Wound Care

• Remove dressing in 2 days. Keep steri-strips or glue in place- unless they fall off.
• Loosen bandage if swelling or progressive numbness occurs in the extremity.
• Bleeding and swelling is normal following surgery; if blood soaks onto the ACE bandage, simply reinforce with additional gauze dressing for the remainder of the day and re-check. The ACE bandage can be laundered and reused.
• You may shower 3 days after surgery; do not scrub the area; just allow water/soap to wash over you. Be sure to pat the incision dry afterwards.
• Do not bathe or swim until approved by surgeon.

Ice

• Do not ice for 2 weeks
• After 2 weeks you may use ice packs or an ice machine for pain relief and swelling.

Crutches & Weight bearing status

• Following a Knee Arthroscopy, you will be weight bearing as tolerated with crutches for 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 can ambulate without a limp and feel comfortable, you can safely discard the crutches and walk unassisted.

Pain Control and Medications

You have been given a regional anesthetic block prior to your operation. This will wear off in the evening following your surgery.

1. Pain Medication: Tylenol 1000mg every 8 hours and, unless discussed otherwise, you have been prescribed a narcotic pain medication (Oxycodone 5mg) to take every 4-6 hours as needed.
• DO NOT drive/use any 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 they may cause confusion or disorientation, we advise you to discontinue this medication should that occur.
• Narcotics can be addictive. Dispose of any excess medication at a police/fire station.
• Take a stool softener (e.g. Colace) while taking narcotic medication, as narcotics may cause constipation.  If this does not help alleviate your constipation, you can try adding miralax or milk of magnesia. Please call our office if this regimen does not alleviate your constipation.
• If you have any questions or concerns about narcotic strength medications, please contact us.
• 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.
2. Anti-nausea: Zofran (Ondansetron): Take as prescribed if needed for nausea
3. Anti-Inflammatory: DO NOT take any NSAIDs for 2 weeks. Unless contraindicated due to other health reasons, you have been prescribed a non-steroidal anti-inflammatory drug (Ibuprofen 800mg) for use postoperatively, after 2 weeks. NSAIDs will interfere with the intentional inflammatory cascade of the PRP therapy. If you have no personal history of adverse response to anti-inflammatories (NSAIDs), take as prescribed every 8 hours with food to help reduce swelling and pain. Do not take other NSAIDs (Advil, Aleve, etc) with Ibuprofen.

Tylenol and Ibuprofen* (after 2 weeks) are the foundation for your pain control regimen

Example dosing: 1000mg Tylenol then 4 hours later 800mg Ibuprofen then 4 hours later repeat- every 4 hours alternate between Tylenol and Ibuprofen. Oxycodone as needed for breakthrough pain.

*You should not exceed 3,000mg of Tylenol or 3,200mg of Ibuprofen in 24 hours.

Oral Contraceptive medication: If you are currently taking oral contraceptive medication, you may be at a higher risk for a blood clot after surgery. You may consider talking with your primary care physician or obstetrician about discontinuing this temporarily surrounding your surgery.

Physical Therapy

• Formal physical therapy will be ordered by your orthopedic surgeon. You should start formal physical therapy within 1 - 5 days.
• The protocol should be given to a physical therapist of your choice.
• Once you schedule surgery, you should contact your physical therapy facility to schedule your first PT appointment within 2-5 days.
• The day following surgery you may begin exercises at home, such as: quad sets, leg raises, flexion and extension, and calf pumps (see pictures below).

Driving

• You may drive once you have full control of your arms and legs AND are off narcotics. If you have surgery on your RIGHT knee, please wait at least 2-4 weeks. If you drive a manual transmission vehicle and have had surgery on your LEFT knee, please also wait 2-4 weeks to prevent irritation from operating the clutch. We recommend you practice driving in an open parking lot before returning to the road. If you have to drive for long periods of time within 2-4 weeks after surgery, we recommend taking frequent breaks to walk and stretch, to decrease the risk of a blood clot.

Return to Work

• You may return to work as soon as you are comfortable, this typically occurs 1-4 weeks post-op. Return to work notes can be obtained at your first post-op appointment.

Follow-up Appointment

• Your first post-operative appointment will be scheduled within 7 days following your surgery. Typically, dissolvable sutures are used during surgery and do not need to be removed. If you do have sutures that need to be removed, this will occur at your first post-operative visit. If you do not have an appointment scheduled when you leave the surgery center, please call 513-354-3700 or 513-441-5639 (Direct Line to Sandy Evans) to make the appointment.

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

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