Download Knee Arthroscopy Under General Anaesthetic

Information for patients
Discharge Instructions
and Advice Following
Knee Arthroscopy Under
General Anaesthetic
Martlesham Ward:
Tel: 01473 702290 (24 hour)
Raedwald Day Surgery Unit:
Tel: 01473 702705 (Mon – Fri, 7.30 am – 8 pm)
DPS ref: 04969-16(RP)
Physiotherapy advice line:
Tel: 01473 702385 (Answer phone service)
Issue 2: November 2016 Review date: October 2019
© The Ipswich Hospital NHS Trust, 2016. All rights reserved. Not to be
reproduced in whole, or in part, without the permission of the copyright owner.
After your operation you will be looked after by the nursing staff
on the ward. It is not routine to be seen by a physiotherapist and we
advise that you follow the advice given in this booklet unless informed
otherwise.
You have had an operation under general anaesthetic. Although you
will be fit to go home when you are discharged, the effects of the
anaesthetic may linger for some hours.
You should go home and rest under supervision until you feel fully
recovered. It is important that a responsible adult remains with you
overnight after your operation. You should not drive, cycle, drink
alcohol or operate machinery (including a cooker or kettle) for at least
48 hours from the time of the anaesthetic.
Wound care
The wound should be kept clean, dry and free from infection until
healed.
You may remove the bandage and padding after 24 / 48 hours and
apply the tubigrip you have been given in a single / double layer
thickness.
You have adhesive strips (steri-strips) which should be removed in
days after the operation.
the bath
Your stitches should be removed by the practice nurse at your GP
surgery 10 days after the operation.
You will be seen in Outpatients
No follow-up appointment is required.
Other instructions
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after your operation.
Post-operative advice
It is normal for your knee to be slightly sore and swollen for a few
days and you are likely to need pain relief to help this settle. It is very
important to keep your pain well controlled so you can mobilise (get
up and move about) comfortably, perform your exercises and resume
normal activities after your surgery.
Pain relief
You will be given pain relief medication to take at home. It is
important that you take this medication regularly and do not wait for
any pain to start.
Elevation
If the knee is swollen, lie down and elevate your leg on pillows for
15 minutes and keep your ankles moving. Repeat this regularly
throughout the day but remember that you should not stay in bed. It
is important that you ‘potter about’. This will aid your circulation and
reduce the risk of developing post-operative complications such as a
deep vein thrombosis (DVT). It is normal for the swelling to last 2 – 3
weeks after this operation.
Ice
After you remove the bandage, ice will help reduce pain and swelling
in your knee.
Instructions for applying an ice pack at home:
• You should ensure that the area to be treated is sensitive to
temperature by placing a cold then a warm object against it and
making sure you can tell the difference.
• Ideally, ice packs should be made from crushed ice, but a bag of frozen
peas or a gel pack available from some sports shops will be OK.
• The ice pack (or frozen peas) must be wrapped in an evenly
dampened towel and not applied directly to the skin, or skin
damage due to an ice burn may occur.
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• The pack, wrapped in towelling, should be placed on the knee and
wrapped around the joint, so that it covers the entire load-bearing
surface. Do not rest the joint or limb on the pack or an ice burn
may occur.
• The ice pack should be lifted from the knee after 5 minutes to
check for adverse reactions. The skin should be red in colour and
cool. If it is white and very cold, remove the pack immediately.
If no adverse reactions are noted and particularly if the skin is
warm and not cold, the pack may be reapplied for a further
10 – 15 minutes. If the skin is in poor condition or the circulation is
particularly bad, the pack should be checked every 5 minutes.
• Ice packs are more effective when applied on a regular basis for
10 – 15 minutes every 3 – 4 hours, rather than on a once-a-day basis
for half an hour.
You should be aware that a poorly applied ice pack or one that is left
on for too long can cause an ice burn.
If you feel pain or intense cold during application of the ice pack,
you must remove it and check the skin for signs of loss of circulation,
such as: white or purple skin, instead of pink and red. Ice packs used
incorrectly can cause ice burns, a form of frostbite.
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Exercises
It is important to prevent stiffness and weakening of your leg after
your operation and to start your exercises as soon as possible.
The strength of the quadriceps muscles (the muscles on the front of
the thigh) is vital for knee stability and prevention of further injury.
In order to strengthen these muscles and reduce the risk of any
associated post-operative complications you should start the exercises
below as soon as you are sufficiently recovered from the anaesthetic.
The exercises should be performed 3 – 4 times a day. Start with 10
repetitions and build up to 30 repetitions if you can manage them.
Exercise 1
Flex your ankle, bring your foot
up so that your toes point towards
your head, and then extend them
to point towards the end of the
bed. Repeat with your other foot.
Exercise 2
Lie on your back and straighten
your leg by pushing the back of
your knee onto the bed. Tighten
your thigh muscle and pull your
toes up towards you. Hold for 5 seconds and then relax.
Exercise 3
Lie on your back, bend your knee
up and down on the bed slowly.
Keep your kneecap and foot facing
the ceiling all the time.
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Exercise 4
Lie on your back or sit up in bed.
Place a roll (cushion or rolled-up
towel) under your operated leg just
above the knee. Push your knee into the roll. Pull up your foot, lift
your heel and straighten your knee (keeping your knee on the roll).
Hold for 5 seconds then slowly relax.
Exercise 5
Lie on your back, exercise the
operated leg by pulling the toes
up, straightening the knee and
lifting the leg just clear of the bed. Hold for 5
seconds then slowly lower.
Exercise 6
Sit on a chair or the edge of the bed.
Pull your toes up, tighten your thigh muscle and
straighten your knee. Hold for 5 seconds and then
slowly relax your leg.
Walking
Unless you are told otherwise, you will be able to walk on your leg
unaided. You should not need a walking aid (stick or crutches). If
walking is very uncomfortable and you are unable to walk unaided
then you will be issued with an appropriate aid to use until the knee is
more comfortable (usually 2 – 3 days).
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Returning to work
Your return to work will depend on your job. In general, if your job
involves sitting for the majority of the day you can return after 3 days.
If your job is more physically demanding and involves heavy manual
handling or standing for long periods then you should discuss this
with your consultant or GP.
Driving
You may start to drive again when your leg is strong, mobile and
without excessive pain. Try sitting in the car using the controls while
stationary and ensure you are able to perform an emergency stop. We
advise you to inform your insurance company of your operation to
ensure your cover is valid.
Sport
You can return to more strenuous activity once your leg is strong and
mobile, without excessive pain and swelling. It is advised to gradually
increase your level of activity. Competitive sport such as running,
skiing, racquet and contact sports can be returned to gradually after
six weeks.
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You may experience a small amount of discomfort or a minor degree
of nausea following your operation. If any of these symptoms are
more severe than you would expect or are causing you concern, please
contact the ward staff on 01473 702290, or your GP.
The NHS 111 service is also available as a source of medical advice and
can be contacted by phoning 111.
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Produced by:
The Ipswich Hospital NHS Trust
Heath Road, Ipswich, Suffolk IP4 5PD
Hospital switchboard: 01473 712233
www.ipswichhospital.nhs.uk