Post-operative Instructions

Post-operative instructions for Achilles tendon repair

You have undergone repair of your Achilles tendon, the structure that connects the calf muscle to the heel. The repair is performed by making a small incision, evacuating the hematoma (blood that forms around the torn tendon edges), and repairing the torn tendon edges together using suture material.

Cast/splint

Your leg has been immobilized with a compressive dressing reinforced by a posterior splint or cast. Although a bit cumbersome, the splint/cast provides comfort by immobilizing the site of surgery.

Swelling/bruising

Swelling can be controlled by elevating your leg. Try to keep your leg up elevated upon a few pillows for the first 48 hours. The goal is for the leg to be above the level of your heart. Swelling is further minimized by use of ice or cold therapy directly over the site of surgery. Alternatives include use of a bag of ice or frozen vegetables (such as peas/corn) beneath your ankle. Even though you are in a splint or cast, temperature at the surgical site will be decreased. Some degree of swelling of your foot and toes is normal. Because bleeding from the surgical site cannot escape, it typically will travel under the skin to the most “dependent” part of the extremity. Do not be alarmed then by the site of an evolving bruising of the foot and/or toes, which can increase over the first few weeks until ultimately resolving.

Dressing/woundcare/bathing

Your dressing/splint/cast will remain in place until seen in the office. It will be removed or changed at follow-up in the office, at which time a cast is typically applied. You may bathe or shower, but should keep the dressing/splint/cast dry, through use of a plastic bag (such as a clean garbage bag) as a cover. Secure it with tape above the dressing/splint to prevent getting it wet. If you are going to take a shower, you should use a plastic chair or some other means of sitting, both for balance and to avoid placing any weight on your leg. As an alternative you may want to try a bath and keep your leg hanging over the side of the tub.

Activity

For the first week try to minimize how much you’re up and about. The more your leg is “dependent” the greater degree of discomfort, including pain and a throbbing sensation in your leg. Do not weight bear (put weight on your leg).

Pain medication

Vicodin® (Hydrocodone) or Percocet® (Oxycodone) narcotic pain killers, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You will be scheduled for a post-op appointment in about 10 – 14 days following surgery, at which time your cast/splint will be removed and we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for ACL reconstruction

You have undergone an arthroscopic-assisted reconstruction of your Anterior Cruciate Ligament (ACL). In this procedure, an autograft (your tissue) or allograft (cadaver tissue) has been “harvested” and used to make a new ACL.

Brace/crutches

You have been placed in a long leg immobilizer for support and comfort when you are up walking around the first week after surgery; immobilization is not required but it is a good idea when you are up and about. Weight-bearing may begin the first day after surgery and is strictly a matter of your comfort. You will not damage the graft or knee by walking on it. Most patients find crutches of value until they are comfortable walking and have good balance, which typically takes about 10-14 days.

Swelling

Some degree of swelling of your foot and toes is normal. Swelling can be minimized by elevating your leg. Try to keep your leg up elevated upon a few pillows (placed under your ankle only) consistently for the first 48 hours, and intermittently thereafter. The goal is for them to be above the level of your heart. Swelling can be further controlled by use of ice or cold therapy directly over the sites of surgery. Place a bag of ice or package of frozen vegetables (which nicely conforms to the surgical site), usually 20 minutes on, and 20 minutes off. If you have a Cryocuff® pad and cooler (arranged pre-operatively for this use), keep the sleeve directly over the dressings. Use it continuously for the first week.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the foot and/or toes, which can increase over the first few weeks, is normal, and will ultimately resolve.

Dressing/bathing

Keep your dressing dry and in place until your post-op visit. You may shower (NO baths), but keep the dressing dry, through use of a plastic bag (such as a clean garbage bag) as a cover. Secure it with tape above the dressing to prevent getting it wet. If you are going to take a shower, you should use a plastic chair or some other means of sitting for balance.

Fever/shortness of breath

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Driving

If surgery was on your right knee you must wait to drive till you have complete control of your leg and foot (meaning you can walk without a limp) – approximately one week and are no longer taking the pain medication. If you had surgery on your left knee you may start driving once you are no longer taking the pain medication.

Range of motion exercises

Begin your post-operative exercises the night of surgery. The exercises are illustrated on the following pages. There are two motions we emphasize immediately after surgery, flexion (knee bending), and extension (knee straightening).

To restore flexion, a CPM, or Continuous Passive Motion machine (if prescribed for you pre-operatively) will facilitate knee bending. The machine is set such that it gently and passively moves your knee through a range of motion, beginning at full extension (fully straight or zero°) to about 50° (approximately halfway bent). The CPM device should be comfortable and as a guideline, is increased by ~ 10° each day. Small increases of 5° at a time, each morning and each afternoon, may be easier than increasing by the 10°. Use the CPM approximately 8-10 hours/day. You may use it in any comfortable combination (such as on for 3 hours, off for one hour, on for another 3, etc.), until you have reached your 8-10 hour minimum. If you find the CPM comfortable while sleeping, feel free to use it, though it does not count against day-time use. The CPM is discontinued upon reaching 110° for 2 consecutive days. Please call the CPM rep if you have any questions/problems with its use (703-281-1200).

Knee extension is achieved by exercises begun the day after surgery. Prop your leg up on several blankets or pillow(s) (placed beneath your ankle), such that nothing is touching the back of your knee. Keep it in this position passively stretching for a half-hour and repeat this for a total of three times a day. During these exercises, the leg should be out of the CPM.

Activity

For the first week try to minimize how much you’re up and down. The more your leg is “dependent” the greater degree of discomfort. If you work at a sedentary job returning to work after one week is generally fine. If you are active and on your feet all day, you may require longer than one week before returning to work.

Pain medication

Oxycontin, a long acting narcotic pain killer and Percocet® (oxycodone), a short acting narcotic pain killer, have been prescribed for pain. Take the oxycontin every 12 hours if you are experiencing severe pain, take the Percocet during those 12 hours if you have “breakthrough pain.” (Please note: You may be able to take only the Percocet and won’t need the Oxycontin). All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe. NSAIDs are also a good alternative option.

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.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Knee arthroscopy exercise guide

Regular exercise to restore your knee mobility and strength is necessary. For the most part this can be carried out at home. Your orthopaedic surgeon may recommend that you exercise approximately 20 to 30 minutes two or three times a day. You also may be advised to engage in a walking program. Your orthopaedic physician may suggest some of the following exercises. The following guide can help you better understand your exercise or activity program that may be supervised by a therapist at the direction of your orthopaedic surgeon. As you increase the intensity of your exercise program, you may experience temporary set-backs. If your knee swells or hurts after a particular exercise activity, you should lessen or stop the activity until you feel better. You should Rest, Ice, Compress (with an elastic bandage), and Elevate your knee (R.I.C.E.). Contact your surgeon if the symptoms persist.

Initial Exercise Program

Hamstring Contraction, 10 repetitions – No movement should occur in this exercise. Lie or sit with your knees bent to about 10 degrees. Pull your heel into the floor, tightening the muscles on the back of your thigh. Hold 5 seconds, then relax. Repeat 10 times.

Quadriceps Contraction, 10 repetitions – Lie on stomach with a towel roll under the ankle of your operated knee. Push ankle down into the towel roll. Your leg should straighten as much as possible. Hold for 5 seconds. Relax. Repeat 10 times.

Straight Leg Raises, 10 repetitions – Lie on your back, with uninvolved knee bent, straighten your involved knee. Slowly lift about 6 inches and hold for 5 seconds. Continue lifting in 6-inch increments, hold each time. Reverse the procedure, and return to the starting position. Repeat 10 times. Advanced: Before starting, add weights to your ankle, starting with 1 pound of weight and building up to a maximum of 5 pounds of weight over 4 weeks.

Buttock Tucks, 10 repetitions – While lying down on your back, tighten your buttock muscles. Hold tightly for 5 seconds. Repeat 10 times.

Post-operative instructions for arthroscopic Bankart repair

You have undergone an arthroscopic Bankart repair, in which a small camera (arthroscope) has been used to repair the torn labrum (the normal cartilage “bumber”) from your shoulder’s glenoid (socket) rim.

Sling

You have been placed in a sling for both comfort and protection of the repair. Remain in this sling until seen in the office, where you will be shown how it may be easily removed and reapplied. You will use the sling for 3 weeks.

Bandages/dressing/bathing

A bulky compressive dressing has been applied to your shoulder to absorb some of the fluid (which can leak out for the first 48 hrs after arthroscopy). You may either keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable. If you keep it in place, keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet. If you remove the dressings, you should apply Band-Aids over each of the small arthroscopic incisions when you shower.

Swelling

Some degree of swelling of your arm, hand and fingers is normal. Swelling can be controlled by use of ice or cold therapy directly over the surgical site. Place a bag of ice or package of frozen vegetables the surgical site; 20 minutes on, and 20 minutes off. The swelling in your hands and fingers can be improved by squeezing the soft ball attached to the sling!

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the arm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

For the first week try to minimize how much you’re up and about. No lifting or carrying anything heavy for the three weeks. Also for the first 3 weeks try to keep your arm to your side with your activities so as to not put pressure on the repair. No driving until you have good control of your arm, which likely will be about three weeks following surgery.

Sleeping

Patients often find that they are more comfortable sleeping in an upright position following shoulder surgery. Whether this requires just another pillow or two, a “husband” (name of triangular pillow that one can obtain from the Healthy back Store, for example) or even resting in a “Lazy Boy” type recliner, you may find sleeping in this position more comfortable for the first few weeks. However, such position is not necessary to protect the repair. It is simply a matter of your comfort.

Pain medication

Oxycontin, a long acting narcotic pain killer and Percocet® (oxycodone), a short acting narcotic pain killer, have been prescribed for pain. Take the oxycontin every 12 hours if you are experiencing severe pain, take the Percocet during those 12 hours if you have “breakthrough pain.” (Please note: You may be able to take only the Percocet and won’t need the Oxycontin). All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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.

Follow-up

You should be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started 1-3 weeks from the date of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for arthroscopic capsular release

You have undergone an arthroscopic capsular release of your shoulder. During this procedure, adhesions that have formed in the joint and associated structures are cleaned/removed thus releasing the shoulder capsule. This helps to immediately restore your range of motion.

Sling

The goal of the post-operative treatment is to maintain the gains of motion achieved during surgery, therefore you do NOT need to wear the sling. The sling should be used only for comfort for an hour or so at a time or for when you are in public to remind others that you have had an operation. It is not necessary to wear at night.

Bandages/dressing/bathing

A bulky compressive dressing has been applied to your shoulder to absorb some of the fluid (which can leak out for the first 48 hrs after arthroscopy). You may either keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable 48 hours later. If you keep it in place, keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet. If you remove the dressings, you should apply Band-Aids over each of the small arthroscopic incisions when you shower.

Swelling

Some degree of swelling of your arm, hand and fingers is normal. Swelling can be controlled by use of ice or cold therapy directly over the surgical site. Place a bag of ice or package of frozen vegetables the surgical site; 20 minutes on, and 20 minutes off.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the arm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

For the first week try to minimize how much you’re up and about but you may use your shoulder/arm to the degree you are comfortable. You risk no injury to your shoulder (other than making it sore from overuse) as nothing was “repaired.”

Sleeping

Patients often find that they are more comfortable sleeping in an upright position following shoulder surgery. Whether this requires just another pillow or two, a “husband” (name of triangular pillow that one can obtain from the Healthy Back Store, for example) or even resting in a “Lazy Boy” type recliner, you may find sleeping in this position more comfortable for the first few weeks. However, such position is not necessary. It is simply a matter of your comfort.

Pain medication

Oxycontin, a long acting narcotic pain killer and Percocet® (oxycodone), a short acting narcotic pain killer, have been prescribed for pain. Take the oxycontin every 12 hours if you are experiencing severe pain, take the Percocet during those 12 hours if you have “breakthrough pain.” (Please note: You may be able to take only the Percocet and won’t need the Oxycontin). All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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.

Follow-up

You should be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is a critical part of your result and must be started within the first two days of surgery; 3 times a week for 3-4 weeks. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for arthroscopic distal clavicle resection

You have undergone surgery to remove the arthritic AC joint of your shoulder. The AC joint allows gliding, shearing and rotational motion of the shoulder. During this procedure the “rough edge” of the AC joint is cleaned up to eliminate pain associated with the rotational motion of the shoulder prior to surgery.

Sling

You have been placed in a sling for comfort. Remain in this sling until seen in the office, where you will be shown how it may be easily removed and reapplied. You will probably use the sling for a short period of a week or so, just until you are comfortable. You may use it at night if you roll on it in your sleep, or when you’re out and about in public, to avoid inadvertent contact.

Bandages/dressing/bathing

A bulky compressive dressing has been applied to your shoulder to absorb some of the fluid (which can leak out for the first 48 hrs after arthroscopy). You may either keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable. If you keep it in place, keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet. If you remove the dressings, you should apply Band-Aids over each of the small arthroscopic incisions when you shower.

Swelling

Some degree of swelling of your arm, hand and fingers is normal. Swelling can be controlled by use of ice or cold therapy directly over the surgical site. Place a bag of ice or package of frozen vegetables the surgical site; 20 minutes on, and 20 minutes off.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the arm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

You may use the shoulder based on the degree of your comfort. Avoid lifting anything heavy or wearing a heavy back-pack or purse. Avoid driving until you have good control of your shoulder and you are off narcotic pain medication. Take it easy for the first week or so.

Sleeping

Patients often find that they are more comfortable sleeping in an upright position following shoulder surgery. Whether this requires just another pillow or two, a “husband” (name of triangular pillow that one can obtain from the Healthy Back Store, for example) or even resting in a “Lazy Boy” type recliner, you may find sleeping in this position more comfortable for the first few weeks. However, such position is not necessary. It is simply a matter of your comfort.

Pain medication

Vicodin® (Hydrocodone) or Percocet® (oxycodone) narcotic pain killers, have been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started in the first week following your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for arthroscopic knee microfracture

You have undergone a “microfracture” of your knee. In this procedure, a drill or other instrument is used to make small holes (microfractures) in the area where articular (the shellac-like finish covering the joints’ surface) cartilage is damaged/missing.

Crutches

You are non-weight bearing on your surgical leg. You must use your crutches at all times until you are told to discontinue them.

Swelling

Some degree of swelling of your foot and toes is normal. Swelling can be minimized by elevating your legs. Try to keep your legs up elevated, especially for the first few days. Ideally the leg should be higher than the level of your heart. Swelling can be further controlled by use of ice or cold therapy directly over the sites of surgery. Place a bag of ice or package of frozen vegetables (which nicely conforms to the surgical site), usually 20 minutes on, and 20 minutes off. Do not apply the ice directly to the skin, but either over the dressing or over a towel between the skin and the ice.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the foot and/or toes, which can increase over the first few weeks, is normal, and will ultimately resolve.

Dressing/bathing

Keep your dressing dry and in place until the dressing has been removed. You may do this yourself on the 2nd post-op day by un-wrapping the ace bandage and disposing of it and the underlying padding. You will see that there are 2-4 small “arthroscopic” incisions in the front (and sometimes the sides of your knee). You may leave the incisions open to the air, or cover them with Band-Aids. For showering, criss-cross two Band-Aids over each incision. After the shower (NO baths), you may remove them and pat the incisions dry, or you may re-apply Band-Aids. No medicine or ointment is necessary to apply to the incisions. If you prefer, you may wait until your post-op visit for us to remove your dressing. If so, keep it dry while showering. A plastic bag (such as a clean garbage bag) can be applied over the dressing.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

Begin your post-operative exercises the night of surgery. The exercises are illustrated on the following pages. Use your symptoms as a rough guide as to what you can and can’t do. However, be careful not to overdo it, as swelling and pain may occur if you do too much. You may drive as soon as you are off pain medication and have complete control of your surgical leg (if it is the right leg) and don’t walk with a significant limp. If you are non weight bearing in your right leg this means NO driving until you are told you can weight bear on that leg.

Pain medication

Vicodin® (also known as Hydrocodone), a narcotic pain killer, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe. NSAIDs are also a good alternative option.

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.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) twice a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater then 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Knee arthroscopy exercise guide

Regular exercise to restore your knee mobility and strength is necessary. For the most part this can be carried out at home. Your orthopaedic surgeon may recommend that you exercise approximately 20 to 30 minutes two or three times a day. You also may be advised to engage in a walking program. Your orthopaedic physician may suggest some of the following exercises. The following guide can help you better understand your exercise or activity program that may be supervised by a therapist at the direction of your orthopaedic surgeon. As you increase the intensity of your exercise program, you may experience temporary set-backs. If your knee swells or hurts after a particular exercise activity, you should lessen or stop the activity until you feel better. You should Rest, Ice, Compress (with an elastic bandage), and Elevate your knee (R.I.C.E.). Contact your surgeon if the symptoms persist.

Initial Exercise Program

Hamstring Contraction, 10 repetitions – No movement should occur in this exercise. Lie or sit with your knees bent to about 10 degrees. Pull your heel into the floor, tightening the muscles on the back of your thigh. Hold 5 seconds, then relax. Repeat 10 times.

Quadriceps Contraction, 10 repetitions – Lie on stomach with a towel roll under the ankle of your operated knee. Push ankle down into the towel roll. Your leg should straighten as much as possible. Hold for 5 seconds. Relax. Repeat 10 times.

Straight Leg Raises, 10 repetitions – Lie on your back, with uninvolved knee bent, straighten your involved knee. Slowly lift about 6 inches and hold for 5 seconds. Continue lifting in 6-inch increments, hold each time. Reverse the procedure, and return to the starting position. Repeat 10 times. Advanced: Before starting, add weights to your ankle, starting with 1 pound of weight and building up to a maximum of 5 pounds of weight over 4 weeks.

Buttock Tucks, 10 repetitions – While lying down on your back, tighten your buttock muscles. Hold tightly for 5 seconds. Repeat 10 times.

Post-operative instructions for arthroscopic meniscectomy

You have undergone an arthroscopic “clean up” of torn cartilage (meniscus) in your knee.

Crutches

You may begin to bear weight on your leg the day of surgery. The amount of weight you apply is strictly a matter of comfort. You will not injure your knee by walking on it. Most patients find crutches of value until they are comfortable walking and have good balance, which typically takes only a few days.

Swelling

Some degree of swelling of your foot and toes is normal. Swelling can be minimized by elevating your legs. Try to keep your legs up elevated, especially for the first few days. Ideally the leg should be higher than the level of your heart. Swelling can be further controlled by use of ice or cold therapy directly over the sites of surgery. Place a bag of ice or package of frozen vegetables (which nicely conforms to the surgical site), usually 20 minutes on, and 20 minutes off. Do not apply the ice directly to the skin, but either over the dressing or over a towel between the skin and the ice.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the foot and/or toes, which can increase over the first few weeks, is normal, and will ultimately resolve.

Dressing/bathing

Keep your dressing dry and in place until the dressing has been removed. You may do this yourself on the 2nd post-op day by unwrapping the ace bandage and disposing of it and the underlying padding. You will see that there are 2-4 small “arthroscopic” incisions in the front (and sometimes the sides of your knee). You may leave the incisions open to the air, or cover them with Band-Aids. For showering, criss-cross two Band-Aids over each incision. After the shower (NO baths), you may remove them and pat the incisions dry, or you may re-apply Band-Aids. No medicine or ointment is necessary to apply to the incisions. If you prefer, you may wait until your post-op visit for us to remove your dressing. If so, keep it dry while showering. A plastic bag (such as a clean garbage bag) can be applied over the dressing.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

Begin your post-operative exercises the night of surgery. The exercises are illustrated on the following pages. You may weight bear as you tolerate. Each person’s response to surgery varies, depending upon the extent of the injury and the amount of surgery necessary. Therefore, use your symptoms as a rough guide as to what you can and can’t do. However, be careful not to overdo it, as swelling and pain may occur if you do too much. You may drive as soon as you are off pain medication and have complete control of your surgical leg (if it is the right leg) and don’t walk with a significant limp.

Pain medication

Vicodin® (also known as Hydrocodone), a narcotic pain killer, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe. NSAIDs are also a good alternative option.

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.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for arthroscopic meniscus repair

You have undergone an arthroscopic meniscus repair of your knee. In this procedure, devices or sutures are used to repair the torn meniscus (cartilage pad).

Crutches/bracing

You are to be non-weight bearing with the use of crutches. The length of time you are not allowed to put weight on your leg depends on the extent and type of the repair. You will also be placed in a brace that will restrict some or all of your range of motion. The length of use of this brace and non-weight bearing status will be discussed at your first post-operative visit.

Swelling

Some degree of swelling of your foot and toes is normal. Swelling can be minimized by elevating your legs. Try to keep your legs up elevated, especially for the first few days. Ideally the leg should be higher than the level of your heart. Swelling can be further controlled by use of ice or cold therapy directly over the sites of surgery. Place a bag of ice or package of frozen vegetables (which nicely conforms to the surgical site), usually 20 minutes on, and 20 minutes off. Do not apply the ice directly to the skin, but either over the dressing or over a towel between the skin and the ice.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the foot and/or toes, which can increase over the first few weeks, is normal, and will ultimately resolve.

Dressing/bathing

Keep your dressing dry and in place until the dressing has been removed. You may do this yourself on the 2nd post-op day by un-wrapping the ace bandage and disposing of it and the underlying padding. You will see that there are 2-4 small “arthroscopic” incisions in the front (and sometimes the sides of your knee). You may leave the incisions open to the air, or cover them with Band-Aids. For showering (do NOT take a bath), criss-cross two Band-Aids over each incision. After the shower, you may remove them and pat the incisions dry, or you may re-apply Band-Aids. No medicine or ointment is necessary to apply to the incisions. If you prefer, you may wait until your post-op visit for us to remove your dressing. If so, keep it dry while showering. A plastic bag (such as a clean garbage bag) can be applied over the dressing.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

You must use crutches so as not to weight bear on the affected knee. Begin your post-operative exercises the night of surgery. The exercises are illustrated on the following pages. Use your symptoms as a rough guide as to what you can and can’t do. However, be careful not to overdo it, as swelling and pain may occur if you do too much. You may drive as soon as you are off pain medication and are allowed to bear weight on your surgical leg. (This does not apply if surgery was on your left leg, in which you may drive as soon as you are done taking the narcotics).

Pain medication

Vicodin® (also known as Hydrocodone), a narcotic pain killer, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe. NSAIDs are also a good alternative option.

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.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for arthroscopic rotator cuff repair

You have an undergone a rotator cuff repair using a small camera placed within your joint. During this procedure, your rotator cuff has been reattached to its normal insertion site on the humerus.

Sling

You have been placed in a “sling shot” sling for comfort and protection. Remain in this sling (including during sleeping) until seen in the office, where you will be shown how it may be easily removed and reapplied. Unless told otherwise, you will be using the sling for a period of 4-6 weeks.

Bandages/dressing/bathing

A bulky compressive dressing has been applied to your shoulder to absorb some of the fluid (which can leak out for the first 48 hrs after arthroscopy). You may either keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable 48 hours later. If you keep it in place, keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet. If you remove the dressings, you should apply Band-Aids over each of the small arthroscopic incisions when you shower.

Swelling

Some degree of swelling of your arm, hand and fingers is normal. Swelling can be controlled by use of ice or cold therapy directly over the surgical site. Place a bag of ice or package of frozen vegetables the surgical site; 20 minutes on, and 20 minutes off. The swelling in your hands and fingers can be improved by squeezing the soft ball attached to the sling!

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the arm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

For the first week try to minimize how much you’re up and about. Because your rotator cuff was repaired, you must avoid lifting your arm away from your side, usually for a six week period (the time it takes for the cuff to heal on average). Any activities in which your elbow is at the side are ok, including simple activities such as eating, cutting your food, writing, or typing. A good “rule of thumb” is that any activity in which your elbow is away from your waist is probably not a good activity (except when performed passively by your therapist). No lifting or carrying anything heavier than a coffee cup for the first 12 weeks. You should not drive until you have good control of the wheel, which typically takes a good 6 wks (the first four are in the sling).

Sleeping

Patients often find that they are more comfortable sleeping in an upright position following shoulder surgery. Whether this requires just another pillow or two, a “husband” (name of triangular pillow that one can obtain from the Healthy Back Store, for example) or even resting in a “Lazy Boy” type recliner, you may find sleeping in this position more comfortable for the first few weeks. However, such position is not necessary to protect the repair. It is simply a matter of your comfort.

Pain medication

Oxycontin, a long acting narcotic pain killer and Percocet® (oxycodone), a short acting narcotic pain killer, have been prescribed for pain. Take the oxycontin every 12 hours if you are experiencing severe pain, take the Percocet during those 12 hours if you have “breakthrough pain.” (Please note: You may be able to take only the Percocet and won’t need the Oxycontin). All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started 1 week from the date of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions arthroscopic SLAP repair

You have undergone an arthroscopic repair of a “SLAP” lesion (Superior Labrum Anterior Posterior). Using a small camera (arthroscopy), the superior labrum (the top-most lip of cartilage which rings the shoulder’s socket) has been reattached to the top of the glenoid (socket’s) rim.

Sling

You have been placed in a sling for both comfort and protection of the repair. Remain in this sling until seen in the office, where you will be shown how it may be easily removed and reapplied. You will use the sling for 3 weeks.

Bandages/dressing/bathing

A bulky compressive dressing has been applied to your shoulder to absorb some of the fluid (which can leak out for the first 48 hrs after arthroscopy). You may either keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable. If you keep it in place, keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet. If you remove the dressings, you should apply Band-Aids over each of the small arthroscopic incisions when you shower.

Swelling

Some degree of swelling of your arm, hand and fingers is normal. Swelling can be controlled by use of ice or cold therapy directly over the surgical site. Place a bag of ice or package of frozen vegetables the surgical site; 20 minutes on, and 20 minutes off. The swelling in your hands and fingers can be improved by squeezing the soft ball attached to the sling!

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the arm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

For the first week try to minimize how much you’re up and about. No lifting or carrying anything heavy for the three weeks. Also for the first 3 weeks try to keep your arm to your side with your activities so as to not put pressure on the repair. No driving until you have good control of your arm, which likely will be about three weeks following surgery.

Sleeping

Patients often find that they are more comfortable sleeping in an upright position following shoulder surgery. Whether this requires just another pillow or two, a “husband” (name of triangular pillow that one can obtain from the Healthy back Store, for example) or even resting in a “Lazy Boy” type recliner, you may find sleeping in this position more comfortable for the first few weeks. However, such position is not necessary to protect the repair. It is simply a matter of your comfort.

Pain medication

Oxycontin, a long acting narcotic pain killer and Percocet® (oxycodone), a short acting narcotic pain killer, have been prescribed for pain. Take the oxycontin every 12 hours if you are experiencing severe pain, take the Percocet during those 12 hours if you have “breakthrough pain.” (Please note: You may be able to take only the Percocet and won’t need the Oxycontin). All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started 1-3 weeks from the date of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for arthroscopic subacromial decompression

Using a small camera (the arthroscope), the subacromial space (bordered by the undersurface of the acromion or shoulder blade above and the rotator cuff muscle tendons below), has been decompressed. During this procedure, bone spur(s) and/or thickened soft tissue are pared down or removed to open up the space available for free excursion of the underlying cuff.

Sling

You have been placed in a sling for comfort. Remain in this sling until seen in the office, where you will be shown how it may be easily removed and reapplied. You will probably use the sling for a short period of a week or so, just until you are comfortable. You may use it at night if you roll on it in your sleep, or when you’re out and about in public, to avoid inadvertent contact.

Bandages/dressing/bathing

A bulky compressive dressing has been applied to your shoulder to absorb some of the fluid (which can leak out for the first 48 hrs after arthroscopy). You may either keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable. If you keep it in place, keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet. If you remove the dressings, you should apply Band-Aids over each of the small arthroscopic incisions when you shower.

Swelling

Some degree of swelling of your arm, hand and fingers is normal. Swelling can be controlled by use of ice or cold therapy directly over the surgical site. Place a bag of ice or package of frozen vegetables the surgical site; 20 minutes on, and 20 minutes off.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the arm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

You may use the shoulder based on the degree of your comfort. Avoid lifting anything heavy or wearing a heavy back-pack or purse. Avoid driving until you have good control of your shoulder and you are off narcotic pain medication. Take it easy for the first week or so.

Sleeping

Patients often find that they are more comfortable sleeping in an upright position following shoulder surgery. Whether this requires just another pillow or two, a “husband” (name of triangular pillow that one can obtain from the Healthy back Store, for example) or even resting in a “Lazy Boy” type recliner, you may find sleeping in this position more comfortable for the first few weeks. However, such position is not necessary. It is simply a matter of your comfort.

Pain medication

Vicodin® (Hydrocodone) or Percocet ® (oxycodone) narcotic pain killers, have been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started in the first week following your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for knee arthroscopy

You have undergone an arthroscopic “clean up” of your knee either involving your meniscus or articular surfaces of your knee.

Crutches

You may begin to bear weight on your leg the day of surgery. The amount of weight you apply is strictly a matter of comfort. You will not injure your knee by walking on it. Most patients find crutches of value until they are comfortable walking and have good balance, which typically takes only a few days

**if you had an OATS procedure, meniscal repair, or microfracture you are NON-weight bearing!!

Swelling

Some degree of swelling of your foot and toes is normal. Swelling can be minimized by elevating your legs. Try to keep your legs up elevated, especially for the first few days. Ideally the leg should be higher than the level of your heart. Swelling can be further controlled by use of ice or cold therapy directly over the sites of surgery. Place a bag of ice or package of frozen vegetables (which nicely conforms to the surgical site), usually 20 minutes on, and 20 minutes off. Do not apply the ice directly to the skin, but either over the dressing or over a towel between the skin and the ice.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the foot and/or toes, which can increase over the first few weeks, is normal, and will ultimately resolve.

Dressing/bathing

Keep your dressing dry and in place until the dressing has been removed. You may do this yourself on the 2nd post-op day by unwrapping the ace bandage and disposing of it and the underlying padding. You will see that there are 2-4 small “arthroscopic” incisions in the front (and sometimes the sides of your knee). You may leave the incisions open to the air, or cover them with Band-Aids. For showering, criss-cross two Band-Aids over each incision. After the shower (NO baths), you may remove them and pat the incisions dry, or you may re-apply Band-Aids. No medicine or ointment is necessary to apply to the incisions. If you prefer, you may wait until your post-op visit for us to remove your dressing. If so, keep it dry while showering. A plastic bag (such as a clean garbage bag) can be applied over the dressing.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

Begin your post-operative exercises the night of surgery. The exercises are illustrated on the following pages. You may weight bear as you tolerate. Each person’s response to surgery varies, depending upon the extent of the injury and the amount of surgery necessary. Therefore, use your symptoms as a rough guide as to what you can and can’t do. However, be careful not to overdo it, as swelling and pain may occur if you do too much. You may drive as soon as you are off pain medication and have complete control of your surgical leg (if it is the right leg) and don’t walk with a significant limp.

Pain medication

Vicodin® (also known as Hydrocodone), a narcotic pain killer, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe. NSAIDs are also a good alternative option.

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.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You willbe scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Knee arthroscopy exercise guide

Regular exercise to restore your knee mobility and strength is necessary. For the most part this can be carried out at home. Your orthopaedic surgeon may recommend that you exercise approximately 20 to 30 minutes two or three times a day. You also may be advised to engage in a walking program. Your orthopaedic physician may suggest some of the following exercises. The following guide can help you better understand your exercise or activity program that may be supervised by a therapist at the direction of your orthopaedic surgeon. As you increase the intensity of your exercise program, you may experience temporary set-backs. If your knee swells or hurts after a particular exercise activity, you should lessen or stop the activity until you feel better. You should Rest, Ice, Compress (with an elastic bandage), and Elevate your knee (R.I.C.E.). Contact your surgeon if the symptoms persist.

Initial Exercise Program

Hamstring Contraction, 10 repetitions – No movement should occur in this exercise. Lie or sit with your knees bent to about 10 degrees. Pull your heel into the floor, tightening the muscles on the back of your thigh. Hold 5 seconds, then relax. Repeat 10 times.

Quadriceps Contraction, 10 repetitions – Lie on stomach with a towel roll under the ankle of your operated knee. Push ankle down into the towel roll. Your leg should straighten as much as possible. Hold for 5 seconds. Relax. Repeat 10 times.

Straight Leg Raises, 10 repetitions – Lie on your back, with uninvolved knee bent, straighten your involved knee. Slowly lift about 6 inches and hold for 5 seconds. Continue lifting in 6-inch increments, hold each time. Reverse the procedure, and return to the starting position. Repeat 10 times. Advanced: Before starting, add weights to your ankle, starting with 1 pound of weight and building up to a maximum of 5 pounds of weight over 4 weeks.

Buttock Tucks, 10 repetitions – While lying down on your back, tighten your buttock muscles. Hold tightly for 5 seconds. Repeat 10 times.

Post-operative instructions for open debridement for lateral epicondylitis of the elbow

During this procedure, a small incision is made over the lateral (outside) aspect of your elbow, and the abnormal tendon of the forearm muscles is debrided (removal of unhealthy tissue) from it’s origin along the lateral epicondyle (bony prominence over the outside of the elbow).

Sling

You have been placed in a sling for comfort. Remain in this sling until seen in the office. You will probably use the sling for a short period of a week or so, just until you are comfortable. You may use it at night if you roll on it in your sleep, or when you’re out and about in public, to avoid inadvertent contact.

Bandages/dressing/bathing

A compressive dressing has been applied to your elbow. Keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable after 48 hours. You can best keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet.

Swelling

Some degree of swelling of your forearm, hand and fingers is normal. Swelling can be decreased by elevating your elbow. Swelling can be further controlled by use of ice or cold therapy directly over the surgical site. Ensure there is some fabric such as a washcloth, between the cold and the skin to prevent frostbite. Place a bag of ice or package of frozen vegetables (which nicely conforms to) the surgical site, 20 minutes on and 20 minutes off.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the forearm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

You may use the elbow based on the degree of your comfort. Do not lift or carry anything heavy until you are released to do so. You may drive when you have good control of your arm and off narcotic pain medication. You may eat a regular diet. Drink plenty of fluids.

Pain medication

Vicodin® (also known as Hydrocodone), a narcotic pain killer, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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.

Follow-up

You willbe scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually delayed for about six weeks to permit the tissues time to heal and avoid injury. You may or may not require formal therapy. If you require PT we will be glad to help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for open debridement for medial epicondylitis of the elbow

During this procedure, a small incision is made over the Medial (inside) aspect of your elbow, and the abnormal tendon of the forearm muscles is debrided (removal of unhealthy tissue) from it’s origin along the medial epicondyle (bony prominence over the inside of the elbow)

Sling

You have been placed in a sling for comfort. Remain in this sling until seen in the office. You will probably use the sling for a short period of a week or so, just until you are comfortable. You may use it at night if you roll on it in your sleep, or when you’re out and about in public, to avoid inadvertent contact.

Bandages/dressing/bathing

A compressive dressing has been applied to your elbow. Keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable after 48 hours. You can best keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet.

Swelling

Some degree of swelling of your forearm, hand and fingers is normal. Swelling can be decreased by elevating your elbow. Swelling can be further controlled by use of ice or cold therapy directly over the surgical site. Ensure there is some fabric such as a washcloth, between the cold and the skin to prevent frostbite. Place a bag of ice or package of frozen vegetables (which nicely conforms to) the surgical site, 20 minutes on and 20 minutes off.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the forearm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

You may use the elbow based on the degree of your comfort. Do not lift or carry anything heavy until you are released to do so. You may drive when you have good control of your arm and off narcotic pain medication. You may eat a regular diet. Drink plenty of fluids.

Pain medication

Vicodin® (also known as Hydrocodone), a narcotic pain killer, has been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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 if possible.
• To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.

Follow-up

You willbe scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually delayed for about six weeks to permit the tissues time to heal and avoid injury. You may or may not require formal therapy. If you require PT we will be glad to help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5213 Option 3 (Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for ORIF patella fracture

You have undergone Open Reduction and Internal Fixation (ORIF) of your patella fracture.

Brace/Splint/Crutches

Your knee has been immobilized with a compressive dressing reinforced by an immobilizer. The immobilizer provides initial comfort by minimizing any motion at the surgical site. You are to remain non-weight bearing on the surgical leg until told otherwise.

Swelling

Some degree of swelling of your foot and toes is normal. Swelling can be minimized by elevating your leg. Try to keep your leg up elevated upon a few pillows consistently for the first 48 hours, and intermittently thereafter. The goal is for the leg to be above the level of your heart. Swelling can be further controlled by use of ice or cold therapy directly over the site of surgery. Place a bag of ice or package of frozen vegetables (which nicely conforms to the surgical site), usually 20 minutes on, and 20 minutes off. If you have a Cold Therapy® pad and cooler (arranged pre-operatively for this use), keep the sleeve directly over the dressings. Use it continuously for the first week.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the foot and/or toes, which can increase over the first few weeks, is normal, and will ultimately resolve.

Dressing/Bathing

Keep your dressing dry and in place until your post-op visit. A cast is usually applied at your post-operative visit. You may shower, but keep the dressing dry, through use of a plastic bag (such as a clean garbage bag) as a cover. Secure it with tape above the dressing/splint to prevent getting it wet. When taking a shower, you should use a plastic chair or some other means of sitting, both for balance and to avoid placing any weight on your leg. As an alternative you may want to try a bath and keep your leg hanging over the side of the tub (so as to keep the incision dry).

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

Activity

For the first week try to minimize how much you’re up and about. The more your leg is “dependent” the greater degree of discomfort. Do not weight bear (put weight on your leg).

Pain medication

Vicodin® (Hydrocodone) or Percocet ® (oxycodone) narcotic pain killers, have been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.

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.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You willbe scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Post-operative instructions for osteochondral autograft transplantation (OATS) procedure

You have undergone transplantation of osetochondral (bone and cartilage) autograft (your tissue) plugs. In this procedure an incision is made in the front of your knee, and size and shaped-matched graft(s) are inserted into the area of cartilage surface damage.

Brace/Crutches

Your knee has been immobilized with a compressive dressing reinforced by an immobilizer. The immobilizer provides initial comfort by minimizing any motion at the surgical site. Occasionally, A CPM (Continuous Passive Motion machine) will be used to help restore/maintain your motion. If you have a CPM, the immobilizer is to be used when up and walking around.

Swelling

Some degree of swelling of your foot and toes is normal. Swelling can be minimized by elevating your leg. Try to keep your leg up elevated upon a few pillows consistently for the first 48 hours, and intermittently thereafter. The goal is for the leg to be above the level of your heart. Swelling can be further controlled by use of ice or cold therapy directly over the site of surgery. Place a bag of ice or package of frozen vegetables (which nicely conforms to the surgical site), usually 20 minutes on and 20 minutes off. If you have a Cold Therapy® pad and cooler (arranged pre-operatively for this use), keep the sleeve directly over the dressings. Use it continuously for the first week.

Bruising

Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most “dependent” part of the extremity. An evolving bruising of the foot and/or toes, which can increase over the first few weeks, is normal, and will ultimately resolve.

Dressing/Bathing

Keep your dressing in place until your post-op visit. You may shower (NO baths), but keep the dressing dry, through use of a plastic bag (such as a clean garbage bag) as a cover. Secure it with tape above the dressing to prevent getting it wet. If taking a shower, you should use a plastic chair or some other means of sitting, both for balance and to avoid placing any weight on your leg. As an alternative you may want to try a bath and keep your leg hanging over the side of the tub (as to keep your incision dry).

Fever

A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.

CPM (Continuous Passive Motion) Machine

A CPM machine may have been arranged for you to use to improve restoration of knee flexion (bending). The machine is set such that it gently and passively moves your knee through a range of motion, beginning at full extension (fully straight or zero°) to about 50° (~ halfway bent). The CPM device should be comfortable and as a guideline, is increased by 10° each day. Small increases of 5° at a time, each morning and each afternoon, may be easier than increasing by the 10°. Use the CPM approximately 8-10 hours/day. You may use it in any comfortable combination (such as on for 3 hours, off for one hour, on for another 3, etc.), until you have reached your 8-10 hour minimum. You may use it at night. Call the CPM rep with any equipment questions (703-281-1200).

Activity

Begin your post-operative exercises the night of surgery. The exercises are illustrated on the following pages. For the first week try to minimize how much you’re up and about. The more your leg is “dependent” the greater degree of discomfort. Do not put weight on your surgical leg.

Pain medication

Vicodin® (Hydrocodone) or Percocet ® (oxycodone) narcotic pain killers, have been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe. NSAIDs are also a good alternative option.

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.

DVT (blood clot) precautions

Deep Venous Thrombosis (DVT, aka blood clot) is an uncommon complication that can occur following lower extremity surgery. Starting the day after your surgery, take an enteric coated 325mg aspirin (which acts as a blood thinner) once a day for three weeks. Because aspirin can cause stomach upset, you may want to take it with food. If you have an allergy to Aspirin, please inform us so we can consider alternative precautions. Remember that Tylenol®, Motrin®, Alleve®, and other Non-steroidal Anti-Inflammatory (NSAID) medications do not protect against DVT, and should not be used for this purpose.

Follow-up

You will be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions.

If you need to verify or change your post-op appointment, please call 703-277-2663.

Physical therapy

Physical therapy is usually started within the first week of your surgery. We will help you in identifying an appropriate therapist if you need assistance.

In case of emergency

You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5217 Option 3 (McLean-Tysons). You should contact me for any of the following symptoms:

• Fever greater than 101.5 degrees F
• Numbness, loss of color or coolness in hand
• Severe pain unresponsive to narcotic medication
• Excessive bleeding or vomiting
• Difficulty breathing or shortness of breath – Call 911

Knee arthroscopy exercise guide

Regular exercise to restore your knee mobility and strength is necessary. For the most part this can be carried out at home. Your orthopaedic surgeon may recommend that you exercise approximately 20 to 30 minutes two or three times a day. You also may be advised to engage in a walking program. Your orthopaedic physician may suggest some of the following exercises. The following guide can help you better understand your exercise or activity program that may be supervised by a therapist at the direction of your orthopaedic surgeon. As you increase the intensity of your exercise program, you may experience temporary set-backs. If your knee swells or hurts after a particular exercise activity, you should lessen or stop the activity until you feel better. You should Rest, Ice, Compress (with an elastic bandage), and Elevate your knee (R.I.C.E.). Contact your surgeon if the symptoms persist.

Initial Exercise Program

Hamstring Contraction, 10 repetitions – No movement should occur in this exercise. Lie or sit with your knees bent to about 10 degrees. Pull your heel into the floor, tightening the muscles on the back of your thigh. Hold 5 seconds, then relax. Repeat 10 times.

Quadriceps Contraction, 10 repetitions – Lie on stomach with a towel roll under the ankle of your operated knee. Push ankle down into the towel roll. Your leg should straighten as much as possible. Hold for 5 seconds. Relax. Repeat 10 times.

Straight Leg Raises, 10 repetitions – Lie on your back, with uninvolved knee bent, straighten your involved knee. Slowly lift about 6 inches and hold for 5 seconds. Continue lifting in 6-inch increments, hold each time. Reverse the procedure, and return to the starting position. Repeat 10 times. Advanced: Before starting, add weights to your ankle, starting with 1 pound of weight and building up to a maximum of 5 pounds of weight over 4 weeks.

Buttock Tucks, 10 repetitions – While lying down on your back, tighten your buttock muscles. Hold tightly for 5 seconds. Repeat 10 times.