After careful wound closure there are a number of small points of detail which will facilitate a rapid post-operative recovery and allow accelerated rehabilitation.  

1. Infiltrate the wound and the cavity of the knee joint with 10 – 20mls of Marcaine 0.5% and Adrenalin 1/200,000.  This allows good pain relief and reduces post-operative bleeding. More recently a cokctail of analgesic and anti-inflammatory drugs injected into the peri-articular tissues is proving effective in reducing post-operative pain wich helps the accelerated rehabilitation program.
   
   
2. There is seldom very much post-operative bleeding and, therefore, it is not necessary to use suction drains either in the knee joint itself or in the subcutaneous tissues unless they are very thick.  
   
   
3. After release of the tourniquet, elevation of the limb by 20° or 30° has been shown to reduce post-operative bleeding by at least 50%.  The elevation should be maintained for 12 to 20 hours.  In other words until the next morning after the operation.
   
   
4. The use of anti-inflammatory analgesics administered by mouth or by suppository is an effective way of reducing post-operative pain and swelling and assists considerably with accelerated rehabilitation.  These drugs are often required for at least two to three weeks after operation or longer if there is significant synovitis.  Gastric side-effects can be considerably reduced with the use of H2 antagonists or protein pump inhibitors.
   
   
5. Ice applied regularly in the post-operative period is very effective in reducing swelling, which will aid rehabilitation.  The Cryocuff or a similar system should be applied four to six times a day.  This treatment may be required for several weeks into the post-operative period.
   
   
6. The patients are generally able to get up and walk on the first post-operative day and start an active range of knee movement.  90° of knee movement is generally achieved within four to six days and the patients can be discharged within this period.
   
   
7. The use of CPM is generally unnecessary and slows recovery.  The occasional patient will be slow to develop flexion in which case the use of CPM for three to four days will help to develop the range of movement.  Occasionally a significant post-operative haemarthrosis develops in which case early arthroscopic wash-out is desirable.  If more than 90° of movement has not been obtained within four weeks then admission for manipulation and intensive rehabilitation is essential.
   
   
8. Physiotherapy is usually helpful as an outpatient after discharge from hospital.