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Post-operative care: Femur or Tibia surface

Weight Bearing:
• MINIMAL TOUCH WEIGHT BEARING (5-10Kg maximum) is essential using crutches for 6 weeks. Again, like avoiding walking on new grass, any greater load through the joint is likely to damage the healing tissue. Even though the knee may feel comfortable the weight must be kept of it to allow the new surface to mature.
• Knee braces are not usually needed.
• For lesions less than 1cm patients are allowed to take weight sooner.

Movement of the knee joint:
• Early movement and bending (flexion) of the knee is encouraged immediately following surgery and a CPM (Continuous Passive Motion) machine may be used. This helps to smooth the growing articular surface, again rather like rolling new lawn without indenting it.
• If a CPM is used then this should be for 4-6 hours a day with range increased as tolerated until full range of motion is achieved with the machine
• Alternatively a static bike can be used without load: 500 revolutions three times a day.

Exercises during first 6 weeks:
• Physiotherapy exercises commence during the postoperative phase with static quadriceps and hamstring exercises while working on range of movement.
• Static one-third knee bends with 90% wt on the unoperated leg begin the day after surgery
• Static bike, with light resistance only, and pool exercises (in deep water) can start from 1-2 weeks.

From 6 weeks:
• Progression to FULL WEIGHT BEARING is allowed at six weeks followed by a gradual increase in exercise activity including elastic cord resistance exercises, cycling with load, cross trainer and eventually step-machines.
• Jogging can start at 3 months earliest if sufficient quads muscle control.
• Free weights and exercises severely loading the joint surfaces are started at 3 – 4 months when balance control is good, strength has returned and there is no swelling in the knee.
• No cutting, turning or jumping activities are allowed for 4 months and this may be longer for competitive or “heavy” patients.
• Return to impact sports is allowed between 4 – 6 months once knee function is satisfactory as measured on functional tests, and there is no swelling in response to activity.

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