DAY OF SURGERY
- Take it easy!!
- Apply ice over the bandage
- Start with clear liquids/foods, and slowly progress to solids
- Drink plenty of fluids
- Narcotic usually is prescribed. Take the minimal amount needed to control the pain.
- Stool softener (Colace) should be taken if narcotic is required on a regular basis. Constipation is a common side effect.
- No driving allowed while on narcotics.
- Narcotic medication is not refilled during evening or weekend hours. Please contact my nurse with appropriate lead time if a refill is required.
- DO NOT TAKE TYLENOL at the same time as narcotic pills. Tylenol is included in the narcotic pills, and taking both simultaneously runs the risk of overdosing on acetaminophen.
- Advil, aleve, or celebrex may be taken in conjunction with either tylenol or narcotic if needed.
- Keep bandage on for 48 hours
- While removing the bandage, do not be alarmed if the dressings are wet and/or saturated with blood. Fluid is used to distend the knee during the operation. This fluid seeps out the portals and often makes the bandages appear more dramatic than they are!
- Place saran wrap over the knee
- Shower normally
- Blot dry with a clean towel. Leave the steristrips in place.
- The portals tend to not leave an obvious scar. However, to minimize this, use Vitamin E cream over the portals beginning four weeks after surgery twice a day. If, a formal incision was made and steri strips (white pieces of tape) were applied Do NOT Remove.
- The portals will be sensitive to burning for six months to a year following surgery. Please apply 45 protection during exposure to the sun.
- You should be seen 7-10 days following surgery.
- Please call 847-724-4978 to arrange for this before surgery.
- You should schedule this with either myself or my physician assistant, Courtney.
- Findings from surgery will be reviewed at that visit along with intraoperative pictures.
- Sutures will be removed at that visit.
- Physical therapy will be arranged at that visit if not already arranged.
- If you wish to have actual clips of your surgery recorded, please bring either a blank DVD, blank CD, or flash drive and give this to Dr. Portland in the holding area and remind him to please record images. THIS NEEDS TO BE GIVEN TO DR. PORTLAND BEFORE SURGERY IN HOLDING IF YOU WISH VIDEO CLIPS.
ACTIVITY FOLLOWING SURGERY
- Screws and absorbable pins have been placed fixing your reconstructed ligament. It is unreasonable to expect your repair to succeed if you do not protect this appropriately. Wear the knee immobilizer placed at the time of surgery to walk. Our quadriceps muscles go to sleep and do not function immediately postoperatively. Walking without the immobilizer during this initial phase places our leg at risk of buckling. Once our quadriceps has been rehabbed the immobilizer is no longer needed.
- Crutches should be used as needed. If a femoral nerve block has been given, crutches are mandatory while the block is working.
- Athletic activity is not permitted until cleared by either your therapist or by Dr. Portland.
- No driving while on narcotic.
- Do not contemplate driving if you are too sore to react in an emergency.
- Remove the knee immobilizer to drive.
- Check with your insurance carrier. You may not be covered within a certain period of time from your surgery.
- Gently flatten the back of the knee against the floor or bed (ten times; three times a day)
- Gently slide the heel along the ground up toward the buttock as far as possible. If a meniscal repair was performed, do not go past ninety degrees. (ten times; three times a day)
- Pump the ankles up and down (four times a day)
- Work on activating the quadriceps muscle
- If you develop significant shortness of breath or chest pain, call 911 immediately. Following this, contact Dr. Portland
- Blood clots are a feared complication. Take a baby aspirin a day for one week, pump your ankles up and down, and ambulate to help prevent this from developing. Some calf discomfort and swelling are common 24-48 hours after surgery as the arthroscopy fluid settles with gravity. If excessive swelling and/or discomfort present, please notify Dr. Portland immediately.
- Call if you develop fever higher than 101 degrees, shortness of breath, chest pain, redness around the incisions, foul drainage from the incisions, or a significant worsening of pain not relieved by icing and anti-inflammatory
- Infection is highly unlikely following an arthroscopy. The knee is bathed continuously during surgery with fluid, and this washes any bacteria away. Antibiotics are given before surgery, and no further dose is required.
- Tips to further prevent infection
- A nasal swab may be performed of your nose before surgery. One in five people are carriers of a bacteria called Staphylococcus Aureus. If you are identified as a carrier, nasal antibiotic ointment can be started before surgery to minimize this risk. Alert my staff if you wish this ordered.
- Purchase hibiclens shower solution from your nearest pharmacy. Take a hibiclens shower the morning of surgery as directed on the bottle.
- Do not play with your incisions.
- Keep a clean and dry band aid over the portals until they begin to heal.
- Narcotic is routinely prescribed.
- Icing and elevation for forty-eight hours after surgery are critical.
- Pain catheters typically are inserted inside the knee at the end of surgery. This allows a continuous anesthetic drip inside the knee.
- Special ice coolers allowing continuous cryotherapy may be ordered prior to surgery. Please let us know ASAP if you wish to order one. (Highly recommended.)
- A nerve block allowing 12-18 hours of relief may be provided by the anesthesiologists. This temporarily helps decrease the amount of narcotic needed. The quadriceps muscle will go to sleep during this time. Ensure you are using crutches and a knee immobilizer during this period. Very slight risks exist with the block. I would recommend a discussion prior to surgery with the anesthesiologist if you wish to pursue this option. My staff can help provide you with contact information.