Discharge Procedures

  • Post Op / Discharge Instructions

For the post operative instructions that best correspond to the type of procedure you've received, please select from the list below:

Arthroscopic Knee Surgery

Activities: Unless otherwise instructed, you may immediately bear full weight on your operated extremity. The local anesthetic in your knee will usually last for 8- 12 hours, so be careful not to overuse the knee during this period. You can walk normally, but do not do any strenuous activities such as running, jogging or jumping until I clear you for this. You may experience some discomfort as you start to walk. Use the pain medication provided, starting about 6 to 8 hours after surgery. Also, unless otherwise instructed, it is not necessary for you to use crutches. However, if you feel more secure with crutches, feel free to use them for a day or two.

Pain Management R.I.C.E. therapy that is, Rest, Ice Compression and Elevation, is the best therapy for your post-surgical pain management. Use R.I.C.E. therapy for the first 24 to 48 hours after your surgery. Ice packs are also helpful in decreasing the swelling and discomfort. It is recommended that you maintain ice packs on your knee at least 50% of the time during the first 24 hours. Ice packs or gel pack can be used for 15-20 minutes per session to reduce swelling and inflammation.

Exercises It is important for you to understand that the large thigh muscle will shrink in size and strength quite rapidly, unless you exercise it. Exercises that are good for you include:

  1. Exercise the calf by rotating foot in a circle.
  2. Straighten your knee as straight as possible and clench thigh muscle tightly, hold the muscle clenched for 5 seconds. Repeat this exercise 10-20 times every hour.
  3. You should try to do at least 100 thigh tightening per day to keep the tone and strength in the muscle.
  4. As soon as you have done the above exercises, you may begin to do straight leg raises.
  5. Start bending your knee the day after surgery and increase the bending until full motion has returned.

Medication A prescription for pain medication will be given to you as you at your preoperative evaluation or leave the hospital recovery room. Please use this medication as needed. Do not take this pain medication on an empty stomach. Do not take anything containing aspirin for a week after surgery (Aspirin thins the blood and may cause an increase in bleeding tendency).

Bandages The rolled on cotton wrapping around your knee, which lies beneath the elastic bandage, may be removed the day after surgery. You should then re-wrap the knee with only the elastic bandage and a gauze pad for about 3-4 days, or until swelling is gone. Do not wrap the elastic bandage too tightly or it will act like a tourniquet and cause ankle swelling. If you have an EBI Cold Therapy System, the sterile pad will be under the cotton wrapping and over the elastic bandages.

Stitches/Sutures/Steri-Strips The small skin incisions, called portals, are held together with skin tapes called "steri-strips". These strips should not be removed, but should remain in place until your first postoperative visit. Unless otherwise instructed, you may remove the outer dressings - except the steri-strips - to take a shower the first day after surgery. Simply pat the knee dry with a plain towel and reapply clean gauze and wrap with the elastic wrapping.

Post Operative Appointment If you were not given a follow up appointment prior to surgery, please call the office at (408) 379-8141 to make an appointment 7 days following surgery.

Please Call (408) 379-8141 at any time, days or nights and weekends:

  1. If you have unusual or uncontrolled pain not relieved by ice, rest, elevation and pain medication.
  2. If the wound(s) or the arthroscopy site is very red, hot or swollen and that is not relieved by application of ice and elevation.
  3. If there is any drainage that is cloudy.
  4. If the wound(s) have a foul odor or look infected.
  5. If your oral temperature is 101 degrees or above.
  6. If your oral temperature is 100 degrees or above for more than 24 hours.
Post-surgical problems following arthroscopic surgery are very rare. However, if you have a problem, please do not hesitate to call. If your call is placed after-hours or over a weekend, please call the office telephone number and the answering service will contact the doctor.

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Rotator Cuff Repair - Open or Closed

Medications A prescription for pain medication will be given to you at the time of your preoperative evaluation or as you leave the hospital. Please use all medications as directed. Unless otherwise instructed, do not take anything with aspirin in it for at least one week after surgery.

Activities In the recovery room, you will notice that your arm is in an abduction pillow or sling. This should be worn at all times. You are to keep your arm in the position that the abduction pillow provides. You may perform a hand exercise, you should acquire a soft rubber ball or some such device in order to do hand squeezes. This also will reduce stiffness and swelling in the surgical extremity. Other instructions on progressive exercises will be given at your follow-up visits. It is important that you maintain your arm in the position as instructed at the time of your discharge to protect surgery.

Wounds and Dressings The postoperative dressings should be maintained intact until the first postoperative visit. The dressings should be kept dry. If you have a cooling pad in place, you may want to place a paper towel or and cloth between the pad and dressings to absorb the moisture that accumulates on the Ice pad.

PROBLEMS - Please contact my office if any of the following should occur:

  1. You develop increasing pain in the shoulder that is not relieved by rest or ice packs.
  2. You develop a temperature above 102° or a persistent temperature above 101°.
  3. You note loss of strength or feeling in the fingers.
Problems following this type of surgery are minimal. However, if you have any questions or feel that there is a problem, please feel free to call at any time.

Return Appointment Unless mentioned otherwise, your shoulder will be rechecked 6-10 days after surgery. Please call my office as soon as you get home if a recheck appointment was not set up prior to having your surgery.

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Anterior Cruciate Ligament Reconstruction

Medications You will be given a prescription for pain medication at the time of the preoperative visit or prior to leaving the hospital. Unless otherwise instructed, do not take anything with aspirin in it for approximately one week after surgery.

Bandages The dressings should not be removed until you have been cleared by me for showering. Steristrips over the incision should not be removed. The Ace (elastic) wrap may be removed the first day following surgery and the rolled-on cotton padding may be removed. The ace wrap should be re-applied at least once daily and any time it becomes excessively loosened or displaced.
A cooling pad or ice packs should be used often over the first 24-48 hours after surgery, and then as needed to help relieve swelling and discomfort.

Activities Your knee brace (or immobilizer) should be worn at all times when you are up. Unless otherwise instructed, you may bear weight as comfortable on the operated extremity. It is advisable to start with approximately 50% weight on crutches and 50% on the foot, increasing your weight bearing as comfortable.

If you are wearing a brace, feel free to move the knee in the range of motion provided by the brace. If you are wearing a knee immobilizer, when awake and non-weight bearing you may remove the immobilizer in an attempt to gently bend the knee.

Also, with the brace or immobilizer, you may work on gently straightening the knee by pressing the back of the knee down against the bed. Bending and straightening exercises should be carried out at least four times daily for 5-10 minutes of each waking hour.

Exercises The thigh musculature will shrink in size and strength quite rapidly unless you exercise it.

  1. Start with muscle tightening (isometric) exercises for the thigh. Clench the thigh muscles tightly and attempt to hold for 5 seconds; then relax.
  2. Next, progress to leg lifts. Lying on your back, attempt to carry out 10-20 leg lift repetitions. Then, turning to the un-operated side, lift the operated leg upward, again attempting 10-20 repetitions.
  3. Exercise the calf muscles by making a circle with the toes.

The initial discomfort sometimes noted when arising from bed may be diminished if you carry out a set of leg exercises immediately prior to getting up on your crutches.

Physical therapy usually begins sometime after the first postoperative visit, but this may vary. Specific instructions will be given at that time.

Return Appointment If you have not already been scheduled for your first postoperative appointment, please call my office.

PROBLEMS - Please contact my office if any of the following should occur:

  1. Increasing knee pain not relieved by rest, ice and elevation.
  2. Temperature of 102° or above.
  3. Persisting temperature (24 hours) of 101°.
Should you develop calf tenderness, please contact me immediately. Blood clots (deep venous thrombosis) are extremely rare following this type of surgery, due to early mobility.

If you have any other question or problems, please feel free to call.

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Arthroscopic Shoulder Surgery

Medications A prescription for pain medication will be given to you at the time of your preoperative visit or prior to leaving the hospital. Please use this medication as directed. Unless otherwise instructed, do not take anything with aspirin in it for approximately one week after surgery.

Activities Your arm is supported in a sling. The sling is for your comfort. It may be removed the morning after surgery. You are encouraged to gently carry out a range of motion of the operated shoulder. You should attempt to carry this out at least a three times a day. Your non-surgical arm may be used to support the operated arm at the elbow as you carry out a range of motion. You may also lean forward and gently swing the operative arm back and forth as a pendulum to help provide progressive motion.

Wounds and Dressings You may remove the postoperative dressings on the day after surgery. Do not remove the steristrips that are directly over the wound. You apply ice to the shoulder for comfort and swelling reduction.

PROBLEMS - Please contact my office if any of the following should occur:

  1. You develop increasing pain in the shoulder that is not relieved by rest, ice packs and pain medication.
  2. You develop a temperature above 102° or a persistent temperature above 101°.
  3. You note loss of strength or feeling in the fingers.
Problems following this type of surgery have been very minimal. Nonetheless, if you have any questions or feel there is any type of problem, please feel free to call.

Return Appointment You will normally be rechecked in 6-10 days following surgery. If a postoperative appointment has not already been made, please call my office as soon as you get home to schedule this.

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