Wound Care

• Remove dressing in 2 days, if sutures in place cover with bandaids
• If steri-strips present, keep in place until they fall off or they are removed at your first post-operative visit.
• After your steri-strips have fallen off, you do not need to cover your incisions with any bandage.
• You may shower in 2 days; be sure to pat the incision dry afterwards.
• Do not scrub the area; just allow water/soap to wash over you.
• Do not bathe or swim until approved by Dr. Pettit.

Ice

• You will be provided with ice packs on the day of your surgery. We recommend that you use ice on a consistent basis for the first 24–48 hours. This will help reduce post-operative swelling. After that, use as necessary.
• Use a cloth between the ice and your skin. DO NOT place ice directly on skin as this may cause frostbite. Do not leave ice wrap or cold therapy on for more than 20 minutes without checking your skin.
• Use a cloth between the ice and your skin. DO NOT place ice directly on skin as this may cause frostbite. Do not leave ice wrap or cold therapy on for more than 20 minutes without checking your skin.

Braces

• With an ankle arthroscopy, a boot may be used briefly for comfort if needed. You will have a bulky dressing initially which can be removed after 2 days. For routine arthroscopy, you are weight bearing as tolerated and may transition out of the boot and into a normal shoe as your comfort allows, typically within 1-2 weeks, per Dr. Pettit.

Crutches & Weight bearing status

• Following an Ankle Arthroscopy, you will use crutches for the first 1-3 days after surgery, to help with pain management and swelling.
• After the initial 1-3 days, you may weight bear as tolerated (placing your foot on the floor using only as much weight as you feel comfortable placing). Be sure that you walk by placing your heel down first, then roll to the toe.
• When you are able to ambulate without a limp and feel comfortable doing so, you can safely discard the crutches and walk unassisted.

Physical Therapy

• Formal physical therapy will be ordered in the form of a written prescription upon discharge from surgery. Following an Ankle Arthroscopy you should start formal physical therapy within 1-5 days.
• Until you begin working with a therapist, you can do some exercises at home, such as: quad sets, leg raises, flexion and extension, and calf pumps (see pictures below). You may begin these exercises the day following your surgery.

Pain Control and Medications

Day of Surgery

• Some swelling and bruising can occur after surgery. Make sure to apply ice to the affected area. Please perform frequent calf pumps to help reduce your swelling. If you are concerned about the amount of swelling or bruising, please contact our office.

Tylenol

• Take 1000mg Tylenol every eight hours. You should not exceed more than 3,000mg of Tylenol in a single day.

Non- Steroidal Anti-Inflammatory Medications:

• You have also been prescribed a non-steroidal anti-inflammatory, Ibuprofen 600 mg every 8 hours as needed for additional pain control. Please take this medication only if you do not have a contraindication to taking this Ibuprofen (i.e. allergy to the medication, stomach ulcers or kidney problems).
• Take this medication with food, and try to stagger the times you take this medication with your narcotic pain medication. This may help decrease the chance of stomach upset.

Narcotics

• You have been prescribed a narcotic pain medication.
• Oxycodone 5mg may be taken every 4-6 hours as needed for pain.
• Journavx (suzetrigine): If Journavx has been prescribed, take it in place of the Oxycodone. Start with a loading dose of 100 mg (two 50 mg tablets), then take one 50 mg tablet twice a day (every 12 hours) for two weeks. If you are not getting adequate pain control with Journavx, you may take Oxycodone instead. Do not take Journavx and Oxycodone at the same time, and avoid grapefruit while taking Journavx.
• Use the medication only as prescribed. Take it with food.
• Do not drive or use any type of heavy machinery, drink alcohol, make any life-changing or legal decisions (i.e. sign a will), or participate in activities that require a lot of physical skill, as narcotics may change your mental acuity. On rare occasions this medication may cause confusion or disorientation, and we advise you to discontinue this medication should these occur.
• You may obtain a partial fill of this medication at your pharmacy.
• This medication can be addictive.
• Please dispose of any excess medication at any police or fire station.
• Take a stool softener, such as Colace, while taking the narcotic medication, because narcotics may cause constipation.  If this does not help alleviate your constipation, you can try adding miralax or milk of magnesia. Please contact our office if this regimen does not alleviate your constipation.
• If you have any questions or concerns about narcotic strength medications, please contact our office prior to your surgery for further discussion.

Nausea

• We can provide you with an anti-nausea medication, Ondansetron, as narcotics can also cause nausea. If you are having significant nausea please contact our office for a prescription

Blood Clot Prevention

• If you can take Aspirin without any difficulty and are NOT CURRENTLY on any anticoagulation, then you should take Aspirin 81 mg daily for 2 weeks, starting the day after your surgery. If you were on 81 mg of Aspirin prior to surgery please resume this dose after 2 weeks.

Driving

• In general, you can resume driving after 3-5 days after your operation, when you have full control of your arms and legs and you are pain free. Do not drive if you are still on narcotic medication.

Return to Work

• You may return to work as soon as you are comfortable and able to safely weight bear without crutches. This typically will occur 1–4 weeks post-op, depending on your job type. Return to work notes can be obtained at your first post-op appointment.

Follow-up Appointment

• Your first post-operative appointment will be scheduled 7-10 days following your surgical procedure. Typically dissolvable sutures are used during surgery, and do not need to be removed. If you do not have a post-operative appointment scheduled when you leave following surgery, please call 513-354-3700 confirm the appointment.

****Signs & Symptoms to Immediately Report****

• Call 911 and go to the nearest hospital if you are having chest pain or trouble breathing.