Post-operative instructions for ACL reconstruction
General
After your anterior cruciate ligament reconstruction, your incisions will heal within 2-3 weeks, but the internal structures of your knee may take several more weeks to recover. This timing depends on the type of procedure done, your age, and if you have pre-existing conditions (i.e. arthritis). You may experience difficulty with stair climbing (6-8 weeks), squatting (2-3 months), and running (6-12 weeks and sometimes we’ll recommend you not resume it).
Pain
Your knee will feel numb and less painful right after surgery because of the medication injected into it. This will wear off later tonight and the pain could increase. The most severe pain usually lasts a day or two and then gradually subsides. As you notice the effect of the numbing medicine wearing off, take your prescribed medicine. Some of its potential side effects are sleepiness, nausea, and rash/ itching. If you notice these symptoms you may be allergic, please let me know.
Swelling
Some swelling is expected. Apply ice for 20 minute periods a few times each day, especially during the first week. Elevate your operated leg above the level of your waist. Do not put a pillow under your knee, even though it may be more comfortable this way. Rather, place a small pillow or rolled up blanket/ towel under your heel. This will keep your knee straighter when you rest, which will make the return to walking easier.
Dressing
Remove your ace wrap and bandages after 48 hours. You may then shower; afterwards dry the incisions, and cover with band-aids.
Wear the ace wrap while you are up and moving to help with swelling and give extra support.
Braces are routinely used and placed on at the time of surgery. Wear the brace most of the time until seen by the physician. May unlock the brace to allow knee motion.
Activity
In general, for the first few days, try to limit extended periods of time standing or walking. The less swollen your knee becomes the easier it is to regain range of motion. You may put full weight on your operated leg, unless the doctor specifically tells you not to. Using crutches for a few weeks helps control the pain and fatigue. You should not run or perform any heavy physical activity until your doctor/ physical therapist clear you for this. If you return to work in an office setting, keep your leg elevated on a chair/stool.
Exercise
Range of motion is regained by bending and straightening your knee beginning the day after surgery for 10-15 minute periods 4 times each day. You may also pedal on a stationary bike set on the lowest resistance.
Quad Sets: While keeping your knee straight, start by tightening your thigh muscle, hold to a count of 10, then relax for 5 and repeat. Do 20 of these at least 3 times a day. When this becomes easy, progress to the following.
Straight Leg Raises: Tighten your thigh, and while keeping it tight and your knee straight, lift the leg about 1 foot high and hold for the count of 10. Lower slowly, relax and repeat. Do sets of 20 at least 3 times a day. These exercises help restore strength to your thigh muscles, which takes 8 weeks to recover.
Once your sutures are removed, we’ll advance your activity level. Physical therapy is needed to assist with your recovery of motion and strength, and our office can often assist you with arranging it. The physical therapy prescription has the PT telephone number. Call now to arrange appointments for physical therapy appointments to start in 5-7 days.
Follow-Up
You will be given information on where and when your post-operative appointment is.
If you need to verify or change your post-op appointment, please call 703-277-2663.
Please notify our office immediately if you notice significant redness; continuous drainage from the knee; pain, swelling, tenderness of the calf; or high fevers.
A mildly elevated temperature is not unusual after surgery, especially if you underwent general anesthesia.
Post-operative instructions for knee arthroscopy/meniscus repair
Use ice and generally remain at rest for the remainder of the day.
Start knee range of motions exercises tomorrow. Use crutches for as long as you feel they are helpful, weight bearing as tolerated.
May remove dressing and shower in 48 hours. Put bandaids over the incisions after showering. Do not soak in water until sutures are removed.
Take pain medicine as needed, per the instructions on the bottle. Your knee will feel numb for a while today because it was injected with a local anesthetic to make you comfortable when you leave the surgical suite. A prescription for nausea is provided if needed.
Start these simple exercises in the next day or two. Tighten your thigh muscle, trying to flatten your knee into the bed, and hold for a count of 20. Do 20 repetitions at least 3 times a day every day. When this becomes easy, start tightening your thigh muscle and then lift your leg off the bed, keeping your knee straight, about 1 foot in the air, and hold it for a count of 10. Lower it and relax, then repeat 20 times, 3 times a day. This is called a straight leg raise.
Call the number on the back of the physical therapy prescription to arrange to start therapy in the next 3-5 days.
You will be told when and where your post-operative appointment is scheduled.
If you need to verify or change your post-op appointment, please call 703-277-2663.
Please notify the Springfield or Burke office for problems.
If you experience shortness of breath or chest pain, call 911.
Post-operative instructions for the lower extremity
Rest, Ice and Elevation
Remain generally at rest. Elevate and apply ice to area for the first 48 hours. Dressings must be kept dry.
Crutches
Use cane or crutches for security and comfort as needed. Discard them as soon as possible unless otherwise specified by your doctor. You will be told if weight-bearing is allowed as tolerated with pain and swelling are your activity guides.
Medications
You will be told which medications to take and how often.
Pain Medication Tips
- Do not drive while taking pain medications.
- Do not drink alcoholic beverages while taking pain medications.
- Pain medication should be taken with food as this will help prevent any stomach upset.
- Often pain medications will cause constipation. Eat high fiber foods and increase your fluid intake if possible.
- To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.
Dressing/Showering
Slight bleeding through the dressing/cast is common. Reinforce the dressing/cast with 4×4 gauze pads and gauze wrap as needed. Dressings/cast must be kept dry. Modify your bathing appropriately. Cover your dressing/cast with plastic when bathing. Use rubbing alcohol to remove the betadine prep solution from the skin.
Questions/Concerns
Your surgeon should be contacted by calling 703-810-5215 Option 3 or 703-525-6100, 24 hours a day for any of the following symptoms:
- Fever greater than 101.5 degrees F.
- Numbness, loss of good color or coolness in the foot.
- Severe pain unresponsive to narcotic medication.
- Excessive bleeding or vomiting.
- Difficulty breathing or shortness of breath – CALL 911
- Medications given to you at the surgery center
Follow-Up
You will be told when and where your post-operative appointment is.
If you need to verify or change your post-op appointment, please call 703-277-2663.
Post-operative instructions for rotator cuff repair
Use ice 20 – 30 minutes three times a day for the first 2 days, and generally remain at rest for the remainder of the day.
Stay in the sling at all times except for bathing, when getting dressed, and when performing the exercise regimen below. You may remove the sling each day to move your elbow and wrist to prevent them from becoming stiff. Do not try to raise your arm or move your shoulder, except as instructed below.
May remove the dressing and shower in 48 hours. Put band-aids over the small arthroscopy incisions and fresh sterile gauze bandage over the larger incision after showering. No baths or pools until cleared by me. After bathing, keep the incisions covered until I remove the sutures.
Exercises: Beginning the day after surgery, start exercising your shoulder by grabbing your wrist of your operated arm with your opposite hand and slowly lift the arm in front of you and gradually overhead, 10 – 15 repetitions, 3 times a day.
Lying flat in bed will be uncomfortable for several days. Sleeping with your back elevated on several pillows can be helpful.
Take the pain medication you were given as needed, per the instruction on the bottle.
A prescription for nausea, in case you develop any, is also provided.
To minimize gastric upset from narcotics eat adequate amounts of food.
Increase fluid and fiber intake to ease constipation from pain medicine
You will be told when and where your post-operative appointment is scheduled.
If you need to verify or change your post-op appointment, please call 703-277-2663.
Call the number on the back of the physical therapy prescription to arrange to start it in the next 3 – 5 days.
Call your surgeon if you have any excessive bleeding, numbness, fever, severe pain not relieved by the prescribed pain medication(s).
If you have shortness of breath or chest pain call 911.
Post-operative instructions for shoulder arthroscopy
Open or arthroscopic shoulder surgery requires a sling for protection post-operatively. Keep the sling in place until seen in the office by your surgeon. You can remove the sling to allow elbow, wrist and hand motions only, three times a day.
Dressings must be kept dry. Modify your bathing appropriately. No swimming is allowed until the wound is completely healed.
Slight bleeding through the dressing is common. Excessive bleeding should be reported to your surgeon.
Lying flat in bed will be uncomfortable for several days. Sleeping with your back elevated on several pillows can be helpful.
Apply ice to the shoulder intermittently for the first 24-48 hours.
You will be prescribed medications. Take them as directed.
To minimize gastric upset from narcotics or anti-inflammatory medicine, eat adequate amounts of food.
Increase fluid and fiber intake to ease constipation from pain medicine.
You will be told when and where your post-operative appointment is scheduled for.
If you need to verify or change your post-op appointment, please call 703-277-2663
Call your surgeon if you have any excessive bleeding, numbness, fever, or severe pain not relieved by the prescribed pain medication(s).
Post-operative instructions for shoulder arthroscopy and SLAP repair
Apply ice to your shoulder 20 – 30 minutes, 3 times a day for 48 hours and generally remain at rest for the remainder of the day.
Stay in the sling at all times except for showering. You may loosen the sling 2 -3 times a day to gently move your elbow and wrist. This will last 4 weeks. Do not move your shoulder until you start therapy and then only as directed.
Do not use the operated arm for anything—no pushing, pulling, lifting or twisting.
Do not put the arm through the sleeve of a shirt unless someone does if for you without lifting your arm away from your body.
May remove the dressing and shower in 48 hours. Put bandaids over the incisions after showering. Do not soak the incisions in water (no baths or pools for 1 month). Leave the paper steri-strips on until your follow-up visist.
Take the pain medication as needed, per the instructions on the bottle. A prescription for nausea if you have any, is also provided. You may also take ibuprofen 800 mg with food every 6 – 8 hours if needed for extra pain relief.
You will be told when and where your post-operative appointment is.
If you need to verify or change your post-op appointment, please call 703-277-2663.
Call the number on the back of the physical therapy prescription now to arrange to start therapy 2 – 3 weeks after surgery.
Call the Springfield office (703) 810-5210 Option3 or the Burke Office (703) 810-5221 Option 3 for any problems. If you have shortness of breath or chest pain, call 911.
Post-operative instructions for shoulder arthroscopy subacromial decompression
Use ice 20 – 30 minutes three times a day for the first 2 days, and generally remain at rest for the remainder of the day.
Stay in the sling until comfortable, then wean out of the sling as tolerated. You may remove the sling each day to get dressed and to move your elbow and wrist to prevent them from becoming stiff.
May remove the dressing and shower in 48 hours. Put band-aids over the incision after showering. Do not soak in water until sutures are removed.
May begin to use the arm in a few days. It is OK to raise the arm overhead, but no lifting or other heavy use. Initially, start exercising it by grabbing your affected side at the wrist with your other hand and slowly lift the arm in front of you and gradually overhead, 10 – 15 repetitions, 3 times a day.
Take the pain medication you were given as needed, per the instruction on the bottle.
A prescription for nausea, in case you develop any, is also provided.
To minimize gastric upset from narcotics eat adequate amounts of food.
Increase fluid and fiber intake to ease constipation from pain medicine
You will be told when and where your post-operative appointment is scheduled.
If you to verify or change your post-op appointment, please call 703-277-2663.
Call the number on the back of the physical therapy prescription to arrange to start it in the next 3 – 4 days.
Call the office if you experience any problems.
If you have shortness of breath or chest pain, call 911.
Post-operative instructions for the upper extremity
Rest, Ice and Elevation
Lying flat in bed will be uncomfortable for several days. Sleeping with your back elevated on several pillows can be helpful. Apply ice to the shoulder intermittently for the first 24 hours.
Exercise
You will be told to do ONE of the following two options:
Option 1: Wear the sling for protection post-operatively. Keep the sling in place until your surgeon sees you in the office. Starting tomorrow you may remove the sling 3-4 times a day to allow elbow, wrist and hand motion. Also begin gentle circular movements and pendulum exercises.
Option 2: Tomorrow remove the sling and begin gentle motion exercises. Discard sling as soon as comfortable. In 3-4 days begin wall climbing exercises and gradual overhead stretches.
Medication
You will be told which medications to take and the dosage.
Pain Medication Tips
- Do not drive while taking pain medications.
- Do not drink alcoholic beverages while taking pain medications.
- Pain medication should be taken with food as this will help prevent any stomach upset.
- Often pain medications will cause constipation. Eat high fiber foods and increase your fluid intake if possible. To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.
You should resume taking your normally prescribed medications unless otherwise directed
Dressing/Showering
Slight bleeding through the dressing is common. Excessive bleeding should be reported to your surgeon. Dressings must be kept dry. Modify your bathing appropriately. Swimming and hot tubs are not allowed until the wound is completely healed. Use rubbing alcohol to remove the betadine prep solution from the skin.
You will be told to follow ONE of the following two options:
Option 1: Leave dressing on.
Option 2: Remove dressing in 48 hours. Apply band aids to incision sites. Avoid direct water when showering. Dry thoroughly after showering and re-apply band aids. Avoid soaking in hot tubs, pools, lake or pond, as this increases the risk of post operative infection.
Questions/Concerns
Your surgeon should be contacted by calling 703-810-5202 Option 3, 24 hours a day for any of the following symptoms:
- Fever greater than 101.5 degrees F.
- Numbness, loss of good color or coolness in the arm.
- Severe pain unresponsive to narcotic medication.
- Excessive bleeding or vomiting.
- Difficulty breathing or shortness of breath, CALL 911.
Follow-Up
You will be told when and where your post-operative appointment is scheduled.
If you need to verify or change your post-op appointment, please call 703-277-2663.