE WITH KNEE BRACE ON. If the brace were to lock up or get stuck, this could be dangerous. If you had a right knee cartilage transplant, it may be about 1 month before you can safely drive. If you had a left knee cartilage transplant, you may drive once you’re off pain medication and can comfortably and safely operate the vehicle.
PREVENTION OF BLOOD CLOTS
Although the risk is very low, there is a small chance of developing blood clots into the leg after a surgery. A blood clot in the leg is called a DVT or deep vein thrombosis. Some patients will be asked to take a 325mg aspirin daily for 1 month after surgery to prevent blood clots. Some patients at higher risk of blood clots will require another form of anticoagulation such as xarelto or coumadin pills or lovenox injections. Those at higher risk include patients who have had prior DVT, are on birth control pills, patients that smoke, obesity, or patients with blood clotting disorders. Signs of a blood clot could include calf pain and leg swelling. If you develop calf pain and/or painful swelling to either leg, please call our office immediately or go to the emergency room.
RETURN TO WORK
This will vary, based on the nature of your job. If you have a desk job, you may return to work as soon as you are off the pain medication, comfortable driving, and feel that you may perform your job. Most patients with desk jobs take at least 1 week off work to rest and focus on therapy. If you have a labor-intense job that may require more walking, squatting or heavy lifting, you will need a minimum of a few months off work. We can discuss this in more detail during your 1st post-operative visit and we can give you work status notes (including light duty if this is an option for your job).
Dr. Mehta talks about Cartilage Restoration
Dr. Mehta Describes Prochondrix for Cartilage
Dr. Mehta Performs Prochondrix Knee Cartilage Restoration
MOST COMMON QUESTIONS
Prochondrix Knee Cartilage Transplant – Patella/Trochlea
When can I drive?
Please do not attempt driving until you are off the pain medications. You should wait to drive until you can comfortably and safely operate the vehicle (get from gas to brake). PLEASE DO NOT DRIVE WITH KNEE BRACE ON. If the brace were to lock up or get stuck, this could be dangerous. If you had a right knee cartilage transplant, it may be about 1 month before you can safely drive. If you had a left knee cartilage transplant, you may drive once you’re off pain medication and can comfortably and safely operate the vehicle.
When can I walk without crutches?
You may put full weight on your operative leg immediately after surgery with the brace on, locked in extension. Typically, if everything is progressing well, the brace can be unlocked at 2 weeks. You will be given crutches and taught how to use them. Wean off the crutches whenever you can safely and comfortably walk without them.
When can I go back to work?
This will vary, based on the nature of your job. If you have a desk job, you may return to work as soon as you are off the pain medication, comfortable driving, and feel that you may perform your job. Most patients with desk jobs take at least 1 week off work to rest and focus on physical therapy. If you have a labor-intense job that may require more walking, squatting or heavy lifting, you may need a few months off work. We can discuss this in more detail during your 1st post-operative visit and we can give you work status notes (including light duty if this is an option for your job).
We know you are eager to return to your sports and hobbies. We want to guide you safely through that process. Please use the following as a guide.
2-3 weeks after surgery. Please don’t start doing a stationary bike until you are progressed in physical therapy.
You may do upper-body weights and core strengthening within 1-2 weeks post op. For lower-body strengthening, please rely on your physical therapist to outline a program for you.
3-4 months post-op, start on an even-surface/treadmill to make sure your knee feels comfortable. Your physical therapist may have you first attempt jogging on a treadmill in therapy to make sure your knee is comfortable and ready. While it may be safe to jog at 3-4 more, cross training is encouraged for the long-term health of your knee after cartilage transplantation. For example, biking, swimming, and an elliptical trainer are better “lower-impact” exercises for the knee.
2 month post-op. Specifically, a gentle free-style or flutter kick. No frog kick or whip kick for 3 months post-op.
Putting 2-3 weeks after surgery (with your brace on locked in extension)
3 months post-op: Chipping, pitching, and half-swings with your short irons
4 months post-op: Full but gentle swings with irons
5-6 months post-op: Full play with no restrictions
*The reason for golf restrictions is because you must avoid excessive pivoting/twisting of the knee
Contact sports, such as basketball, football, and hockey
You will be fully released without restrictions at 6 months post op.
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