Post-operative Instructions

General instructions for after your operation are listed. If you receive personalized instructions, follow those instead.

Post-operative instructions: anterior cruciate ligament (ACL) reconstruction

Rest, Ice, and Elevation

Elevate your knee under heel not the knee to prevent flexion contracture or stiffness in the knee. The Cold Therapy unit is helpful in reducing swelling, minimizing requirements for narcotics and accelerating return to normal knee function. Follow instructions given at the time of discharge and use the cooling system a minimum of 12 hours/day. Continuous use is allowed and encouraged, if not uncomfortable. Keep knee’s dressing dry. Do not remove it. Small amount of bloody drainage on the dressing is not unusual and this can be covered with a clean 4X4 gauze and ACE wrap.

Crutches/Brace

Weight bearing on the operated leg is allowed. Use your crutches for ambulating. Your brace is to be worn at all times. The brace is to be locked in full extension (0 degrees).

Exercises

Begin exercises the night of surgery. Repeat 10 times every hour.

  • Quad sets: Push the back of the knee into bed and hold for the count of 10.
  • Straight leg raises (SLR): lift leg in knee brace off the bed for count of 10.
  • Ankle pumps: Push ankle up and down multiple times to encourage blood flow in leg.
  • Hamstring sets: Push heel into bed for count of 10.

Medication

Take the following prescribed medication as directed:

Take one Enteric Coated Aspirin 325mg by mouth daily starting the day of surgery.

Additional medications may be prescribed for you.

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.

Substitute Tylenol or Advil as soon as possible for pain control. 

Questions/Concerns

Your surgeon should be contacted by calling 703-810-5215 Option 3 or 703-810-5213, 24 hours a day for any of the following symptoms:

  • Fever greater than 101.5 degrees F for 24 hours.
  • Redness or swelling in the calf that doesn’t resolve overnight.
  • Numbness, loss of good color or coolness in the foot.
  • Severe pain unresponsive to narcotic medication.
  • Excessive bleeding or vomiting.
  • Difficulty breathing or shortness of breath – CALL 911

Follow-Up

You will receive information on when and where your post-operative appointment is scheduled.

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

Arrangements to begin your formal ACL rehab program will made at this time.

Post-operative instructions: knee arthroscopy

Rest, Ice, and Elevation

Elevate your knee to help reduce pain and swelling for 24 hours. Apply ice for 6 hours. Keep the dressing and incisions dry at all times. Small amounts of drainage on the dressing are normal and may be reinforced with a 4×4 gauze and Ace wrap. You may bend your knee as much as the dressing allows.

Crutches

Use cane or crutches for security and comfort as needed. Discard them as soon as possible unless otherwise specified by your doctor. You will be told if weight bearing is allowed as tolerated with pain and swelling are your activity guides.

Exercises

Begin exercises as soon as possible. 10 sets every hour up to 100 per day.

  • Quad Sets: Straighten your knee, tense the quad muscle, hold for 5 seconds, then relax for 5 seconds.
  • Straight Leg Raises: Tightening your thigh muscle and lift your leg approximately 24 inches, hold for 5 seconds. Then slowly lower your leg keeping your leg straight and thigh muscle tight.
  • Ankle Pumps: Push your ankle up and down to promote blood flow.

No sports, running, excessive stair climbing, squatting, or jumping. If your job requires little physical activity, you may return to work in two to three days. If your job requires considerable standing, lifting, walking or climbing, discuss your return to work date with the surgeon.

Medication

You will be told the medication(s) to take, including how much and how often.

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.

Dressing/Showering

Remove the dressing 48 hours after surgery. Clean the extremity with rubbing alcohol to remove the surgical prep solution. You may shower at this point, no baths, hot tubs, or swimming. Prior to showering, cover the knee with plastic wrap to keep the knee dry. If the knee gets wet, dry immediately. After the shower cover the incisions with band-aids and re-apply ace wrap. Change the band-aids daily.

Questions/Concerns

Your surgeon should be contacted by calling 703-810-5215 Option 3 or 703-810-5213 Option 3 24 hours a day for any of the following symptoms:

  • Fever greater than 101.5 degrees F.
  • Redness or swelling in the calf that doesn’t resolve overnight.
  • Numbness, loss of good color or coolness in the foot.
  • Severe pain unresponsive to narcotic medication.
  • Excessive bleeding or vomiting.
  • Difficulty breathing or shortness of breath – CALL 911

Follow-Up

You will receive information on when and where your post-operative appointment is scheduled.

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

Post-operative instructions: lower extremity

Rest, Ice, and Elevation

Remain generally at rest. Elevate and apply ice to area for the first 48 hours. Dressings must be kept dry.

Crutches

Use cane or crutches for security and comfort as needed. Discard them as soon as possible unless otherwise specified by your doctor. You will be told if weight-bearing is allowed as tolerated with pain and swelling are your activity guides.

Medications

You will be told the medication(s) to take, including how much and how often.

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.

Dressing/Showering

Slight bleeding through the dressing/cast is common. Reinforce the dressing/cast with 4×4 gauze pads and gauze wrap as needed. Dressings/cast must be kept dry. Modify your bathing appropriately. Cover your dressing/cast with plastic when bathing. Use rubbing alcohol to remove the betadine prep solution from the skin.

Questions/Concerns

Your surgeon should be contacted by calling 703-810-5215 Option 3 or 703-525-6100, 24 hours a day for any of the following symptoms:

  • Fever greater than 101.5 degrees F.
  • Numbness, loss of good color or coolness in the foot.
  • Severe pain unresponsive to narcotic medication.
  • Excessive bleeding or vomiting.
  • Difficulty breathing or shortness of breath – CALL 911
  • Medications given to you at the surgery center

Follow-Up

You will receive information on when and where your post-operative appointment is scheduled.

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

Post-operative instructions: shoulder arthroscopy

Rest, Ice, and Elevation

Lying flat in bed will be uncomfortable for several days. Sleeping with your back elevated on several pillows can be helpful. Apply ice to the shoulder intermittently for the first 24 hours.

Exercises

Open or Arthroscopic shoulder surgery requires a sling for protection post-operatively. Keep the sling in place until your surgeon sees you in the office. You can remove the sling to allow elbow, wrist and hand motion only 3 times a day.

Medication

You will be told the medication(s) to take, including how much and how often.

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.

Dressing/Showering

Slight bleeding through the dressing is common. Excessive bleeding should be reported to your surgeon. Dressings must be kept dry. Modify your bathing appropriately. Swimming or hot tubs are not allowed until the wound is completely healed. Use rubbing alcohol to remove the betadine prep solution from the skin.

Questions/Concerns

Your surgeon should be contacted by calling 703-810-5213 Option 3 or 703-810-5215 Option 3, 24 hours a day for any of the following symptoms:

  • Fever greater than 101.5 degrees F.
  • Numbness, loss of good color or coolness in the arm.
  • Severe pain unresponsive to narcotic medication.
  • Excessive bleeding or vomiting.
  • Difficulty breathing or shortness of breath – CALL 911

Follow-Up

You will receive information on when and where your post-operative appointment is scheduled.

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

Post-operative instructions: upper extremity

Rest, Ice, and Elevation

Remain generally at rest. Elevate and apply ice to area for the first 48 hours. Dressings must be kept dry.

Medication

You will be told the medication(s) to take, including how much and how often.

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.

Dressing/Showering

Slight bleeding through the dressing/cast is common. Dressings/cast must be kept dry. Modify your bathing appropriately. Cover your dressing/cast with plastic when bathing. Use rubbing alcohol to remove the betadine prep solution from the skin.

Questions/Concerns

Your surgeon should be contacted by calling 703-810-5215 Option 3 or 703-810-5213 Option 3 24 hours a day for any of the following symptoms:

  • Fever greater than 101.5 degrees F.
  • Numbness, loss of good color or coolness in the arm.
  • Severe pain unresponsive to narcotic medication.
  • Excessive bleeding or vomiting.
  • Difficulty breathing or shortness of breath – CALL 911

Follow-Up

You will receive information on when and where your post-operative appointment is scheduled.

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