FREQUENTLY ASKED QUESTIONS
GENERAL PRE OP
What type of exercise can I do to prepare for knee surgery?
Maintain strength and range of motion. Walking, biking, and swimming are good choices in addition to stretching.
What can I do to lessen my chance of infection?
Make sure you are infection free around the time of surgery. You will be treated with antibiotics before surgery and undergo nasal screening for Staph.
What can I do to prepare my home for aftercare?
Remove trip hazards such as cords, throw rugs and prepare for stairs and steps. Physical therapy will coach you about steps and stairs.
What about home doses of blood thinners?
Discuss with Dr. Boyett any blood thinners that you might take and have a plan for how long to hold these meds before surgery.
When should I expect a call to let me know what time to arrive?
The surgery department will call you the day before, often in the afternoon, to let you know what time to arrive.
GENERAL POST OP
What are the signs that I should watch for?
Although some mild warmth and discoloration is normal post op, redness and excessive heat are signs someone should check the wound. Excessive swelling that leaves a finger indention upon touch should also be reported, especially if it only involves one leg.
What about fever?
Low-grade fever after joint replacement is common. Fever above 101˚ should be treated and reported.
What are signs and symptoms of blood clots?
Leg swelling on one leg only, sudden onset chest pain or shortness of breath, anxiety for no good reason, fast heart rate, pain in calf, redness around veins, fever, fainting. Blood clot signs and symptoms are often vague and non-specific.
What are the some of the common orthopedic risk factors associated with knee replacement?
Infection, blood clots, stiffness. In addition, there are other orthopedic, medical, and anesthesia risks as well.
What are some of the common risk factors associated with hip replacement?
Infection, blood clots, dislocation, leg length difference, in addition to other medical, other orthopedic and anesthesia risks.
How long should I take my blood thinners?
You should take the entire prescription. That is usually 3-4 weeks after surgery.
How long should i wear compression stocking?
3-4 weeks
TOTAL HIP REPLACEMENT
What if my leg swells after surgery?
It is very common to experience swelling after surgery. Sometimes, you will not swell until several days after your surgery. Remember that your body is healing from the surgery and some swelling is normal. The more activities and physical therapy you perform, the more swelling you may experience.
With that said, we do want you to remain active and participate in therapy. But, when sitting and resting, you can decrease the swelling by elevating your surgical leg and using ice. It is important to elevate your leg, with your knee above the level of your heart, 4-5 times a day for 15-30 minutes each time to help reduce your swelling. Your toes should be above your nose!
You should be alarmed if you have swelling for several days that is accompanied by redness and heat or coolness in your surgical leg, or if the swelling does not resolve after elevating. If this is the case, please contact Dr. Boyett's office.
Will I have bruising after surgery?
Yes, you will have some degree of bruising after surgery, but everyone is different. Some will only experience redness around the incision; others may have bruising down the entire leg. Both are considered normal and will resolve over 10-14 days.
What should I expect my activity level to be?
Every patient is different. Every day you should be increasing your activity level but let your pain level and swelling be your guide. You will make 75 percent of your recovery in the first six weeks, and the remaining improvement will come within the next year.
At some point, most patients overdo with activities and therefore take a few steps back in their recovery. You may have increased swelling or discomfort if this happens. You need to become concerned if you cannot control your pain with rest and pain medications, or if you have difficulty bearing weight through your surgical leg.
What if I am having problems sleeping?
Make sure that your pain is well controlled throughout the day. Avoid caffeine. During the day be careful about taking naps. Try to plan your activities as near normal as possible. if you continue to have issues, please call our office to discuss.
How much weight can I put through my leg after surgery?
Put as much weight as you can tolerate through your surgical leg immediately after surgery. The term is "weight bearing as tolerated." Your physical therapist will instruct you on how to use your walker or cane to perform this properly.
When can I shower or bathe?
You can shower the day after surgery using a waterproof bandage. The bandage placed on before leaving the hospital is waterproof. To ensure that your incision heals properly, we do not want you to bathe or get into a swimming pool until after your 2 week follow up appointment.
What about using a hot tub or whirlpool?
Because of the heat and bacteria in the water, we do not want you to use a hot tub or whirlpool for six weeks.
Is it normal to hear noise in my hip after surgery?
You may hear noise in the hip after surgery and this is normal. It is usually more noticeable after surgery when you have swelling. As the swelling decreases the noise may become less noticeable.
How do I know when to seek medical attention?
Seek medical attention for sustained fever greater than 101˚, shortness of breath, chest pain, excessive redness or warmth, and any medical concern that you feel warrants immediate attention.
TOTAL KNEE REPLACEMENT
Will my leg swell after surgery?
It is very common to experience swelling after surgery, this can usually occur 3-4 days after surgery. The more activities and physical therapy you perform, the more swelling you may experience.
Remember the RICE protocol and continue to rest, ice, and elevate, especially after physical therapy.
Will I have bruising after surgery?
Yes, you will have significant bruising after surgery, but everyone is different. Some will only experience redness around the incision; others may have bruising down the entire leg, and both are very normal.
What should I expect my activity level to be?
Every day you should be increasing your activity level but let your pain level and swelling be your guide. Approximately around 6 weeks after surgery, you will be 75 percent recovered and the remaining improvement will come within the next year.
What if I am having problems sleeping?
Make sure that your pain is well controlled throughout the day to get a good night's rest. Try to avoid naps during the day and plan your normal activities if possible. Avoid caffeine.
How much weight can I put through my leg after surgery?
Put as much weight as you can tolerate through your surgical leg immediately after surgery. The term is *weight bearing as tolerated." Your physical therapist will instruct you on how to use your assistive device in order to perform this properly.
When can I shower or bathe?
You can shower the day after surgery using a waterproof bandage. To ensure that your incision heals properly, we do not want you to bathe or get into a swimming pool until your post-op appointment 3-4 weeks after surgery.
What about using a hot tub or whirlpool?
Because of the heat and bacteria in the water, we do not want you to use a hot tub or whirlpool for six weeks.
How long do I have to wear stockings?
You should wear the compression stockings on both legs for three weeks. Keep the compression stockings on during the day and remove them at night.
I just had a knee replacement. In what positions can I sleep?
You may sleep in any position in which you are comfortable.
Now that I am no longer requiring narcotic pain medication, what can I take if I should experience discomfort?
You may take Tylenol or Extra-Strength Tylenol or over the counter medications, such as Advil or Aleve (Ibuprofen).
How do I know when to seek medical attention?
Seek medical attention for sustained fever greater than 101˚, shortness of breath, chest pain, excessive redness or warmth, and any medical concern that you feel warrants immediate attention.
SHOULDER ARTHROSCOPY
When can I change the dressing?
Change your dressing the second day after surgery. Your dressing is a sterile dressing applied during surgery while still sterile. After the first dressing change, keep incisions covered with a band-aid and change daily until follow-up.
What about taking a bath?
It is ok to shower after the first dressing change as long as you use waterproof band-aids that can be purchased at your pharmacy. Do not submerge your shoulder in bath water, lake, hot tub, pool, or water until sutures are out. Keep bandages clean and dry.
When do sutures come out?
Sutures typically are removed at your 2 weeks postop visit.
Can I use ice?
Yes, ice constricts blood vessels and helps with swelling. Always use a barrier such as a towel or cloth pad between skin and ice bag to prevent frostbite. Use the ice for 15-20 minutes out of the hour for the first 48 hours as needed.
Can I drive?
Do not drive on pain meds or while your shoulder requires an arm sling. You should feel confident in your ability to drive and be off pain meds before driving and no sling or brace before driving.
Can I smoke?
Do not smoke after arthroscopy. Smoking increases your risk of blood clots, and you should avoid smoking in the post-0perative period.
Why am I constipated?
Pain medication causes constipation. Eat lots of fruits and drink water to help prevent this. Several over the counter meds are available if this is a problem. Consult your pharmacist.
What about compression stockings?
They help prevent blood clots and we recommend that you wear them for two weeks.
What about pain medication?
You are typically given a prescription for pain medication at discharge. Take the medication as prescribed on the bottle. Wean yourself from the pain meds as quickly as possible and use the medication only as needed. Most pain meds have Tylenol as part of the medication. Do not take extra Tylenol while taking your pain medication. If you need additional medication, you can use ibuprofen or Aleve as medically permitted.
What about blood thinners?
There are no formal recommendations from authorities such as the American College of Chest Physicians or the American Academy of Orthopedic Surgeons to treat with blood thinner medications such as Coumadin, Heparin, or Lovenox for blood clot prevention after a shoulder scope. We do recommend that you take a low dose baby aspirin daily for one month after scope as a precaution as long as you do not have a contraindication. This should be purchased over the counter at your pharmacy.
Will I need Physical Therapy?
Yes, most shoulder scope patients will need to go to Physical Therapy. The type of shoulder scope that you had will determine when to start PT and what restrictions will be placed on you during therapy.
What home exercises can I do?
Your doctor will direct you as to post-operative activity based on your surgery findings.
How do I know when to seek medical attention?
Seek medical attention for sustained fever greater than 101˚, shortness of breath, chest pain, drainage from the shoulder, severe pain, excessive redness or warmth from the shoulder, and any medical concern that you feel warrants immediate attention.
KNEE SCOPE
When can I change the dressing?
Change your dressing the second day after surgery. Your dressing is a sterile dressing applied during surgery while still sterile. After the first dressing change, keep incisions covered with a band-aid and change daily until follow-up.
What about taking a bath?
It is ok to shower after the first dressing change as long as you use waterproof band-aids that can be purchased at your pharmacy. Do not submerge the knee in bath water, lake, hot tub, pool, or water until sutures are out. Keep bandages clean and dry.
When do sutures come out?
Sutures typically are removed at your 2 weeks postop visit.
Can I use ice?
Yes, ice constricts blood vessels and helps with swelling. Always use a barrier such as a towel or cloth pad between skin and ice bag to prevent frostbite. Use the ice for 15-20 minutes out of the hour for the first 48 hours as needed.
What exercises can I do?
Calf pumps and straight leg raises are helpful to keep strength in the leg and maintain activity. Straight leg raises are performed with the patient lying flat on the back raising the foot up off the floor to about 45 degrees and down. Calf pumps are performed by making the motion with the ankle to press the gas pedal on the car. Perform these exercises 20-25 times three times per day or more often.
Do I need to go to Physical Therapy?
Typical knee scopes do not always require PT. This decision will be made on a case-by-case basis by your doctor.
Can I drive?
Do not drive on pain meds or while needing assistive devices to walk. You should feel confident in your ability to drive and be off pain meds before driving.
Can I smoke?
Do not smoke after knee scope. Smoking increases your risk of blood clots, and you should avoid smoking in the post-operative period.
Why am I constipated?
Pain medication causes constipation. Eat lots of fruits and drink water to help prevent this. Several over the counter meds are available if this is a problem. Consult your pharmacist.
What about pain medication?
You are typically given a prescription for pain medication at discharge. Take the medication as prescribed on the bottle. Wean yourself from the pain meds as quickly as possible and use the medication only as needed. Most pain meds have Tylenol as part of the medication. Do not take extra Tylenol while taking your pain medication. If you need additional medication, you can use ibuprofen or Aleve as medically permitted.
What about blood thinners?
There are no formal recommendations from authorities such as the American College of Chest Physicians or the American Academy of Orthopedic Surgeons to treat with blood thinner medications such as Coumadin, Heparin, or Lovenox for blood clot prevention after a knee scope. We do recommend that you take a low dose Baby aspirin daily for one month after knee scope as a precaution as long as you do not have a contraindication. This should be purchased over the counter at your pharmacy.
What about compression stockings?
They help prevent blood clots and we recommend that you wear them for two weeks.
How do I know when to seek medical attention?
Seek medical attention for sustained fever greater than 101˚, shortness of breath, chest pain, drainage from the knee, severe pain, excessive redness or warmth to the knee, and any medical concern that you feel warrants immediate attention.