There will be a sterile dressing over your surgical wound. You can remove this dressing 1 week after surgery and then there is no need to re-apply any dressings to the wound from that point. You need to keep your wound clean and dry at all times.
Resume your pre-hospital diet. We recommend you eat a well-balanced diet, supplemented by a daily multivitamin.
Unless instructed otherwise, you may bear weight as tolerated on your operative leg. Initially, you will tend to favor the opposite leg and may have a limp, but with practice, you will eventually walk evenly on both legs.
You are advised to wear your compression socks on both legs for 4 to 6 weeks to minimize post-operative swelling. You may take them off before going to bed if needed.
Resume your pre-hospital home medications unless otherwise instructed by your surgeon. In addition, you will be prescribed pain medications and a blood thinner to reduce the risk of blood clot formation. Dr. Halawi commonly prescribes the following medications unless there are contraindications or insurance issues.
- Celecoxib 200 mg: take every 12 hours for 2 weeks. After the second week, take only as needed for pain.
- Acetaminophen 1000 mg: take every 8 hours for 3 days. After the third day, take only as needed for pain.
- Oxycodone 5 mg: take every 4 hours as needed for pain. Minimize the use of this medication whenever possible to avoid its potential adverse side effects. You are also advised to take an over the counter stool softener if using oxycodone to help prevent possible constipation.
- Aspirin enteric coated 325 mg: take every 12 hours for 4 weeks. This is to help reduce the risk of developing a blood clot.
Avoid any strenuous activity or heavy lifting.
Walking is important for your recovery. After the anesthesia effects wear off, you are expected to walk at least 100 feet, usually right after you arrive in your hospital room. Your physical therapist will also teach you specific exercises.
- For total knee replacement, make sure you keep a bump under your HEEL (not knee) at all times when you are in bed or resting. Work on straightening your knee by activating your quadriceps (tightening the muscles on the front part of your thigh) while your heel is over the bump. This will prevent the tendency of your operative knee from getting stiff in a bent position. Proper heel elevation is confirmed when there is at least 2 inches gap under your knee. Be vigilant in terms of working on full knee straightening and bending. The goal is to have your knee go from a straight position to 90 degrees bending in the first 2 weeks. Avoid bending greater than 90 degrees until after your first clinic visit.
- For total hip replacement, the best rehabilitation activity is walking using your rolling walker. You will likely experience a limp and perceived leg length discrepancy that will go away as you practice walking evenly. Before leaving the hospital, your therapist will go over certain hip precautions to prevent the risk of hip dislocation.
Home Health Care
- For total knee replacement, you will have a physical therapist come to your home to help make sure you are progressing with your knee range of motion.
- For total hip replacement, home health therapy is provided on a case by case basis.
While the sterile dressing applied over your surgical wound is water-proof, water can sometimes still leak under the dressing if there are cracks within the seal. For this reason, it is recommended that you wait until after the dressing is removed 1 week after surgery before you shower. Never submerge the wound in still water (pool, bathtub, etc.) until the wound has completely healed (at least 1 month after surgery). Do not apply lotions, creams, hydrogen peroxide, etc. to the wound.
Use of Bed Pillow
Keep a regular puffy pillow between your legs while sleeping for 6 weeks. This only applies if you had a hip replacement.
Do not drive until you are cleared by your surgeon. This will be addressed at your first follow-up visit. Never drive while taking opioid medications (e.g., oxycodone).
You will follow up in clinic in 2 weeks after surgery. All your follow-up appointments will be made automatically.
For emergent issues such as shortness of breath, call 911.
For urgent after-hours issues (e.g., temperature greater than 101.5 Fahrenheit, worsening pain, redness or drainage from incision, increasing leg swelling), contact the orthopaedic surgery resident on call at (860) 679-2000. During business hours, call (860) 679-6600 and ask to be transferred to Dr. Halawi’s staff.
Remember you just had a major surgery. Pain is expected but will gradually improve day after day. Take care of yourself. Eat well and keep yourself hydrated! Exercise to tolerance! We look forward to seeing you in clinic.