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Discharge Instructions

Joint Replacement Patient Education

Dressing

Keep dressing dry and intact. Please do not get the dressing wet. If the dressing starts to fall off, please contact Dr. Chatrath’s Nurse at (507) 537-9007 to make an appointment to get the dressing changed.

Follow-up Appointments

1 week follow up appointment is with Dr. Chatrath’s nurse for a dressing change.

2 week follow up appointment you see Dr. Chatrath or PA, get x-ray, and get your staples removed.

6 week, 3 month, 6 month, and 1 year post operative follow up appointments.

White Stockings

Wear compression stockings for 6 weeks post operatively. The stockings help decrease swelling.

Showering

You will be able to take a shower in the hospital after your dressing has been changed. Once you get home, you should sit in a chair at the bathroom sink to wash up to avoid getting your dressing wet. After your first follow-up appointment, you can shower, but please avoid having the shower run directly over the dressing.

Elevation

Keep your leg elevated above your heart when resting. This will help decrease swelling. It is not unusual to have swelling on and off for a few months after surgery. Do NOT prop a pillow under the bend of your knee. Always put the pillow under your heel. It may be uncomfortable at first, but this will help your knee stay straight and stretch your hamstring muscles out.

Ice Machine

Use the ice machine at least 3-4 times a day or more if wanted. The ice machine is yours to keep. Be sure you use a towel between your skin and the ice pack to avoid skin injury.

SCD pump

The SCD pump squeezes your calf to prevent blood clots. You will use these for 2 weeks. You need to wear them whenever you are sitting or lying down. Please bring the machine back with you to your 2 week post operative follow up appointment with the Physician Assistant. The cost of the machine rental is $110; the bill can be submitted to the insurance company, though you will be responsible for the cost if the insurance company denies payment.

Physical Therapy

Start physical therapy right away. They will let you know when you can start using a cane and when you don’t need any assistive devise to help you walk.

Medication

  • Aspirin 325 mg twice a day for 4 weeks post operative (prevents blood clots)
  • Meloxicam 7.5 mg twice a day (helps inflammation and swelling)
  • Gabapentin 300 mg (helps with nerve pain)
    • *at bedtime for patients 70 years and older
    • *twice a day for patients younger than 70 years old
  • Omeprazole 20 mg daily in the morning (protects your stomach from the medications)
  • Hydrocodone/Acetaminophen 5/325 1-2 tablets every 4 hours as needed for pain
  • Tramadol 50 mg every 6 hours as needed for pain
  • Acetaminophen (Tylenol) 500 mg 1 tab every 4 hours as needed for pain (do not take more than 4,000 mg of Acetaminophen in 24 hours)

Exercises

Work on daily range of motion exercises at home for both straightening and bending. You will learn these exercises from physical therapy. Increase daily household and community walking. Walking is one of the best exercises that you can do after a joint replacement.

Sleeping

You may sleep in any position as comfort allows. Do NOT prop a pillow under the bend of your knee. Always put the pillow under your heel. It may be uncomfortable at first, but this will help your knee stay straight and stretch your hamstring muscles out.

Driving/Traveling

You may drive 4-6 weeks after surgery as comfort allows. It is recommended that you do NOT drive while on pain medication. You should drive with someone in the car with you the first time to make sure you are safe. You may travel and increase activity as comfort allows. If traveling by car, stop every 60-90 minutes to stretch your legs. If traveling by plane, take a walk every hour if possible.

Incision

You can start using cocoa butter or vitamin E lotion on your scar at 4 weeks post operative.

Knee changes

It is not unusual to hear clicking in your knee. Do not worry. It usually begins within the first 4 weeks after surgery as you increase your activity and usually resolves within 6-12 months. It is normal for your surgical joint to be warm and mildly swollen for up to 12 months. This is due to the increased blood flow to the area to heal the soft tissue. Any warmth that is associated with increased redness, drainage, or fever should be reported to the office at once.

Infection

If left untreated, can spread to your new joint by way of the bloodstream. The consequences of this can be quite serious. Please take the following precautions:

  • You must take antibiotics before all dental work. We recommend this as a life-long practice and not just the first few years. This includes fillings, caps, extractions, teeth cleaning, everything. Your surgeon or dentist will provide you with the initial prescription for dental antibiotics. As for now, we do not have clear national guidelines.
  • See your primary care provider if you suspect any kind of infectious process including bladder infection, upper respiratory (bronchitis, pneumonia, or sinus infections) so that the appropriate antibiotic can be provided. The dental antibiotic may not be the proper antibiotic for these infections. Wound infections, although rare, require urgent attention.
  • If you have any surgical procedure scheduled, let your surgeon know that you have had a total joint replacement. You will need prophylactic antibiotics before and possibly after the procedure. You should not have any dental work 8 weeks before AND after your joint replacement surgery.
  • You will need antibiotics for all urology procedures. Let your urologist know that you have had a joint replacement.
  • If you have a sigmoidoscopy or colonoscopy, you will need antibiotics prior to the procedure.
  • A PAP smear, D&C, breast biopsy, and cataract surgery do not require antibiotics prior to the procedure.
  • Routine toenail trimming by a podiatrist does not require antibiotics prior to the appointment. Treatment for ingrown toenails require antibiotics prior to your podiatrist appointment. If your ingrown toenail is infected, you must seek immediate treatment from your podiatrist or primary care provider.
  • Airport Security: We do not give out joint replacement cards; they do not work. You should wear loose clothing. When (or if) asked, you should show your scar. You could also obtain your operative note from medical records to bring with you to the airport.
  • Call us if there is any doubt whether you need antibiotics. This is very important. Consider it an investment in your joint.