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General Postoperative Guidelines for Patients




Day after surgery

Please ensure you take your pain medication as per the script provided. As regional or local anaesthesia done during surgery subside, it is important to allow for adequate pain management with oral medication.

We might have applied a circular bandage around your knee. This can be removed the day after surgery. Underneath this bandage you will find surgical site dressings which should not be removed.

Once discharged, when mobilizing to the toilet or around your home, please ensure to have someone with you at all times to prevent you from falling should you feel dizzy or loose balance.


Smoking?

Smoking cigarettes increases your risk of infection as well as it delays healing of bone and soft tissue. It is best to stop 6 weeks prior to surgery and tobacco-free for a minimum of 6 months after surgery to increase your chances of success post-operatively.

How can I reduce swelling after the surgery?

• raise your leg above the level of your heart

• apply ice

• Ankle movement (moving your foot up and down)

• TED stocking.


How long should I use the surgical stockings (TED)?

There is some evidence that TED hose stockings reduce deep vein thrombosis and they should be worn for the first weeks. You can removed them daily to wash but put back on as soon as possible after this. Make sure not to slip and fall while walking without shoes.


When do I have my sutures (stitches) removed?

Most commonly we use sutures to close the scope portals or surgical incisions which will dissolve underneath your skin and don’t need to be removed. If we used non-dissolvable sutures these will need to be cut at 2 weeks post-operatively. This is done at your follow-up visit.


Can I shower?

Your dressings and wound must stay dry the first 2 weeks to decrease the risk of infections. Cut a plastic bag to make a tube, slip into it like a stocking and close it off above and below the knee with a rubber band. After two weeks, you can get the incision briefly wet in the shower but must not bath for month after the surgical procedure.

Why do I have to take a blood thinner and for how long?

Any orthopedic surgery is a risk factor for developing a blood clot, also known as a DVT (deep vein thrombosis). In order to decrease the chance of a blood clot, patients are placed on one of two blood thinners depending on their weight bearing status post-operatively. The type of medication you will be placed on will be discussed during your pre-operative visit. Please notify our providers if you are on any hormone medications (including birth control) or if you have any personal or family history of blood clots or blood clotting disorders as these also increase your risk for blood clots.


What are signs of a blood clot and what do I do if I suspect one?

Please contact us immediately if you have:

• Severe calf/leg swelling or diffuse redness.

• Severe calf pain with moving foot up/down or when squeezing the calf.

We check your leg with an ultrasound to rule out a blood clot. You can call our office during office hours, otherwise please contact our emergency department.

*If you develop chest pain or difficulty breathing, call the preferred emergency service IMMEDIATELY.

What are signs of an infection and what do I do if I suspect one?

While infection is not common, there is always a risk with any type of surgery. Symptoms are:

• Fever

• yellow drainage (pus)

• excessive redness or swelling around the incision site(s).


What if I need a refill on a medication?

Pain medication prescriptions are provided on the day of discharge for inpatient surgeries or the day of the pre-operative visit for outpatient surgeries. All other medications (anti-nausea, anti-constipation and blood thinners) are prescribed day of surgery. If you require a refill on any of these medications, please contact our office during business hours. Best is if you ask your pharmacist to get in contact with us, with requested medications so we can coordinate with your pharmacy. If you are not within driving distance, we recommend you see your primary care provider or an urgent care clinic for further evaluation.

*While our team takes your pain concerns very seriously, we are devoted to the international effort in decreasing the opioid addiction epidemic. We abide by strict guidelines provided by the CDC and have created a pain medication agreement plan with a link below.


May I take anti-inflammatory medicines after the surgery?

We usually don’t prescribe anti-inflammatory medicines (NSAIDs – such as ibuprofen, voltaren, naproxen, etc.) for our patients after surgery as these can potentially delay bone healing and interfere with ligament graft healing.


How much weight can I bear on my leg after surgery?

Weight bearing status is dependent on both the type of surgery and anesthesia you will undergo. If you decide to have a nerve block during surgery, you will be automatically placed in a knee immobilizer with non-weight bearing status until the nerve block is removed. We will discuss your weight bearing limitations during your pre-operative visit and again after your surgery. The physiotherapists will also help instruct you on the proper use of your crutches to ambulate.


How do I obtain braces/crutches and for how long am I supposed to wear my brace/knee immobilizer?

Details regarding the duration you are to wear your brace will be discussed during your pre-operative visit as well as along your recovery process during post-operative clinical visits. Any required post-operative braces or crutches will be fitted and provided the day of your surgery. If you have any issues with your brace/crutches, we have an in-house team that will help you with any adjustments you may need upon your next clinical visit with us.


How soon do I start physical therapy?

Physical therapy is started the day after surgery! Your physical therapy protocol will detail what specific activities you can perform at different time frames during your rehab. Follow these instructions carefully and DO NOT ADVANCE or let your physiotherapist advance your protocol beyond the normal time frames unless directed so by your surgeon.


When is my first post-operative visit with the team?

Our team will see you during our rounds the day after your surgery, we will perform dressing changes, discuss activities of daily living and obtain post-operative x-rays. There will be an opportunity to have any further questions answered, although we will be available throughout your recovery process to address your concerns.

What is the expected timeline for post-op office visits?

Most likely our patients will have post-operative office visits with the following timeline below:

• 2 weeks: the suture removal is performed. If you are not able to make this visit, we recommend you follow up with your primary care provider for post-op wound care.)

• 6weeks (Depending on procedure type.)

• 3 months (Depending on your procedure)

• 6 months

• 12 months

• Annually


This protocol was adopted from Dr LaPrade (USA)


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