DR. MORA’S POST-OPERATIVE INSTRUCTIONS FOLLOWING TOTAL OR PARTIAL KNEE REPLACEMENT

  1. Your Incision: The dressing over the incision is water tight.  The incision is covered with a type of skin glue plus tape.  The sutures used to close the incision are placed under the skin and will dissolve with time.  The water proof covering will be peeled off 10-14 days after your surgery.   It is okay to shower once you are discharged from the hospital.  Apply a simple ace wrap during the day.  No submerging the knee in a bath or Jacuzzi until the incision is totally dry.  This may take 3 weeks.  It will take about 6 weeks for the incision to look really nice.
  2. Hospital Stay:  You will stay overnight following your surgery.  You will be able to go home the day after your surgery.  Discharge is usually in the afternoon and after your second physical therapy session.  Patients who have no family support can go to a nursing home.  The nursing home transfer is arranged by the hospital discharge planner. Dr. Mora prefers you go home.  There is less risk of getting a post operative infection at home.  Hospitals and nursing homes are known to harbor resistant bacteria.
  3. Exercise: It is encouraged to bend and fully straighten the knee daily. Focus on getting the knee to fully straighten out.  Once your knee fully straightens out you will be able to walk without a limp.  Walking is also encouraged.  The more you exercise and stretching the less pain you will have.  You can do a stationary bike as soon as you are able to bend the knee.
  4. Physical Therapy: This will start in the hospital the day after your surgery.   The hospital therapist will see you in the AM and again in the afternoon.  Once the therapist sees you in the afternoon you can go home.  HOME physical therapy will be 2-3 times a week for 2-3 weeks.  The duration usually depends on your insurance.  Once the home therapy is complete you can start OUTPATIENT physical therapy.  Dr. Mora will provide you a prescription for your outpatient therapy on your first post operative visit.
  5. Crutches/Walker: Usually used for about 2-4 weeks. The therapist will guide you. You can apply as much weight as you can tolerate.
  6. FIRST Visit after Surgery: You will see Dr. Mora 2-3 weeks after the surgery. Please call the office and arrange this visit if it is not already scheduled.
  7. Tips for Wound Healing: Avoid tobacco, take probiotics/daily multi-vitamin/Vit C 500mg twice a day and staying well hydrated.
  8. Constipation:  Very common after surgery.  Usually due to pain medication, changes in diet, medications etc.  Hydrate before and after surgery. Walking helps gut function.  Take a probiotic.  Over the counter Milk of Magnesia or Smooth Move Tea once a day is recommended.
  9. Icing: As long as there is swelling, applying a bag of ice over a towel across the knee is beneficial. Do this for 20 min three times a day.  This is helpful the first 2 weeks.
  10. Driving: This is partially up to you: You should be able to drive when the knee is not a distraction and when you can safely push the brake and gas pedals. It may take 2-3 weeks before it can be done. Research has shown that you are at increased risk driving soon after surgery.  Please use common sense. Driving is not recommended while taking pain killers.  Please know that you can be arrested if you are driving under the influence of pain killers.
  11. TED Stocking: Use the first 3 weeks. Take off at night and once a day.  These stokings help to decrease the risk of deep blood clots.
  12. Blood Thinner Med:  Dr. Mora prefers to use oral  Xarelto 10mg once daily x 30 days.  You will receive a prescription prior to surgery.  Once the 30 day Xarelto treatment is completed, please take an enteric coated aspirin (ECASA) 81mg once a day for 2 months. If you are on Coumadin for other medical problems you will not be taking Xarelto nor aspirin.  If your incision starts to bleed you will have to stop the blood thinner.
  13. Future Dental Work: These recommendations vary depending on surgeon preference. Patients who are immunocompromised (diabetes, rheumatoid arthritis) should take Amoxicillin or Clindamycin (PCN allergy patients) one hour prior to dental procedures.  The dentist will usually provide the antibiotics.  Dr. Mora prefers you take prophylactic antibiotics the first year.  re. After the first year, the risk of infection is much less but it is still advisable to take antibiotics especially if a major dental procedure or if you are immunocompromised.  Your dentist will prescribe the medication in advance.
  14. For General Questions: St. Joseph Hospital has an excellent Joint Replacement Program Nurses.  You can call the hospital and ask for the Orthopedic floor.  They can provide info if you were recently discharged.  You can also email Dr. Mora for non urgent questions at smora@restoreorthopedics.com
  15. Airport Metal Detector: You should not have any problem getting through the airport. There is NO universal “ID card” for operated patients. If you set off the detector you will be taken aside and scanned again at which point the surgical incision can be shown. You will not have problems.
  16. Red Flags:  Please know that fevers (101.5 or higher) are not expected.  Also if your knee looks like its been badly sun burned you should come in sooner than scheduled.  You can be seen without an appointment through our urgent care if necessary.  Your knee will feel a little warmer than the other side.  This is expected.
  17. Recovery:  It usually takes 2-3 months to feel good.  You will notice significant improvement up to a year after surgery.