General Instructions 

 

What to expect after surgery:

• You may notice bruising around the incision and into the thigh or leg.  This is common and should begin to go away within 2 weeks after surgery.

 

• You may have swelling and warmth about the knee for 6 weeks after surgery. This will gradually decrease, but may take 6 months to a year for the swelling to resolve completely.

 

• When the surgical incision was made down the front of your knee the nerves in the skin were divided. For this reason, the skin in this area may feel fuzzy or numb. This is normal, and the sensation should decrease with time.

 

What you can do to minimize swelling/pain:

• Elevate your leg when you are resting to help minimize the swelling. Keep your knee straight while lying in bed. You can place a pillow or rolled towel under your heel to help with this. 

 

• Use ice to help control the swelling and pain.  DO NOT USE HEAT – this will increase the swelling. 

 

What to do if you are concerned about your symptoms after discharge:

• Call the office (858-939-5434) if you develop fevers (over 100.5) or chills, develop drainage from the site of the wound or redness surrounding the wound, increased pain, increased leg swelling, or new/severe headache.

 

• Go to the emergency room if you develop chest pain or shortness of breath.

 

When to follow up with your surgeon:

• Your home physical therapist will remove your staples at 2 weeks after surgery.  If they are unable to do so for any reason please call 858-939-5434 and we will set up a cast room appointment about 2 weeks following your discharge from the hospital for staple removal.   

 

• Generally, you should return to see your surgeon at the following intervals, but this may be individualized depending on special circumstances:

  • Approximately 4 weeks after surgery 

  • Approximately 4 to 6 months after surgery 

  • One year after surgery 

  • Then once every 2 to 4 years. 

 

Medications

 

Pain medication

• You will likely be taking a short acting pain narcotic medication after surgery such as Percocet or Tramadol.  To help wean off of the pain medications or to supplement pain control you can use Tylenol and Celebrex.

 

• You may experience side effects from narcotic pain medications.  Common side effects are constipation, nausea, drowsiness or sleepiness, dizziness, headache, dry mouth, and itching. 

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• Opioids can be dangerous if you take them with alcohol, sleeping pills, or with certain other drugs. Make sure you tell your doctor about any medications you are taking, including over-the-counter, vitamins and homeopathic medications.

  • **DO NOT mix pain medications with alcohol.

  • **DO NOT drive while taking narcotics.

 

• Take your Colace, Senna, and any other medications on a daily basis (Miralax, Dulcolax, Milk of Magnesia, Metamucil, etc.) to prevent constipation. Take these medications DAILY for as long as you are taking narcotic pain medications.​

 

Prevention of blood clots

• You will be taking aspirin 81 mg twice daily for 4 weeks to prevent blood clots unless otherwise told by your surgeon.  

  • If you are already taking aspirin, do not add this to your prescribed aspirin regimen. Take only the prescribed amount of aspirin and do not resume your normal aspirin until speaking with your surgeon.

 

• Try to avoid taking additional anti-inflammatories such as Advil, Motrin, ibuprofen, meloxicam (Mobic), etc for 4 weeks.

 

• Wear your white stockings during the day – these help control the typical swelling in your legs after surgery and minimize the chance of blood clots.

 

Antibiotics

• You will not be discharged from the hospital with any antibiotics unless you are a special high risk case. 

 

Wound Care

 

• You may shower when you get home from the hospital if the dressing is dry, has NO drainage, and is well bonded to your skin.  Keep your dressing in place for two weeks or until your staples are removed and avoid direct spray on the dressing.​ 

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• If there are any concerns regarding the amount of drainage onto the dressing call the office.  

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• Keep water exposure to the incision site brief and blot it dry when you get out.

 

• Do not bathe, swim, or jacuzzi (i.e. do not submerge the incision) for at least 6 weeks or until cleared by your surgeon.

 

• Do not use ointments or creams on the incision for 6 weeks.  

 

Activity

 

• You can put all of your weight on your operated leg.

 

• You may walk as much as you can tolerate with your walker or other assistive device.   

 

• Driving: Doctors do not have a license with the DMV to “clear you” or “release you” to return to driving. To return to driving, there are 3 primary criteria that must be met:

1. You need to be off of narcotic pain medicines (otherwise you are driving under the influence).

2. You need to be able to get in and out of the driver’s seat comfortably.

3. You must have regained your normal reflexes / strength.  

 

• Average time to return to driving is around 4 weeks but depends on the individual, and also partly depends on what side had surgery (i.e. right leg operates the pedals; people with left side surgery can generally get back to driving much sooner unless you have a clutch).

 

Bowel Management after Joint Replacement Surgery 

 

In patients taking opiate pain medications after surgery, constipation is very common.  The following medication regimen will help to prevent this problem:

 

1) Senna S daily ((docusate sodium 50 mg and Senna 8.6mg) 1-2 tablets by mouth each day)

 

2) MiraLax ((polyethylene glycol 3350) 17g diluted in water or juice) twice a day while patient is taking opiates.

 

If no BM x 3 days, give mag citrate ½ of a bottle (approximately 150 mL or approximately 5 oz). If no results after the first ½ of mag citrate, then give the other ½ bottle the next day.  Please note, if the patient has renal disease, mag citrate should be avoided.  If the patient still has no results, please contact physician.