Arthroscopic Knee Surgery
MEDICATION & ICING:
PAIN MEDICATION: Please make sure you are taking Norco hydrocodone (10/325mg) two tablets by mouth every 6-8 hours for pain as scheduled for at least the first 2 days post-operatively. It's important to stay on top of your pain and take it scheduled.* At post-operative day #3, you can begin to wean off this medication and taking it as needed. Eventually, you can transition to Tylenol Extra Strength 500mg, available over the counter. We prefer that you do not take NSAIDS for the first 6-8 weeks including Ibuprofen, Motrin, Advil, Aleve, etc.
ASPIRIN DAILY: Starting the evening of your surgery, please take Aspirin 325mg once daily by mouth for 14 days. This is very important to help prevent blood clot development near your operative knee.
CONSTIPATION: Miralax or Colace (stool softener/laxative) is highly recommended and available over the counter. One of the most common side effect of general anesthesia and Norco or narcotic medication is constipation, so start taking this postoperatively as instructed on label.
NAUSEA: Another common side effect of general anesthesia and Norco is nausea. If feeling nauseous, please take the prescribed Phenergan 25mg, 1 tab by mouth every 8 hours as needed.
ICE REGULARLY: Please ice your knee regularly, meaning 20 minutes on, 20 minutes off during your waking hours, for the first 3-7 days post-operatively. You may use a bag of frozen vegetables and place on and around operative knee. CVS or Walgreens also sells over the counter Cold Packs designed for the knee.
* Due to current opioid epidemic, our clinical department and team by policy does not allow prescribing narcotic pain medication beyond 6 weeks postoperatively. We certainly support and validate your post-operative pain, but we encourage realistic goals for weaning off pain medications by the end of week 2 or earlier to prevent side-effects and addiction.
If you require further narcotic pain medication beyond our policy guidelines, we can refer you to a pain management doctor. If you already have a pain management doctor, please visit them prior to surgery and post-operatively to have them manage your pain. By law, we cannot prescribe pain medication if you have a pain management doctor.
ACE WRAP, EXERCISES, & POST OP CARE
Please keep your white compression stocking and knee ACE Wrapped for the first 48 hours. You may require assistance of crutches when walking for the first 3-7 days. With the first few steps, walk gingerly applying partial weight on your steps, until you are more comfortable and can trust your knee when walking. As you gain confidence and trust your knee with steps, you can start applying more body weight, with improved range of motion and more of a normal gait, and wean off crutches or assisted walking device. It is okay to be limping for the first week, as you recover. Always wear ACE Wrap when walking for support and swelling control. The goal for the first week is to rest and elevate leg, apply ice, compress the knee with ACE wrap, keep pain under control, and attempt walking four times daily for roughly 2 minutes each time.
At your 1 week postop clinic appointment, we will give a prescription and protocol to start physical therapy approximately 2x/week, depending on specifics of your knee surgery and our clinical postop assessment. PT will start with passive range of motion (therapist motioning your knee), then active assisted range of motion (you motion with assistance), and finally active range of motion (you motioning knee by yourself). Range of motion exercises are dedicated for the first 8-12 weeks; and then you can advance to strengthening thigh, knee, and leg (always start very light with strengthening in about 12 week postop).
DRIVING: Okay to drive once you are no longer taking Norco and feel confident that you can drive with operative knee, and not be a danger to self or others.
TRAVEL: You are okay to travel (air or automobile) as a passenger as early as the following day after surgery. While you may experience pain and discomfort with travel, it is not detrimental to your knee outcome.
RETURN TO WORK: You may return to work once you are no longer taking narcotic pain medication during the waking hours, and once you are comfortable performing your job. Typically, light office clerical work is permissible 1-3 days post-op. But work requiring excessive walking/climbing or lifting will be permitted in 1-2 weeks post-op, based on how you are progressing.
REMOVING BANDAGES: Okay to cut off the white compression stocking (with scissors) and then remove the large ACE Wrap with bandage and gauze on knee 48 hours post-operatively. However, the steri-strips that are directly on skin covering the incision portals will be removed in 1 week in clinic. After you have removed the gauze, then reapply the ACE wrap around knee again.
SHOWERING: Keep bandage and incisions relatively dry. For the first 2 days, place an impermeable bag over knee to keep area dry. In 48 hours, it is okay to shower knee and get steri-strips & incision area wet; just pat dry when out of shower and re-apply ACE wrap. No scrubbing on incision site. Also do not submerge knee under water (no tubs, jacuzzi, pools) at least for the first 2 weeks, until steri-strips are removed and incisions are closed and well healed.
TOPICAL CREAM: You may have received topical creams from a compound pharmacy by mail. In 48 hours post-operatively, you may apply the topical anti-inflammatory cream (i.e. Diclofenac/Voltarin) on to knee 2 times per day or as needed, and around incisions or steri strips. Lidocaine/Prilocaine cream can also be applied onto area approximately once daily, particularly for bedtime. After 1 weeks postoperative when the steri strips are removed, apply scar cream (i.e. Mederma) once daily directly on incisions for wound healing. You may mix a small amount of Fluocinonide to Mederma to treat swelling and scar therapy at the same time. If you have not received these topical creams, please ask us during your post-op clinic appointment(s).
CONCERNS: You may experience swelling, water/blood drainage, and bruising in knee post-operatively, this is expected. Continue icing your knee to help with these symptoms. And stay on top of pain meds if you are still experiencing pain. Popping sounds in knee can occur and are expected. Keep your knee in ACE Wrap when walking. If you have any concerns, please contact us.
1 WEEK POST-OP CLINIC APPOINTMENT
You will need to schedule an appointment with Fabian (Dr. Fullick’s PA) in 1 week from surgery/procedure. Please call our office at (713) 486-7543 to schedule your postop clinic appointment.
If you have any post-operative questions, please call our office at (713) 486-7543 available Monday-Friday 8am-5pm. If outside of these work hours, please call (713) 486-7543 to speak with call center. You can also email Fabian (Dr. Fullick’s PA) at Fabian.Morice@uth.tmc.edu and please include your name, DOB, and pharmacy phone number if requesting further medication. While Fabian is prompt with replies, he is not an on-call service, so please allow 24-48 hours for email response.
In case of emergency (i.e. fever (>100.4), redness, excessive knee warmth, numbness >48hours, pus drainage from incision, intense knee pain non-responsive to meds >48hours, etc), please call 911 or go to your local emergency department.