Post Orthopaedic Surgery Care

Wound Care

After knee surgery, the initial operative dressing and bandage can be removed one or two days after the procedure. If arthroscopic surgery was performed, apply Band-Aids and either an Ace bandage or an elastic or neoprene knee sleeve. This helps to prevent swelling and gives more support. If you are more comfortable without it, and there is no significant swelling, then leave it off.

If you had shoulder surgery, the dressing can be removed a day or two after surgery and Band-Aids applied. In all cases, your sling or shoulder immobilizer may be removed for hygiene and washing. Be sure to follow instructions as to which movements are advised and which are to be avoided.

Patients who undergo total joint replacement will have their dressings removed while in the hospital.

Notify the office immediately if the wound becomes red, swollen or angry-looking, or if there is excessive drainage or pus. Also call us if you have severe pain or if you have a fever. If you feel that you must be seen immediately, go to the emergency department at Beth Israel Medical Center or your local hospital.

Showering

As a general policy, all patients with surgical incisions can shower as long as the wound is dry and sealed. If leakage or drainage occurs (other than a small amount of blood or yellow fluid) call our office. Afterwards, the wound should be patted dry.

Swelling

Following any surgery swelling of the area, including the thigh, knee, foot and ankle is common and can persist for several weeks or months. In rare cases the swelling may be permanent. Bruising of the area of surgery ("black and blue") is common and to be expected. Rarely, blistering may occur. If swelling is accompanied by pain, especially in the calf, this could be a sign of a blood clot. Call us if you have concerns about your postoperative progress or have any questions.

Numbness

It is also common to experience some "numbness" about the incision area. This is especially common after knee replacement on the lateral (outer) side of the knee incision. This may persist for weeks or months. This usually gets smaller and gradually subsides, but in rare cases it may be permanent. Numbness does cause any functional problem.

Cold Therapy for Control of Pain and Swelling

Application of ice to the surgical site is extremely helpful in reducing swelling and pain. I used a mechanical continuous cold therapy delivery system after my own surgery and it worked even better than oral medications to relieve local pain and discomfort. If you are an in-patient, cold therapy will be provided in the hospital for you. You may take home the wrap but you must purchase the pumping unit for use at home. We will give you information about how to get one at a reduced affordable price. In some cases your insurance will reimburse you. If you do not get the mechanical device, cover the area with a thin towel or cloth, and apply the ice in a plastic bag for about 20 minutes and repeat every hour as needed. The mechanical continuous system works much better and I urge you to get it. With the initial post-operative dressing, the cold may not get thorough.

Pain and Anti-Inflammatory Medication

Patients typically receive a prescription for a codeine-containing painkiller called Vicodin and an anti-inflammatory medication like Celebrex or Relafen. If you are allergic to Codeine or Aspirin, please let us know and we will substitute other drugs. Anti-inflammatory medications contain no aspirin but are similar, so allergic reactions can occur.

Do not take it if you have a history of easy bleeding or ulcers. A true "allergy" means a rash, hives, breathing difficulties, etc. All medications can have "side effects" and these can include drowsiness, constipation, headaches, stomach upset and more rarely, bleeding. While you may not need to take the pain medication, especially if you use the ice regimen, please take the anti-inflammatory drug if possible.

Phone and Office Follow-Up

Logistics may make it impossible for me to see you immediately after your surgery in the recovery area. For ambulatory patients, I will call you either the night of surgery or the next day. Please give the number where you can be reached to my assistant or nurse when they interview you at the hospital. If something unexpected, unusual or not previously discussed with you was found at the time of surgery, be assured that I will tell you about it in the hospital before you leave. Otherwise, you may assume that all went well, as was expected and planned, with no complications. If my call is answered by a machine, I will leave a message about your surgery.

Arthroscopic surgery patients will be seen in the office about 10 days after surgery and joint replacement patients between 2 and 3 weeks after surgery, usually by my assistant John J. Lichardi, RPA-C. This visit is to check your wound, possibly to remove the sutures and to ensure that you are making satisfactory progress. You might need to return in another week if the sutures are not ready to be removed. Your appointment with me will be about 3-4 weeks after arthroscopic surgery. A 3 month visit may be needed for some procedures such as ACL reconstruction or rotator cuff repair.

For joint replacement patients, you will be seen for a wound check and suture removal at 2-3 weeks and a follow-up visit with me at 6 weeks, 3 months and for yearly check-ups thereafter, to ensure continued success of your implant. X-rays are taken at these visits. We generally like to see you each year for the first 3 years, then at 5 years and every 5 years thereafter. If you have any problems or symptoms then of course come whenever you feel necessary.

Return to Work, Driving and Traveling

Since everyone's occupation is unique regarding specific duties, mode of travel, and distance. It is impossible to make absolute predictions about when to return to work. Generally, you may return to work as soon as you are comfortable. Depending upon how you get to work and what you do and the type of surgery you had, this may be as soon as 2 days for an arthroscopic procedure and 2-3 weeks for a joint replacement. If your job requires standing for long periods, heavy lifting or a lot of walking, then a longer recovery, up to 3 months, may be needed. Arthroscopic patients may drive as soon as they feel comfortable and safe. Joint replacement patients may begin to drive and travel at 4 weeks. Because of an increased risk of blood clots, air travel is not recommended until 6 weeks after joint replacement surgery. Remember that walking, going up and down stairs, and carrying packages will not damage the joint or your surgery. All patients should try to resume normal activities, including walking outside, as soon as possible.

Living With Your Joint Replacement

Patients who undergo total joint replacement can return to most normal activities of daily living and enjoy many recreational hobbies, sports and exercises. Annual check-ups are recommended to make sure all is well. A wallet card in your packet will identify you as a joint replacement patient should the need arise for security screening. Importantly, the card advises you of the need for antibiotics when undergoing surgical, gynecological, urological and dental procedures. Please ask for one if you do not already have it.

« Return to Surgery Information Page