Total Knee Discharge Instructions

Congratulations! You are now ready to begin your recovery after total joint replacement surgery. These are some simple instructions to help you in your first steps in this new phase of your journey. Please feel free to contact our office if you have any specific questions or concerns.

Wound Care

Remove your outer ACE bandage surgical bandages 5 days after your surgery. Leave the underlying bandage in place. Please do not apply any lotions, ointments or creams to the surgical site. Please leave steri-strips (white paper strips) on your wound until you see the doctor.

Unless stated otherwise, you may shower 3 days after surgery, or as instructed by your doctor. Do not allow the shower water to hit the incision directly. USE A CAST BAG around your leg to protect the underlying dressing from getting wet. Allow soapy water to run over the surgical area. Please avoid scrubbing the surgical site when showering. Whatever you decide to do, please use CAUTION!! Be careful not to slip, twist, or fall. A stool placed in the shower so you can sit is a great idea so you can stabilize yourself. Do NOT soak in a bath tub, hot tub, or pool until the doctor tells you it is O.K. to do so.

Post-Operative Medications

Medicine after Total Joint Replacement are used to reduce your risk of a blood clot (DVT), control pain, and limit common side effects after surgery. Sometimes it is appropriate not to take some of your regular home medications until cleared to restart by the Total Joint Team or your Primary Care Provider. Ask, if you are not sure.

DVT Prevention

Aspirin: 81mg, Take 1 tab every 12 hours for 4 weeks after surgery.
- This is a blood thinning medicine to help lower your risk developing a blood clot, also called a deep vein thrombosis (DVT).
- Please take with food. This medication may upset your stomach.
NOTE:If you were on a different blood thinner before surgery, we will likely restart that medication. If you have had a DVT or PE before, have had a stroke, or have an allergy to aspirin (and you were not on a blood thinner) we will likely use a different medicine based on the best medical recommendations.

Pain Medicine

Acetaminophen: 500mg, take 1-2 tabs every 6 hours, as needed for pain.
- This is a medicine for pain. This medicine is not addictive.
- We recommend using this regularly for the first 2 weeks after surgery.
- Generally, start with 2 tabs and as your pain levels improve, taper to 1 tab. This will help provide steady baseline pain control.
- To avoid the risk of liver injury when combined with other sources of acetaminophen, please review labels of all over-the-counter medications and follow dosing directions carefully.
- Do not exceed the maximum daily dose of acetaminophen: 3000mg.
Meloxicam: 15mg, take 1 tab every 24 hours, as needed for pain.
- This is a medicine for pain and inflammation. This medicine is not addictive.
- We recommend using this regularly for the first 3-4 weeks after surgery.
- Generally, when used with the acetaminophen, this will help provide steady baseline pain control.
- Please take with food. This medication may upset your stomach.
- This is a Non-Steroidal Anti-Inflammatory Drug (NSAID), and is not appropriate to take with other NSAIDs or if you have kidney problems.
Oxycodone or hydrocodone: 5mg IR, take 1-2 tabs every 6 hours, as needed for severe pain.
- This is a narcotic/opioid pain medicine and potentially addictive. Long-term use is discouraged.
- We recommend using 1-2 tabs every 6 hours for the first 3-4 days after surgery.
- As your pain levels improve, taper to 1 tab, and discontinue as tolerated.
Tramadol: 50mg, take 1-2 tabs every 6 hours, as needed for pain.
- This is a narcotic/opioid pain medicine and potentially addictive. Long-term use is discouraged.
- We recommend using 1-2 tabs every 6 hours for the first 1-2 weeks after surgery.
- As your pain levels improve, taper to 1 tab, and discontinue as tolerated.
- This medicine may not be provided for all cases.
NOTE:If appropriate, Dr. Akoh’s Team will provide for pain management for the 90 days following your surgery. Pain medication needs outside of this window should be discussed with your Primary Care Provider or Pain Management Physician.

Other Medications

Docusate: 100mg, take 1-2 tabs once a day, as needed for constipation.
- This is a stool softener that you should only need while you are taking the narcotic/opioid pain medications. It will help reduce constipation, a common side effect of narcotic/opioid pain medications.
Ondansetron: 4mg, take 1 tab every 8 hours, as needed for nausea.
- This is a medicine to reduce nausea. You only need to take it if you vomit or feel like you may vomit.

Activity

ICE the area of your surgery for 20-30 minutes, 3-5 times a day. Do not put ice directly on your skin! This can cause serious injury to you skin! Cover the skin with a towel or cloth before applying an ice pack.

ELEVATE your operative leg for 20-30 minutes, 3-5 times a day. This means that the knee and ankle of your operative leg are propped higher than your heart.

WALK on your operative leg. Unless told otherwise, you may put your full weight on your operative leg.

USE the walker. This will help you walk safely for the next few weeks until your post-op visit or advanced by PT.

WORK with Physical Therapy. You should know before you leave the hospital if PT will be coming to your home or you will be going to their office. You should work with PT a few times at home or at their office before your first post-op visit around 2 weeks after surgery.

DVT Prevention

One possible complication after surgery is a blood clot, or deep vein thrombosis (DVT). The best way to reduce your risk for a blood clot is to walk several times per day. If you are at increased risk for blood clots, you will be prescribed an additional medication.

Common Concerns

A low-grade fever is not uncommon. If you develop a significant fever greater than 101, or if you develop redness or excess drainage from your incision(s), call the clinic during business hours or go to the Emergency Room after business hours.

Atelectasis is a common condition in patients who have been under anesthesia and is a common cause of low-grade fevers during the first 24-48 hours following surgery. It occurs if a patient is not taking normal (deep) breaths and not moving around with normal activity, which is what often happens when patients are recovering from surgery. Taking narcotic pain medications and not doing the normal amount of walking and other activity restrictions can predispose a patient to this condition. However, it is easily remedied by either taking 10 deep breaths at least once or twice every hour, or using the incentive spirometer instrument (ball that floats up in a tube when take a deep breath) if your doctor prescribed one for you when you were discharged.

Constipation commonly occurs after surgery due to taking narcotic pain medication, being inactive, or both. If your bowel habits have slowed significantly or you are unable to have a bowel movement, and you were not sent home on a stool softener, you may need to call the Ortho clinic and ask your doctor to order a stool softener to help you have a bowel movement.

It is important to watch for:

Increasing pain after 4-5 days
increasing redness, warmth, or swelling of your operative leg
drainage from your wound
a temperature over 101°

If you have any of these symptoms, you should call the office immediately, (706) 266-1250.

Driving After Surgery:

The ability for someone to resume driving after surgery is seldom a medical question, but usually a legal question. It is the responsibility of all licensed drivers to always drive safely, no matter what their permanent or temporary impairment may be. Reaction time following surgery may be compromised, secondary to medication and/or pain. The ability to fully use all extremities may be impaired after surgery.

Follow-Up Instructions:

Call to confirm the date and time of your appointment, (706) 266-1250. Usually the first Post-Op appointment is two weeks after surgery with the Orthopedic Surgeon or the Physician Assistant.
Contact your physician's office during office hours at 770-266-1250. The orthopedic staff on-call can be reached through this method if a medical emergency arises.

When to Call the Office?

Do not hesitate to contact our office if any concerns arise. We make every effort to return phone calls in a timely manner. During normal business hours please call the office at 770-266-1250. If after hours, please use the same number, but your call will be routed to one of the physicians on call for our group.