Post-operative Instructions

Follow these instructions after your operation.

Post-operative instructions for Achilles tendon repair

You have undergone repair of your Achilles tendon, the structure that connects the calf muscle to the heel. The repair is performed by making a small incision, evacuating the hematoma (blood that forms around the torn tendon edges), and repairing the torn tendon edges together using suture material.

Cast/splint

Your leg has been immobilized with a compressive dressing reinforced by a posterior splint or cast. Although a bit cumbersome, the splint/cast provides comfort by immobilizing the site of surgery.

Swelling/bruising

Swelling can be controlled by elevating your leg. Try to keep your leg up elevated upon a few pillows for the first 48 hours. The goal is for the leg to be above the level of your heart. Swelling is further minimized by use of ice or cold therapy directly over the site of surgery. Alternatives include use of a bag of ice or frozen vegetables (such as peas/corn) beneath your ankle. Even though you are in a splint or cast, temperature at the surgical site will be decreased. Some degree of swelling of your foot and toes is normal. Because bleeding from the surgical site cannot escape, it typically will travel under the skin to the most “dependent” part of the extremity. Do not be alarmed then by the site of an evolving bruising of the foot and/or toes, which can increase over the first few weeks until ultimately resolving.

Dressing/woundcare/bathing

Your dressing/splint/cast will remain in place until seen in the office. It will be removed or changed at follow-up in the office, at which time a cast is typically applied. You may bathe or shower, but should keep the dressing/splint/cast dry, through use of a plastic bag (such as a clean garbage bag) as a cover. Secure it with tape above the dressing/splint to prevent getting it wet. If you are going to take a shower, you should use a plastic chair or some other means of sitting, both for balance and to avoid placing any weight on your leg. As an alternative you may want to try a bath and keep your leg hanging over the side of the tub.

Activity

For the first week try to minimize how much you’re up and about. The more your leg is “dependent” the greater degree of discomfort, including pain and a throbbing sensation in your leg. Do not weight bear (put weight on your leg).

Pain medication

Vicodin® (Hydrocodone) or Percocet® (Oxycodone) narcotic pain killers, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

Pain medication tips

  • Do not drive while taking pain medications.
  • Do not drink alcoholic beverages while taking pain medications.
  • Pain medication should be taken with food as this will help prevent any stomach upset.
  • Often pain medications will cause constipation. Eat high fiber foods and increase your fluid intake if possible.
  • To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You will be scheduled for a post-op appointment in about 10 – 14 days following surgery, at which time your cast/splint will be removed and we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5213 Option 3 (Tysons). You should contact me for any of the following symptoms:

  • Fever greater then 101.5 degrees F
  • Numbness, loss of color or coolness in hand
  • Severe pain unresponsive to narcotic medication
  • Excessive bleeding or vomiting
  • Difficulty breathing or shortness of breath – Call 911

Brace/crutches

You have been placed in a long leg immobilizer for support and comfort when you are up walking around the first week after surgery; immobilization is not required but it is a good idea when you are up and about. Weight-bearing may begin the first day after surgery and is strictly a matter of your comfort. You will not damage the graft or knee by walking on it. Most patients find crutches of value until they are comfortable walking and have good balance, which typically takes about 10-14 days.

Swelling

Some degree of swelling of your foot and toes is normal. Swelling can be minimized by elevating your leg. Try to keep your leg up elevated upon a few pillows (placed under your ankle only) consistently for the first 48 hours, and intermittently thereafter. The goal is for them to be above the level of your heart. Swelling can be further controlled by use of ice or cold therapy directly over the sites of surgery. Place a bag of ice or package of frozen vegetables (which nicely conforms to the surgical site), usually 20 minutes on, and 20 minutes off. If you have a Cryocuff® pad and cooler (arranged pre-operatively for this use), keep the sleeve directly over the dressings. Use it continuously for the first week.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the foot and/or toes, which can increase over the first few weeks, is normal, and will ultimately resolve.

Dressing/bathing

Keep your dressing dry and in place until your post-op visit. You may shower (NO baths), but keep the dressing dry, through use of a plastic bag (such as a clean garbage bag) as a cover. Secure it with tape above the dressing to prevent getting it wet. If you are going to take a shower, you should use a plastic chair or some other means of sitting for balance.

Fever/shortness of breath

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Driving

If surgery was on your right knee you must wait to drive till you have complete control of your leg and foot (meaning you can walk without a limp) – approximately one week and are no longer taking the pain medication. If you had surgery on your left knee you may start driving once you are no longer taking the pain medication.

Range of motion exercises

Begin your post-operative exercises the night of surgery. The exercises are illustrated on the following pages. There are two motions we emphasize immediately after surgery, flexion (knee bending), and extension (knee straightening).

To restore flexion, a CPM, or Continuous Passive Motion machine (if prescribed for you pre-operatively) will facilitate knee bending. The machine is set such that it gently and passively moves your knee through a range of motion, beginning at full extension (fully straight or zero°) to about 50° (approximately halfway bent). The CPM device should be comfortable and as a guideline, is increased by ~ 10° each day. Small increases of 5° at a time, each morning and each afternoon, may be easier than increasing by the 10°. Use the CPM approximately 8-10 hours/day. You may use it in any comfortable combination (such as on for 3 hours, off for one hour, on for another 3, etc.), until you have reached your 8-10 hour minimum. If you find the CPM comfortable while sleeping, feel free to use it, though it does not count against day-time use. The CPM is discontinued upon reaching 110° for 2 consecutive days. Please call the CPM rep if you have any questions/problems with its use (703-281-1200).

Knee extension is achieved by exercises begun the day after surgery. Prop your leg up on several blankets or pillow(s) (placed beneath your ankle), such that nothing is touching the back of your knee. Keep it in this position passively stretching for a half-hour and repeat this for a total of three times a day. During these exercises, the leg should be out of the CPM.

Activity

For the first week try to minimize how much you’re up and down. The more your leg is “dependent” the greater degree of discomfort. If you work at a sedentary job returning to work after one week is generally fine. If you are active and on your feet all day, you may require longer than one week before returning to work.

Pain medication

Oxycontin, a long acting narcotic pain killer and Percocet® (oxycodone), a short acting narcotic pain killer, have been prescribed for pain. Take the oxycontin every 12 hours if you are experiencing severe pain, take the Percocet during those 12 hours if you have “breakthrough pain.” (Please note: You may be able to take only the Percocet and won’t need the Oxycontin). All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe. NSAIDs are also a good alternative option.

Pain medication tips

  • Do not drive while taking pain medications.
  • Do not drink alcoholic beverages while taking pain medications.
  • Pain medication should be taken with food as this will help prevent any stomach upset.
  • Often pain medications will cause constipation. Eat high fiber foods and increase your fluid intake if possible.
  • To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5213 Option 3 (Tysons). You should contact me for any of the following symptoms:

  • Fever greater then 101.5 degrees F
  • Numbness, loss of color or coolness in hand
  • Severe pain unresponsive to narcotic medication
  • Excessive bleeding or vomiting
  • Difficulty breathing or shortness of breath – Call 911

Knee arthroscopy exercise guide

Regular exercise to restore your knee mobility and strength is necessary. For the most part this can be carried out at home. Your orthopaedic surgeon may recommend that you exercise approximately 20 to 30 minutes two or three times a day. You also may be advised to engage in a walking program. Your orthopaedic physician may suggest some of the following exercises. The following guide can help you better understand your exercise or activity program that may be supervised by a therapist at the direction of your orthopaedic surgeon. As you increase the intensity of your exercise program, you may experience temporary set-backs. If your knee swells or hurts after a particular exercise activity, you should lessen or stop the activity until you feel better. You should Rest, Ice, Compress (with an elastic bandage), and Elevate your knee (R.I.C.E.). Contact your surgeon if the symptoms persist.

Initial Exercise Program

Hamstring Contraction, 10 repetitions – No movement should occur in this exercise. Lie or sit with your knees bent to about 10 degrees. Pull your heel into the floor, tightening the muscles on the back of your thigh. Hold 5 seconds, then relax. Repeat 10 times.

Quadriceps Contraction, 10 repetitions – Lie on stomach with a towel roll under the ankle of your operated knee. Push ankle down into the towel roll. Your leg should straighten as much as possible. Hold for 5 seconds. Relax. Repeat 10 times.

Straight Leg Raises, 10 repetitions – Lie on your back, with uninvolved knee bent, straighten your involved knee. Slowly lift about 6 inches and hold for 5 seconds. Continue lifting in 6-inch increments, hold each time. Reverse the procedure, and return to the starting position. Repeat 10 times. Advanced: Before starting, add weights to your ankle, starting with 1 pound of weight and building up to a maximum of 5 pounds of weight over 4 weeks.

Buttock Tucks, 10 repetitions – While lying down on your back, tighten your buttock muscles. Hold tightly for 5 seconds. Repeat 10 times.

Post-operative instructions for arthroscopic Bankart repair

You have undergone an arthroscopic Bankart repair, in which a small camera (arthroscope) has been used to repair the torn labrum (the normal cartilage “bumber”) from your shoulder’s glenoid (socket) rim.

Sling

You have been placed in a sling for both comfort and protection of the repair. Remain in this sling until seen in the office, where you will be shown how it may be easily removed and reapplied. You will use the sling for 3 weeks.

Bandages/dressing/bathing

A bulky compressive dressing has been applied to your shoulder to absorb some of the fluid (which can leak out for the first 48 hrs after arthroscopy). You may either keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable. If you keep it in place, keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet. If you remove the dressings, you should apply Band-Aids over each of the small arthroscopic incisions when you shower.

Swelling

Some degree of swelling of your arm, hand and fingers is normal. Swelling can be controlled by use of ice or cold therapy directly over the surgical site. Place a bag of ice or package of frozen vegetables the surgical site; 20 minutes on, and 20 minutes off. The swelling in your hands and fingers can be improved by squeezing the soft ball attached to the sling!

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the arm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

For the first week try to minimize how much you’re up and about. No lifting or carrying anything heavy for the three weeks. Also for the first 3 weeks try to keep your arm to your side with your activities so as to not put pressure on the repair. No driving until you have good control of your arm, which likely will be about three weeks following surgery.

Sleeping

Patients often find that they are more comfortable sleeping in an upright position following shoulder surgery. Whether this requires just another pillow or two, a “husband” (name of triangular pillow that one can obtain from the Healthy back Store, for example) or even resting in a “Lazy Boy” type recliner, you may find sleeping in this position more comfortable for the first few weeks. However, such position is not necessary to protect the repair. It is simply a matter of your comfort.

Pain medication

Oxycontin, a long acting narcotic pain killer and Percocet® (oxycodone), a short acting narcotic pain killer, have been prescribed for pain. Take the oxycontin every 12 hours if you are experiencing severe pain, take the Percocet during those 12 hours if you have “breakthrough pain.” (Please note: You may be able to take only the Percocet and won’t need the Oxycontin). All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

Pain medication tips

  • Do not drive while taking pain medications.
  • Do not drink alcoholic beverages while taking pain medications.
  • Pain medication should be taken with food as this will help prevent any stomach upset.
  • Often pain medications will cause constipation. Eat high fiber foods and increase your fluid intake if possible.
  • To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.

Follow-up

You should be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started 1-3 weeks from the date of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5213 Option 3 (Tysons). You should contact me for any of the following symptoms:

  • Fever greater then 101.5 degrees F
  • Numbness, loss of color or coolness in hand
  • Severe pain unresponsive to narcotic medication
  • Excessive bleeding or vomiting
  • Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for arthroscopic capsular release

You have undergone an arthroscopic capsular release of your shoulder. During this procedure, adhesions that have formed in the joint and associated structures are cleaned/removed thus releasing the shoulder capsule. This helps to immediately restore your range of motion.

Sling

The goal of the post-operative treatment is to maintain the gains of motion achieved during surgery, therefore you do NOT need to wear the sling. The sling should be used only for comfort for an hour or so at a time or for when you are in public to remind others that you have had an operation. It is not necessary to wear at night.

Bandages/dressing/bathing

A bulky compressive dressing has been applied to your shoulder to absorb some of the fluid (which can leak out for the first 48 hrs after arthroscopy). You may either keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable 48 hours later. If you keep it in place, keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet. If you remove the dressings, you should apply Band-Aids over each of the small arthroscopic incisions when you shower.

Swelling

Some degree of swelling of your arm, hand and fingers is normal. Swelling can be controlled by use of ice or cold therapy directly over the surgical site. Place a bag of ice or package of frozen vegetables the surgical site; 20 minutes on, and 20 minutes off.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the arm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

For the first week try to minimize how much you’re up and about but you may use your shoulder/arm to the degree you are comfortable. You risk no injury to your shoulder (other than making it sore from overuse) as nothing was “repaired.”

Sleeping

Patients often find that they are more comfortable sleeping in an upright position following shoulder surgery. Whether this requires just another pillow or two, a “husband” (name of triangular pillow that one can obtain from the Healthy Back Store, for example) or even resting in a “Lazy Boy” type recliner, you may find sleeping in this position more comfortable for the first few weeks. However, such position is not necessary. It is simply a matter of your comfort.

Pain medication

Oxycontin, a long acting narcotic pain killer and Percocet® (oxycodone), a short acting narcotic pain killer, have been prescribed for pain. Take the oxycontin every 12 hours if you are experiencing severe pain, take the Percocet during those 12 hours if you have “breakthrough pain.” (Please note: You may be able to take only the Percocet and won’t need the Oxycontin). All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

Pain medication tips

  • Do not drive while taking pain medications.
  • Do not drink alcoholic beverages while taking pain medications.
  • Pain medication should be taken with food as this will help prevent any stomach upset.
  • Often pain medications will cause constipation. Eat high fiber foods and increase your fluid intake if possible.
  • To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.

Follow-up

You should be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is a critical part of your result and must be started within the first two days of surgery; 3 times a week for 3-4 weeks. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5213 Option 3 (Tysons). You should contact me for any of the following symptoms:

  • Fever greater then 101.5 degrees F
  • Numbness, loss of color or coolness in hand
  • Severe pain unresponsive to narcotic medication
  • Excessive bleeding or vomiting
  • Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for distal biceps tendon repair

You will receive your customized post-op instructions after your surgery.

Activity and Restrictions

Please avoid lifting anything heavier than a cup of coffee for the first week following surgery.

Wound Care

  • You will be placed in a soft dressing following surgery. Please keep the soft dressing in place for 48 hours. During this time, please cover dressing with plastic bag or wrap.
  • After 48 hours, the dressing may be removed to shower. Allow soapy warm water to run over incision, but do not scrub. Pat incision dry. You may reapply Band-Aids as needed. You will have a suture line in place that will be removed at your two weeks follow up appointment.
  • Keep the dressing dry. Small amounts of drainage on the dressing are normal and may be reinforced with a 4 X 4 gauze and ace wrap.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, Ice and Elevation

Use the following strategies to help with pain and swelling after surgery:

  • Elevate your arm by resting it on a pillow placed on your chest so it is higher than the level of your heart.
  • You may bend the elbow as much as the dressing allows
  • Use ice throughout the day – thirty minutes on followed by thirty minutes off.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Motrin 800 mg every 8 hours as needed for pain (anti-inflammatory medication)
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical Therapy

If recommended by Dr. Thompson, physical therapy will begin 3-5 days following surgery. A referral and list of locations will be provided. This is crucial to your recovery!

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Fever (101.5° or higher) or chills
  • Severe calf pain
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room

Post-operative instructions for hip arthroscopy

Activity and Restrictions

Crutches will be needed for ambulation during the immediate post-operative period. Partial weightbearing (Flat foot with weight of leg) with crutches for three weeks following surgery.If prescribed a brace, it should be worn when out of bed for 3 weeks. This helps protect the tissues during their early healing process.

Wound Care

  • You will have a large waterproof dressing over incisions right after surgery. Keep the dressing in place for 48 hours.
  • After 48 hours, the dressing may be removed to shower. Allow soapy warm water to run over incisions, but do not scrub. Pat incisions dry. You may reapply Band-Aids as needed.
  • You will have 2-3 stitches in place that will be removed at your two weeks follow up appointment.
  • Keep the dressing dry. Small amounts of drainage on the dressing are normal and may be reinforced with a 4 X 4 gauze and/or Band-Aids.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, Ice and Elevation

Use the following strategies to help with pain and swelling after surgery:

  • Use ice throughout the day for the first week following surgery – thirty minutes on followed by thirty minutes off.
  • After the first week, you may want to still consider icing after therapy session or when swelling occurs.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Diclofenac 100mg once a day for one month (anti-inflammatory medication)
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical Therapy

Physical therapy will begin 5-7 days following your surgery date. A referral and list of locations have been provided. This is crucial to your recovery!

You may begin a home exercise program to start the day after surgery. These exercises should be performed 2-3 times per day:

  1. Hamstring sets: push heel into bed for count of 10.
  2. Heel slides: sit on a firm surface with your leg straight in front of you. Slowly slide the heel of your operative leg toward your buttock by pulling your knee to your chest when you slide.
  3. Prone lying: lay on your stomach for a combined total of two hours per day, divided into multiple sessions. This will help stretch the front portion of your hip joint
    1. Note: We recommend using a stationary bike with no resistance to encourage early motion in your hip joint. Start the day after surgery. Begin with small sessions of approximately 10 minutes at a time, twice daily. Use your good leg to push the pedals, with the surgical leg not doing any work.
    2. If a constant passive motion (CPM) device was recommended, please begin using it the morning following surgery. You should set the initial parameters for 0 – 40 degrees of motion. Then, advance by 10 degrees per day until you have reached 0 – 90 degrees. DO NOT exceed 90 degrees. You may discontinue the CPM once you have started physical therapy.

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Fever (101.5° or higher) or chills
  • Severe calf pain
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room

Post-operative instructions for knee arthroscopy

You will receive your customized post-op instructions after your surgery.

Activity and Restrictions

Use cane or crutches for security and comfort as needed. Discard them as soon as possible unless otherwise specified. Weight bearing is allowed as tolerated. Use pain and swelling as your guide to activities and exercise.

Wound Care

  • Keep the dressing in place for 48 hours. During this time, please cover dressing with plastic bag or wrap.
  • After 48 hours, the dressing may be removed to shower. Allow soapy warm water to run over incision, but do not scrub the incisions. Pat incision dry. You may reapply Band-Aids as needed.
  • You will have 2-3 stitches in place that will be removed at your two weeks follow up appointment.
  • Keep the dressing dry. Small amounts of drainage on the dressing are normal and may be reinforced with a 4 X 4 gauze or Band-Aids.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, Ice and Elevation

Use the following strategies to help with pain and swelling after surgery:

  • Elevate your knee and apply an ice pack to help reduce pain and swelling for 24-48 hours.
  • Use ice throughout the day – thirty minutes on followed by thirty minutes off. Do not sleep with ice on your knee.
  • You may bend your knee as much as the dressing allows.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Motrin 800 mg every 8 hours as needed for pain (anti-inflammatory medication)
  • Aspirin 81 mg twice a day for 3 weeks—blood thinner to prevent blood clots. (Other blood thinners may be used in place of this in higher risk patients.)
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical Therapy

If advised by Dr. Thompsons, please contact a physical therapy office and schedule an appointment 3-5 days following surgery. A list of facilities has been provided. This crucial to your recovery!

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Fever (101.5° or higher) or chills
  • Severe calf pain
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room

Post-operative instructions for knee manipulation

You will receive your customized post-op instructions after your surgery.

Activity and Restrictions

You are encouraged to move your knee as much as possible.

Rest, Ice and Elevation

Use the following strategies to help with pain and swelling after surgery:

  • Elevate your leg by resting it on a pillow placed underneath your ankle, NOT KNEE. This will prevent your knee from getting stuck in a bent position.
  • Use ice throughout the day – thirty minutes on followed by thirty minutes off. You are encouraged to move your knee as much as possible immediately following surgery.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Motrin 800 mg every 8 hours as needed for pain (anti-inflammatory medication).
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical Therapy

You will begin physical therapy, 1 session five days a week for two weeks to maintain full range of motion of the knee. This should be completed before surgery to ensure appropriate scheduling.

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation
  • Fever (101.5° or higher) or chills
  • Severe calf pain

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room.

Post-operative instructions for ORIF ankle

You will receive your customized post-op instructions after your surgery.

Activity and Restrictions

You will be non-weight bearing for the first four weeks following surgery. You will be given crutches to help with walking. Patients often find it useful to order a Scooter to help get around. This can be ordered from amazon.

Wound Care

  • You will be placed in a soft splint covered with ace wrap after surgery. Please cover splint with plastic bag or wrap.
  • After 2 weeks, at your post-operative appointment, your soft splint will be removed, and your sutures/ staples will be taken out in the office. At this time, you will go into a tall boot for immobilization.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, Ice and Elevation

Use the following strategies to help with pain and swelling after surgery:

  • Elevate your leg by resting it on a pillow so it is higher than the level of your heart.
  • Monitor your toes in the soft splint. They should remain pink in color, and warm. Please call the office if you begin to feel like the splint is too tight preventing good circulation to the foot.
  • Use ice throughout the day – thirty minutes on followed by thirty minutes off.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Motrin 800 mg every 8 hours as needed for pain (anti-inflammatory medication).
  • Aspirin 81 mg twice a day for 3 weeks—blood thinner to prevent blood clots. (Other blood thinners may be used in place of this in higher risk patients.)
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical Therapy

Physical therapy will begin four weeks following your surgery date. A referral and list of locations have been provided. This is crucial to your recovery!

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Fever (101.5° or higher) or chills
  • Severe calf pain
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room.

Post-operative instructions for ORIF distal radius

You will receive your customized post-op instructions after your surgery.

Activity and Restrictions

Please avoid any lifting during this time for the first week following surgery.

Wound Care

  • You will be placed in a soft splint covered with ace wrap after surgery. Please cover splint with plastic bag or wrap for showers to keep it dry.
  • After 1 week, during your post-operative appointment, your soft splint will be removed, and your sutures/ staples will be taken out in the office. At this time, you will go into a Velcro brace and begin physical therapy/ Occupational therapy to work on strength and range of motion.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, Ice and Elevation

Use the following strategies to help with pain and swelling after surgery:

  • Elevate your arm by resting it on a pillow placed on your chest so it is higher than the level of your heart.
  • Monitor your fingers in the soft splint. They should remain pink in color, and warm. Please call the office if you begin to feel like the splint is too tight preventing good circulation to the hand.
  • Use ice throughout the day – thirty minutes on followed by thirty minutes off.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Motrin 800 mg every 8 hours as needed for pain (anti-inflammatory medication).
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical Therapy

Physical therapy will begin one week following your surgery date. This is crucial to your recovery!

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation
  • Fever (101.5° or higher) or chills
  • Severe calf pain

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room.

Post-operative instructions for ORIF tibial plateau

You will receive your customized post-op instructions after your surgery.

Activity and Restrictions

  • You will be non-weight bearing for four weeks. You will be given crutches to help with walking. You may also find it helpful to use a wheelchair.
  • You will be in a brace that will allow flexion and extension of the knee for four weeks.
  • After four weeks of non-weight bearing, you will slowly progress to partial weight bearing.

Wound Care

  • Keep the dressing in place for 72 hours. During this time, please cover dressing with plastic bag or wrap.
  • After 72 hours, the dressing may be removed to shower. Allow soapy warm water to run over incision, but do not scrub. Pat incision dry. You may reapply Band-Aids and ace wrap as needed. Brace should remain in place.
  • You will have a suture line in place that will be removed at your two weeks follow up appointment.
  • Keep the dressing dry. Small amounts of drainage on the dressing is normal and may be reinforced with a 4 X 4 gauze and Ace Wrap.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, Ice and Elevation

Use the following strategies to help with pain and swelling after surgery:

  • Elevate your leg by resting it on a pillow so it is higher than the level of your heart.
  • Use ice throughout the day – thirty minutes on followed by thirty minutes off.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Motrin 800 mg every 8 hours as needed for pain (anti-inflammatory medication).
  • Aspirin 81 mg twice a day for 3 weeks—blood thinner to prevent blood clots. (Other blood thinners may be used in place of this in higher risk patients.)
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical Therapy

Start physical therapy as soon as possible following your surgery date. A referral and list of locations have been provided to you. This is crucial to your recovery.

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Fever (101.5° or higher) or chills
  • Severe calf pain
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room.

Post-operative instructions for partial knee replacement

You will receive your customized post-op instructions after your surgery.

About your surgery

A partial knee replacement is a safe and effective way to reduce pain due to arthritis when medications, exercises, and modification of activities are no longer helpful. The surgical procedure takes approximately 90 minutes and is done with spinal or general anesthesia. Frequently a nerve block is also used to decrease pain and need for narcotics both during and after surgery. Numbness in the leg from this can often last greater than 24 hours. At the beginning of the procedure, a vertical incision is made in the front of the knee to access the joint. During the procedure, the arthritic parts of the femur and tibia are removed and the joint resurfaced with components of metal and plastic called a prosthesis.

Activity and restrictions

Weight bearing on the operative leg is restricted to partial weight bearing for the first two weeks following surgery to minimize short- and long-term pain associated with the procedure. Crutches, cane, or walker may be used during that time for support.

Driving

You may resume driving when you have stopped taking narcotic pain medication.

We advise you to drive in an empty parking lot to practice slamming on the brakes to ensure you are comfortable with driving prior to driving with traffic. You should be cleared to drive by Dr. Thompson. This is usually 2 weeks for a left knee, and 6 weeks for a right knee.

Wound care

You will be placed in a long ace wrap following surgery:

  • Keep the dressing in place for 5-7 days. During this time, please cover dressing with plastic bag or wrap.
  • After 5-7 days, the dressing may be removed to shower. Allow soapy warm water to run over incision, but do not scrub the incisions. Pat incision dry. You may reapply Band-Aids as needed.
  • You will have several staples in place that will be removed at your two weeks follow up appointment.
  • Keep the dressing dry. Small amounts of drainage on the dressing are normal and may be reinforced with a 4 X 4 gauze and ace wrap.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, ice and elevation

Use the following strategies to help with pain and swelling after surgery:

  • Elevate your leg by placing a pillow under the ankle; NOT KNEE. This will help prevent the knee getting stuck in a bent position.
  • Apply an ice pack to help reduce pain and swelling for 24-48 hours.
  • Use ice throughout the day – thirty minutes on followed by thirty minutes off.
  • You may also use a Cold Therapy Unit to help with swelling and reduce the use of narcotics. Do not let the cooling pad touch the skin. You may use a dressing or cloth between your skin and the ice/ Cold Therapy Unit. This can be used full time for two days following surgery.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Celebrex 200 mg twice a day as needed for pain and inflammation (anti-inflammatory medication).
  • Aspirin 81 mg twice a day for 6 weeks—blood thinner to prevent blood clots. (Other blood thinners may be used in place of this in higher risk patients.)
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.
  • Antibiotic: You will be given an antibiotic, usually Augmentin in 1-2 doses, to be taken prophylactically to prevent infection following surgery.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical Therapy

We expect outpatient physical therapy to begin as soon as possible. You should work on Range of Motion of the operative knee immediately following surgery until physical therapy. At that time, they will provide you with exercises to complete at home.A list of facilities has been provided. This crucial to your recovery!

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation
  • Fever (101.5° or higher) or chills
  • Severe calf pain

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room

Post-operative instructions for rotator cuff repair

You will receive your customized post-op instructions after your surgery.

Activity and restrictions

A sling will be provided following surgery. You should expect to remain in the sling for 4-6 weeks. Please avoid range of motion exercises during this time.

Wound care

  • Keep the dressing in place for 48 hours. During this time, please cover dressing with plastic bag or wrap.
  • After 48 hours, the dressing may be removed to shower. Allow soapy warm water to run over incision, but do not scrub the incisions. Pat incision dry. You may reapply Band-Aids or 4×4 gauze, as needed.
  • You will have 3-4 stitches in place that will be removed at your two weeks follow up appointment.
  • Keep the dressing dry. Small amounts of drainage on the dressing are normal and may be reinforced with a 4 X 4 gauze or Band-Aids.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, ice and elevation

Use the following strategies to help with pain and swelling after surgery:

  • Use ice throughout the day – thirty minutes on followed by thirty minutes off. Do not sleep with ice on your shoulder.
  • Lying flat in bed will be uncomfortable for several days. Sleeping with your back elevated on several pillows or in a recliner can be helpful.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Motrin 800 mg every 8 hours as needed for pain (anti-inflammatory medication).
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical Therapy

Please contact a physical therapy office and schedule an appointment 4-6 weeks following surgery.Dr. Thompson will provide you with a more precise time following surgery. The decision is based on the size and extent of the tear. A list of facilities has been provided. This crucial to your recovery!

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation
  • Fever (101.5° or higher) or chills
  • Severe calf pain

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room.

 

Post-operative instructions for shoulder arthroscopy

You will receive your customized post-op instructions after your surgery.

Activity and restrictions

  • A sling may be provided for comfort following surgery, but you should begin to wean from it as pain tolerates.
  • You should remove the sling to work on gentle range of motion exercises for the elbow wrist, and hand motion 3 times a day.
    • Bend over at the waist letting the affected arm hang down at your side.
    • Sway your body back and forth using the weight of the arm and gravity to generate small circles at the surgical shoulder.
    • Use this technique to move your arm in clockwise and counter-clockwise circles.

Dressing/shower

  • Keep the dressing in place for 48 hours. During this time, please cover dressing with plastic bag or wrap.
  • After 48 hours, the dressing may be removed to shower. Allow soapy warm water to run over incision, but do not scrub. Pat incision dry. You may reapply Band-Aids as needed.
  • You will have 3 stitches in place that will be removed at your two weeks follow up appointment.
  • Keep the dressing dry. Small amounts of drainage on the dressing are normal and may be reinforced with a 4 X 4 gauze and ace wrap, or Band-Aid. If you have excessive drainage, please contact your surgeon.
  • You may use rubbing alcohol to remove the prep solution used to clean your skin prior to surgery.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, ice and elevation

Use the following strategies to help with pain and swelling after surgery:

  • Lying flat in bed will be uncomfortable for several days. Sleeping with your back elevated on several pillows or in a recliner can be helpful.
  • Apply ice to the shoulder intermittently for the first 24-48 hours.
  • Unless otherwise indicated, schedule Physical Therapy to start 3-5 days after surgery.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Motrin 800 mg every 8 hours as needed for pain (anti-inflammatory medication)
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical therapy

You will begin physical therapy, if needed, 3-5 days following surgery

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation
  • Fever (101.5° or higher) or chills
  • Severe calf pain

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room

Post-operative instructions for shoulder manipulation

You will receive your customized post-op instructions after your surgery.

Activity and restrictions

You are encouraged to move your arm as much as possible.

Rest, ice and elevation

Use the following strategies to help with pain and swelling after surgery:

  • Elevate your arm by resting it on a pillow placed on your chest.
  • Use ice throughout the day – thirty minutes on followed by thirty minutes off. You are encouraged to move your arm as much as possible immediately following surgery

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Motrin 800 mg every 8 hours as needed for pain (anti-inflammatory medication).
  • Percocet oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical therapy

You will begin physical therapy, 1 session five days a week for two weeks to maintain full range of motion of the shoulder. This should be completed before surgery to ensure appropriate scheduling.

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Fever (101.5° or higher) or chills
  • Severe calf pain
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room.

Post-operative instructions for total knee replacement

You will receive your customized post-op instructions after your surgery.

About your surgery

A total knee replacement is a safe and effective way to reduce pain due to arthritis when medications, exercises, and modification of activities are no longer helpful. The surgical procedure takes approximately 90 minutes and is done with spinal or general anesthesia. Frequently a nerve block is also used to decrease pain and need for narcotics both during and after surgery. Numbness in the leg from this can often last greater than 24 hours. At the beginning of the procedure, a vertical incision is made in the front of the knee to access the joint. During the procedure, the arthritic parts of the femur, tibia, and kneecap are removed and replaced with artificial components called a prosthesis.

Activity and restrictions

Full weight bearing on the operative leg is allowed and encouraged immediately following surgery. This will minimize swelling, stiffness associated with the procedure. Crutches, cane, or walker may be used as needed for comfort until the pain subsides to begin full weight bearing.

Driving

You may resume driving when you have stopped taking narcotic pain medication

We advise you to drive in an empty parking lot to practice slamming on the brakes to ensure you are comfortable with driving prior to driving with traffic. You should be cleared to drive by Dr. Thompson. This is usually 2 weeks for a left knee, and 6 weeks for a right knee.

Wound Care

You will be placed in a long ace wrap following surgery:

  • Keep the dressing in place for 5-7 days. During this time, please cover dressing with plastic bag or wrap.
  • After 5-7 days, the dressing may be removed to shower. Allow soapy warm water to run over incision, but do not scrub the incisions. Pat incision dry. You may reapply Band-Aids as needed.
  • You will have several staples in place that will be removed at your two weeks follow up appointment.
  • Keep the dressing dry. Small amounts of drainage on the dressing are normal and may be reinforced with a 4 X 4 gauze and ace wrap.
  • No bath, hot tubs, or swimming for 3-4 weeks following surgery to allow the incision to fully close and prevent infection.

Rest, ice and elevation

Use the following strategies to help with pain and swelling after surgery:

  • Elevate your leg by placing a pillow under the ankle; NOT KNEE. This will help prevent the knee getting stuck in a bent position.
  • Apply an ice pack to help reduce pain and swelling for 24-48 hours.
  • Use ice throughout the day – thirty minutes on followed by thirty minutes off.
  • You may also use a Cold Therapy Unit to help with swelling and reduce the use of narcotics. Do not let the cooling pad touch the skin. You may use a dressing or cloth between your skin and the ice/ Cold Therapy Unit. This can be used full time for two days following surgery.

Swelling is a major cause of post-operative pain. The more you elevate and ice, the happier you will be!

Medications

You will receive prescriptions for the following medications after surgery. Do not drink alcohol while using these medications and take them with food to prevent nausea or vomiting.

  • Celebrex 200 mg twice a day as needed for pain and inflammation (anti-inflammatory medication)
  • Aspirin 81 mg twice a day for 6 weeks—blood thinner to prevent blood clots. (Other blood thinners may be used in place of this in higher risk patients.)
  • Percocet (oxycodone/apap, oxycodone/acetaminophen) or Norco (hydrocodone/acetaminophen)—narcotic pain medication to be taken every 4 hours only as needed for pain. Keeping track of how many tablets are needed per day is a good way to keep track of how much pain you are having.
  • Antibiotic: You will be given an antibiotic, usually Augmentin in 1-2 doses, to be taken prophylactically to prevent infection following surgery.

Pain medications can cause constipation. To help avoid this, eat foods high in fiber and increase your fluid intake. To alleviate constipation, over the counter medications such as Colace, pericolace, or MiraLax can be used – follow the instructions on the package.

Pain medications can sometimes cause itching. This should be treated with over the counter Benadryl or Claritin.

Please continue taking all previously prescribed medications unless otherwise directed.

Physical therapy

We expect outpatient physical therapy to begin as soon as possible. You should work on Range of Motion of the operative knee immediately following surgery until physical therapy. At that time, they will provide you with exercises to complete at home.A list of facilities has been provided. This crucial to your recovery!

Notify Dr. Thompson by calling 703-810-5210 (option 3) if you experience any of the following:

  • Numbness, loss of color or coolness in the leg
  • Feeling that the bandage is too tight or painful
  • Severe pain unresponsive to narcotic pain medication, rest, ice, and elevation
  • Fever (101.5° or higher) or chills
  • Severe calf pain

If you develop chest pain, difficulty breathing: call 911 and go directly to the nearest Emergency Room