Texas Institute - For Hip And Knee Surgery
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Orthopaedic Specialists Of Austin - Texas Institute - For Hip And Knee Surgery
 

FAQ

Knee Arthroscopy (Medial and Lateral Meniscectomy)

  • Can I walk after surgery? Yes, you may put full weight on your affected extremity the day of surgery.

  • Do I need crutches after surgery? Yes, most people use crutches for 1-2 days to assist with walking after surgery.

  • What activity restrictions will I have after surgery? For the first week or two, it is recommended that you put full weight on your affected extremity with or without crutches to assist with walking. After that, it is recommended that people slowing increase the amount of standing/physical activity each day. Most people usually return to work fairly fast depending on work requirements. You may resume driving when you are not using narcotic medications and walking without assistive devices.

  • Can I shower after surgery? For the first 48 hours, keep your surgical dressing clean and dry. After two days you may shower with no protection over your surgical wound. Avoid submerging your wound in water.

  • Do I have to change my surgical dressing after surgery? Yes, after 48 hours you can take your surgical dressing off and let your knee get wet in the shower. Make sure the surgical wound is clean and dry after showering and apply bandaids to the affected areas.

  • Will I get a prescription for pain medication after surgery? Yes, you will receive a prescription narcotic after surgery for post-operative pain; however, you may use NSAIDs if they are effective. The narcotic pain medication should be used if NSAIDs are not effective.

Total Knee Arthroplasty

  • Which of my home medications should I stop before surgery? You can take all your regularly scheduled home medications as prescribed the night before surgery. The morning of your surgery, you should take only certain medications, like heart or blood pressure medication. Stop taking Aspirin 5 days prior to the day of your surgery. Your anesthesiologist may have some recommendations as well.

  • Will I receive antibiotics before surgery? Yes, everyone receives prophylactic antibiotics to decrease the risk of infection before, during, and after surgery (these stop 24 hours after surgery).

  • How long can I expect to be in the hospital? - The length of hospital stay after total knee replacement surgery varies from patient to patient but most patients stay 1-3 days.

  • What kind of anesthesia will I have? Most patients receive a regional nerve block and general anesthesia. This produces pain and anxiety control. Deep sedation is also utilized in patients who wish to avoid a general anesthetic.

  • Will I be able to walk after surgery? - Yes, in most cases, you can put full weight on both lower extremities after surgery (usually with a walker).

  • Will I need to be on a blood thinner after surgery? Yes, we recommend all patients take Coumadin for a total of 4 weeks after total joint replacement surgery. This is to minimize the risk of blood clots after surgery. There are other alternatives to minimize the risk of blood clots. The use of aspirin of 325 mg per day is growing in popularity. You should discuss this more in depth with your surgeon at your pre-operative visit.

  • When can I drive? This varies from patient to patient and is highly dependent on which leg is affected from surgery, one's comfort and confidence, and whether or not someone is taking narcotics. If one's left knee is affected, most people can drive 1-3 weeks after surgery. If one's right knee is affected, most people can drive 2-4 weeks after surgery. One should not drive while under the influence of narcotics.

  • When can I return to work? This depends on one's profession and varies greatly between individuals. Usually patient's with a sedentary/desk job can return to work in 2-4 weeks. For patient's with work that is more labor intensive, it may take between 4 and 10 weeks before they can return to full duty.

  • Will I need to participate in physical therapy after surgery? Yes, a physical therapist will work with you everyday while you are in the hospital to improve your range of motion, balance, strength, and ambulation. If you go home after being released from the hospital, a physical therapist will come to your house to work with you 2-3 times each week. If you go to a rehabilitation facility, a physical therapist will work with you everyday you are there. Once released from home therapy, most patients will go to an outpatient facility for further recovery.

  • Will I go home or to a rehabilitation facility once I am ready to leave the hospital after surgery? There are many factors that help determine whether someone should go home or to a rehabilitation facility after surgery. These factors include the amount of assistance one has at home with regard to family or friends, postoperative functional status as evaluated by a physical therapist in the hospital, and the overall safety of the environment at home.

  • What type of pain medication will I have after surgery? After surgery you will receive intravenous narcotic pain medication which will be transitioned to oral narcotic pain medication before being released from the hospital. Other options exist depending on the needs of each patient.

  • What kind of rehabilitation equipment will I go home with after surgery? Various equipment such as walker, commode, toilet seat riser, etc.

  • Will a visiting nurse come to my home after surgery? Yes, usually twice each week to draw blood samples.

  • Do I need a CPM (continuous passive motion) machine after total knee replacement surgery? You will use a CPM machine in the hospital. Most will utilize this at home for the first 2 weeks post-operatively.

  • What is the expected recovery time? Everyone heals from surgery at different rates. Typically, patients will use a walker while in the hospital after surgery. This is mostly to assist with balance, and most patients can bear weight on their lower extremity as their comfort allows. As a patient's balance, strength, and confidence improve, they may progress to a cane at 2-3 weeks. By 4-6 weeks, many patients do not require any assistive devices. It may take up to 3 months before returning to normal function. Most patients continue to improve with regard to their comfort, function, and mobility for up to one year after surgery.

  • When can I take a bath or go in a swimming pool? Your knee can be totally immersed 4 weeks after surgery.

  • Will I have staples or sutures in my knee after surgery? Most people have staples after surgery however each patient is different and you should discuss this further with your surgeon if you have any concerns. Staples or sutures will be taken out in the office usually in 10-14 days.

  • How long will I be on pain medication? It is common for most patients to be on some form of pain medication for 8-12 weeks. Initially, most patients are on strong pain medication such as narcotics however after 4-6 weeks, some patients are able to manage their discomfort with over the counter medications such as Tylenol or Ibuprofen.

  • Should I apply ice or heat after surgery? Initially after surgery, ice is most helpful to reduce swelling; however, after several weeks you may try using heat and choose what helps you the best.

  • How long should I wear compression stockings? We recommend that you wear a knee high or thigh high compression stocking on your affected extremity for 2-3 weeks. You can take this stocking off at night when you sleep however it should be put back on in the morning before you start your day.

  • Do I need antibiotics before having dental work done after surgery? Yes, it is recommended that each patient take 2 grams of Amoxicillin or Cefalexin 1 hour prior to the dental procedure. This is to minimize the risk of infection occurring in the knee due to bacteria in our mouths getting into the bloodstream and traveling to the knee joint.

  • My knee clicks or makes a noise when I walk or bend my knee. Is this normal? Yes, this is the metal prosthesis contacting the plastic. A majority of patients experience this sensation and it is not harmful.

  • Why does the skin around my incision feel numb? This is a normal side effect from surgery as the sensory nerves are disrupted with the knee incision. The numbness will be to the lateral side of the incision. Often, this sensation improves with time, but may always feel different.

  • What should I be worried about? Please call your physician's office as soon as possible if you experience any of the following:
    • increasing redness around the wound

    • increasing redness around the wound

    • increased drainage from the wound

    • a temperature of more than 101.0

    • leg or foot swelling that does not resolve with elevation or the use of compression stockings

  • Will I set off metal detectors in airports? Yes, you most likely will. Generally TSA officials will then ask to use a metal detecting wand over your extremity. You do not need a note/letter from your surgeon.

  • Can I kneel after surgery? After several months you may try kneeling although it may be uncomfortable. You are not harming your knee replacement but because of local healing around your incision, you may be persistently tender in that area for quite some time. It is helpful to use a pad under your knee.

  • I feel persistently more tired than normal since surgery. Is this normal? Yes, in some cases it may take patients up to 3-6 months to regain their energy level after surgery.

  • I have insomnia/difficulty sleeping since surgery. Is this normal? Yes, difficulty sleeping can be a common complaint after knee replacement surgery. Over the counter medications such as Benadryl, melatonin, and other sleep aids can be helpful to restore your normal sleep cycle.

  • I have been constipated since surgery. Is this normal? Yes, this is due to a number of different factors and is generally worsened by taking narcotic pain medication. There are several ways to treat constipation after surgery. A high fiber diet, drinking prune juice and overall adequate oral intake can all help with preventing constipation after surgery. Medications such as fiber supplements (FiberCon, Metamucil, Konsyl, Serutan and Citrucel), stool softeners (Colace and Surfak), and laxatives/osmotics (Milk of Magnesia, Cephulac, Sorbitol and Miralax) can also be very helpful in treating constipation after surgery.

  • When do I need to follow up after surgery? Follow up appointments are made at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and every other year after that.

Total Hip Arthroplasty

  • Which of my home medications should I stop before surgery?
    You can take all your regularly scheduled home medications as prescribed the night before surgery. The morning of your surgery, you should take only certain medications, like heart or blood pressure medication. Stop taking Aspirin 5 days prior to the day of your surgery. Your anesthesiologist may have some recommendations as well.

  • Will I receive antibiotics before surgery?
    Yes, everyone receives prophylactic antibiotics to decrease the risk of infection before, during, and after surgery (these stop 24 hours after surgery).

  • How long can I expect to be in the hospital?
    The length of hospital stay after total hip replacement surgery varies from patient to patient but most patients stay 1-3 days.

  • What kind of anesthesia will I have?
    Most patients receive general anesthesia.

  • Will I be able to walk after surgery?
    Yes, in most cases, you can put full weight on both lower extremities after surgery (usually with a walker).

  • Will I have hip precautions after surgery?
    This depends on what surgical approach your surgeon uses to access your hip. If you are having an Anterior Hip Replacement (your incision is in the front), then you will not have "typical" hip precautions. If your surgeon is using a posterior or lateral approach (your incision is in the back or side of the hip), then your activity will be restricted up to 8 weeks after your surgery. For more information regarding the different approaches please speak to your surgeon.

  • Will I need to be on a blood thinner after surgery?
    Yes, we recommend all patients take a blood thinner after total joint replacement surgery. This is to minimize the risk of blood clots after surgery.

  • When can I drive?
    This varies from patient to patient and is highly dependent on which leg is affected from surgery, one's comfort and confidence, and whether or not someone is taking narcotics. If your left leg is affected, most people can drive 1-3 weeks after surgery. If your right leg is affected, most people can drive 2-4 weeks after surgery. One should not drive while under the influence of narcotics.

  • When can I return to work?
    This depends on one's profession and varies greatly between individuals. Usually patients with a sedentary/desk job can return to work in 2-4 weeks. For patients with work that is more labor intensive, it may take between 4 and 10 weeks before they can return to full duty.

  • Will I need to participate in physical therapy after surgery?
    Yes, a physical therapist will work with you every day while you are in the hospital to improve your range of motion, balance, strength, and ambulation. If you go home after being released from the hospital, a physical therapist will come to your house to work with you 2-3 times each week. If you go to a rehabilitation facility, a physical therapist will work with you every day you are there. Once released from home therapy, most patients will go to an outpatient facility for further recovery.

  • Will I go home or to a rehabilitation facility once I am ready to leave the hospital after surgery?
    There are many factors that help determine whether someone should go home or to a rehabilitation facility after surgery. These factors include the amount of assistance one has at home with regard to family or friends, postoperative functional status as evaluated by a physical therapist in the hospital, and the overall safety of the environment at home.

  • What type of pain medication will I have after surgery?
    After surgery you will receive intravenous narcotic pain medication which will be transitioned to oral narcotic pain medication before being released from the hospital. Other options exist depending on the needs of each patient.

  • What kind of rehabilitation equipment will I go home with after surgery?
    Various equipment such as walker, commode, toilet seat riser, etc.

  • Will a visiting nurse come to my home after surgery?
    A physical therapist might come to your home to help you with therapy after your surgery, and depending on what blood thinner your doctor decides to use for your case, you might need blood samples drawn twice a week.

  • What is the expected recovery time?
    Everyone heals from surgery at different rates. Typically, patients will use a walker while in the hospital after surgery. This is mostly to assist with balance, and most patients can bear weight on their lower extremity as their comfort allows. As a patient's balance, strength, and confidence improve, they may progress to a cane at 2-3 weeks. By 4-6 weeks, many patients do not require any assistive devices. It may take up to 3 months before returning to normal function. Most patients continue to improve with regard to their comfort, function, and mobility for up to one year after surgery.

  • When can I take a bath or go in a swimming pool?
    Your hip can be totally immersed 4 weeks after surgery.

  • How long will I be on pain medication?
    It is common for most patients to be on some form of pain medication for 8-12 weeks. Initially, most patients are on strong pain medication such as narcotics however after 4-6 weeks, some patients are able to manage their discomfort with over the counter medications such as Tylenol or Ibuprofen.

  • Should I apply ice or heat after surgery?
    Initially after surgery, ice is most helpful to reduce swelling; however, after several weeks you may try using heat and choose what helps you the best.

  • How long should I wear compression stockings?
    We recommend that you wear a knee high or thigh high compression stocking on your affected extremity for 2-3 weeks. You can take this stocking off at night when you sleep however it should be put back on in the morning before you start your day.

  • Do I need antibiotics before having dental work done after surgery?
    Yes, it is recommended that each patient take 2 grams of Amoxicillin or Cefalexin 1 hour prior to the dental procedure. This is to minimize the risk of infection occurring in the hip due to bacteria in our mouths getting into the bloodstream and traveling to the hip joint.

  • My hip clicks or makes a noise when I walk or bend. Is this normal?
    Yes, this is the metal prosthesis contacting the plastic. A majority of patients experience this sensation and it is not harmful.

  • Why does the skin around my incision feel numb?
    This is a normal side effect from surgery as the sensory nerves are disrupted with the incision. The numbness will be to the lateral side of the incision. Often, this sensation improves with time, but may always feel different.

  • What should I be worried about? Please call your physician's office as soon as possible if you experience any of the following:
    • increasing redness around the wound
    • increased drainage from the wound
    • a temperature of more than 101.0
    • leg or foot swelling that does not resolve with elevation or the use of compression stockings


  • Will I set off metal detectors in airports?
    Yes, you most likely will. Generally TSA officials will then ask to use a metal detecting wand over your extremity. You do not need a note/letter from your surgeon.

  • I feel persistently more tired than normal since surgery. Is this normal?
    Yes, in some cases it may take patients up to 3-6 months to regain their energy level after surgery.

  • I have insomnia/difficulty sleeping since surgery. Is this normal?
    Yes, difficulty sleeping can be a common complaint after joint replacement surgery. Over the counter medications such as Benadryl, melatonin, and other sleep aids can be helpful to restore your normal sleep cycle.

  • I have been constipated since surgery. Is this normal?
    Yes, this is due to a number of different factors and is generally worsened by taking narcotic pain medication. There are several ways to treat constipation after surgery. A high fiber diet, drinking prune juice and overall adequate oral intake can all help with preventing constipation after surgery. Medications such as fiber supplements (FiberCon, Metamucil, Konsyl, Serutan and Citrucel), stool softeners (Colace and Surfak), and laxatives/osmotics (Milk of Magnesia, Cephulac, Sorbitol and Miralax) can also be very helpful in treating constipation after surgery.

  • When do I need to follow up after surgery?
    Follow up appointments are made at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and every other year after that.

Hip Arthroscopy

  • Can I walk after surgery?
    You will have weight bearing restrictions after surgery. Most patients are instructed to allow their foot on their operative leg to touch the floor to help with their balance. The amount of weight put on the leg will be limited to the weight of the leg (no body weight). This is called foot flat weight bearing. You will be given crutches or a walker to help you get around while your weight bearing status is limited. The restrictions can last from 2 to 4 weeks depending on the type of Arthroscopic procedure you are having.

  • Can I shower after surgery?
    You will have a thin, clear dressing over your incision called a tegaderm. As long as this dressing is completely intact you may shower. This dressing does not need to be changed. If you notice the dressing has become visibly soiled or has begun to peel away from the skin, please change your dressing. You can find water proof dressing like Tegaderms at most retail pharmacies, or you can use water proof band-aids.

  • Will I get a prescription for medications after surgery?
    Yes, you will receive a prescription for post-operative pain. You will also receive a prescription for a Non-Steroidal Anti-Inflammatory (NSAID) which you will be instructed to take for 20 days, and Aspirin which you will be instructed to take for 3 months.

  • My leg feels numb around my surgical site, is this normal?
    During the surgery your doctor used a medication called Marcaine to numb around the surgical area. Marcaine is similar to Lidocaine, the drug dentists sometimes use to numb your mouth, but it typically lasts a little longer. The area around your incision might remain numb for a little as 1 hour or as long as 6-8 hours, depending on the strength and amount given during surgery.

  • My thigh feels tight and swollen, is this normal?
    In order to verify the correct placement of the arthroscope and/or other surgical instruments, your doctor will inject air and/or fluid into the joint under x-ray guidance. This might cause swelling in your groin, buttock, and thigh. The swelling will typically improve over the next few days. If you notice:
    • increasing redness around the wound
    • increased drainage from the wound
    • a temperature of more than 101.0
    • leg or foot swelling that does not resolve with elevation Please notify your doctor immediately

Stem Cell Injections

  • Should I stop taking any medications before and after my procedure?
    Avoid NSAIDS like Ibuprofen, Aleve, Motrin, and Advil for 3 days prior to your injection and for 5 days after.

  • What do I need to bring to the surgery center?
    You might have been given a prescription for Niravam, you will need to fill the prescription and bring it with you to your procedure.

  • When can I shower?
    It is ok to shower without a dressing/bandage after your procedure.

  • When can I take off my dressing?
    You may remove the steri-strips from your hip wound 5 days after your procedure.

  • Are there any limitations to my activity?
    Normal walking only for 2 weeks; no vigorous exercise involving the injected side.

  • I am a little sore, is there anything I can do to help?
    Apply ice every 4 hours as needed for pain for the first 48 hours

    You may use an Ace wrap or knee sleeve if it helps with pain.
  • When do I come back in to see the doctor?
    You will follow up in 7-10 days.

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