ARTHROSCOPIC MICROFRACTURE SURGERY
PREOPERATIVE INSTRUCTIONS WITHIN A FEW WEEKS BEFORE SURGERY:
Dr. Gill will see you in the office. He will do a preoperative history and physical examination and complete the necessary paperwork. It is recommended that you utilize a stationary cycle to maintain your knee range of motion and improve the overall function of the knee prior to surgery.
SEVERAL DAYS PRIOR TO SURGERY:
Wash the knee several times a day to get it as clean as you can. This decreases the risk of infection. Be careful not to get any scratches, cuts, sunburn, poison ivy, etc. The skin has to be in very good shape to prevent problems. You do not need to shave.
THE DAY BEFORE SURGERY:
Please be in touch with Dr. Gill’s office to confirm the exact time that you should report to the hospital for surgery. You can have nothing to eat or drink after midnight on the day before surgery. It is very important to have a completely empty stomach prior to surgery for anesthesia safety reasons. If you have to take medication, you can do so with a sip of water early in the morning prior to surgery (but later tell the anesthesiologist you have done so).
DAY OF SURGERY:
• Bring any brace, ice machine, or imaging studies that you may have received.
Microfracture is a surgical procedure aimed at cartilage regeneration. The arthroscopic technique involves clearing damaged tissue from the knee joint and creating tiny holes
("microfractures") in the bone area where the cartilage is defective. The underlying bone marrow seeps out through the holes and becomes part of a blood clot that forms over the area. The marrow contains stem cells, which have the ability to form replacement cartilage between the bare-bone surfaces of the knee. Appropriate rehabilitation of the knee
after surgery is critical to the success of the operation. Continuous Passive Motion (CPM), where the knee is moved gently by a machine for 10 out of 24 hours a day for 6 weeks,
keeping weight off of the joint for a period of 6-8 weeks, and strict adherence to an aggressive physical therapy program following surgery all appear to enhance the success of the procedure.
Prior to surgery, a continuous passive motion (CPM) machine will be delivered to your home. This is a small apparatus that sits on the bed onto which your knee rests. The CPM very slowly bends and straightens out the knee. You will be able to adjust the CPM with a hand-controlled unit. Start the machine from 0 to 50 degrees and advance to 100 degrees as tolerated.
The dressing should be changed the day following surgery and can be removed at two days. The wound is sealed with steri-strips (small pieces of tape on the skin). You can shower on the second day following surgery, but be careful standing in the shower so that you do not fall. It is better to have a small stool to be able to sit on. However, you can get the leg wet and wash it. Do not submerge the knee under water in a bath, hot tub or swimming pool.
If you develop calf pain or excessive swelling in the leg, call Dr. Gill’s office.
The cryocuff is a blue wrap that is put on the knee to keep it cold. You can use this as often as you want to cool down the knee to reduce swelling and pain. Check your skin every time that you remove the wrap to make sure that it is intact.
For 6 weeks following surgery, it is best to be in the CPM for at least 10 out of 24 hours a day. You can get up whenever you want to but it is best to get up more frequently for short periods of time.
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