Dr. Bartlett's Post-Op MAKOplasty Knee Arthroplasty Instructions

The following are instructions to follow after your knee surgery.

Wound Care

You may remove your dressing after hospital discharge unless you have drainage. You should continue to massage the sides of your knee 3 times daily with lotion. It is important that you do the massage yourself. Your staples will be removed at your first post-op visit 10-14 days after surgery, if they were not removed at the hospital or nursing facility.

Medication

• Oxycontin 10 mg orally every 12 hours for the first three days that you are back home or in the nursing home.
• Vicodin or Percocet. A prescription has been provided. Take with food.
• Celebrex 200 mg daily for 3 weeks
• nticoagulation: Aspirin (OTC) 325 mg twice daily for 2 months after surgery OR Coumadin - dose to be managed by your primary care Physician for 2 months after surgery. (Maintain INR of 1.5 to 2.0)
• Multivitamin (OTC) for two months after surgery.

Pain

Your pain should continue to decrease each day. Ice and elevation will be very beneficial in reducing your pain. You may use ice or a hospital supplied cooling wrap as often as you would like. There will be a permanent area of skin numbness on the outside (lateral) of your knee. This is normal. It will become smaller over time and never affects knee function.

Activity Modifications

You may put full weight on your leg. Use a walker or crutches until your knee feels strong and stable. You should pace yourself and plan rest periods throughout the day. Walking is an excellent activity to gradually increase your exercise tolerance.

Bathing

You may take a quick shower beginning one week from surgery, if there is no drainage from your wound. If you have a dressing on the wound, remove it for showering and then reapply. Do not tub bathe, swim, or get into a whirlpool until your staples have been out for 48 hours.

Driving Limitations

You may resume driving when you can lift and forcefully brake with your right leg (usually 3 weeks)

Elastic Stockings

You may remove your elastic stockings for laundering and at night. Continue to wear the stockings during the day until your activities increase. We recommend that you wear them during your waking hours for at least two weeks after surgery and thereafter if you experience any increased swelling in the calf or ankle.

Dental work or other potential infection precautions

If possible, refrain from dental work including cleaning for at least 3 months following surgery. Antibiotics are recommended prior to dental work and other invasive procedures. A prescription may be obtained from our office or from your dentist's office. The recommendations are: If not allergic to Penicillin: Cephalexin 2 grams 1 hour before the procedure. If Allergic to Penicillin: Clindamycin 600 mg 1 hour before procedure. Should you develop any type of infection or undergo any invasive surgery, make sure to inform your health care provider that you have an artificial joint.

Post-Op Exercises

The following exercises are to be used to complement your physical therapy treatment. These improve strength and endurance, help decrease swelling and improve mobility and flexibility. CAUTION: Discontinue if you have increased pain, temperature, or swelling of the joint. Begin formal PT the day after discharge unless otherwise instructed.

Quadriceps Isometrics Tighten the muscles in the front of the thigh and hold for a slow count of 10 then relax for a slow count of 5. Do this 25 times, 4 times a day,

Hamstring Curls/Knee Flexion While lying face down on the bed or while standing with support, bring heel towards buttocks. Pull hard and hold for a count of 5, straighten and relax. Repeat for a total of 25 times - 4 times daily.

Straight leg raises While lying face up on the bed, hold knee stiff and raise leg. Do 10 times, 3 times daily.

Follow-up Appointment

Following your first post-op appointment, you will also have appointments at 1, 2, and 3 months after surgery. Call to verify appointment (608) 238-9311.