Pre-procedure antibiotics Must Be Taken For The Rest Of Your Life for All routine dental cleaning and dental work.
- Patients not allergic to Penicillin, Cephalexin, Cephradine or Amoxicillin: 2 grams orally 1 hour prior to procedure
- Patients not allergic to Penicillin, BUT are unable to take oral medications: Cefazolin 1 gram, OR Ampicillin 2 grams IM/IV 1 hour prior to procedure
- Patients allergic to Penicillin: Clindamycin 600mg orally 1 hour prior to procedure
- Patients allergic to Penicillin and unable to take oral medications: Clindamycin 600 mg IM/IV 1 hour prior to procedure
** You must take antibiotic one hour prior to any dental appointment for the rest of your life**
Additionally, prior to any urological, gastrointestinal or surgical procedure you must notify your doctor that you have a joint replacement. You may need to take antibiotics to protect the prosthesis from infection.
Please give a copy of this to your dentist or physician
Blood Clot Information
Preventing Blood Clots:
- Ambulate one time per waking hour
- Keep your leg 6 inches above your heart
- Wear the compression stockings as advised by your provider
- Change your position as often as possible
- Do not stay sitting or standing in the same position for more than 1 hour at time
- Do not cross legs
- Take your blood thinner as directed
Warning Signs of Possible Blood Clots:
- Pain in your calf and leg
- Tenderness in your calf
- Redness in your calf
- Swelling of your thigh, calf, ankle or foot
- Reddish or bluish skin discoloration
- Leg that is hot to the touch
Warning Signs of Pulmonary Embolism: (signs that a blood clot has traveled to your lung include)
- Sudden shortness of breath
- Sudden onset of chest pain
- Localized chest pain with coughing
If you are experiencing these symptoms during or after business hours contact the Colorado Joint Replacement or seek help immediately by going to an Emergency Room or calling 911.
Bruising & Swelling
Bruising around your knee may last for several weeks following surgery. Bruising is typically a purplish discoloration that indicates blood in the area. It can also cause additional tenderness. You can reduce inflammation and bruising by elevating your leg on a pillow in bed (keep your toes above your nose), or by icing the joint and adding heat to the muscles. If you have further questions regarding the bruising that you are experiencing, please contact our office.
Swelling is a normal part of the healing process. The swelling will gradually reduce but can last for three to six months after surgery.
Treatments to reduce swelling include:
- Ambulate (walk) one time per waking hour
- Elevate your lower extremity (keep your toes above your nose)
- Avoid dependent positions (sitting) for prolonged periods of time
- Ice packs – in general ice may be applied to the affected area 3-4 times per day for about 20 minutes at a time. Please be sure there is a layer between the ice and the body part to decrease the risk of skin breakdown or ice burns
- Pump your feet up and down 20 times each hour while awake and perform physical therapy exercises
- Please discuss any dental work needed prior to surgery directly with your doctor this should include a routine cleaning
- Please discuss ANY dental work for 3 months after surgery with your individual provider for approval
- Any questions of a dental abscess or acute infection must be addressed prior to undergoing a total joint replacement surgery
- If you have any questions regarding a procedure you are due to have; please let the office know as soon as possible so we can prescribe the appropriate pre-medications
Discharge from the Hospital
Please plan on staying in the hospital for 1 to 2 nights. The length of your stay will be discussed with your provider at your pre-operative appointment and will be re-assessed while you are in the hospital.
Prior to surgery, please make arrangements for help when you return home. Some items for consideration are:
- Having a family member or friend helping with your daily activities: meals, grocery shopping, medication refills, cleaning
- Planning for transportation to and from physical therapy and your post-operative appointments
- Making sure any tripping hazards are removed: rugs, mats and items you might need to step over
- Having sleeping arrangements on the main floor if you will not be able to use stairs
- Discussing care for an animal that might trip or bump you during recovery
After Surgery your tentative Post-Operative schedule is as follows:
- 2 weeks (with Physician Assistant)
- Staple Removal
- Range of Motion Check
- Physical Therapy Plans
- 6 weeks (with Doctor)
- Range of Motion Check
- 3 months (with Physician Assistant)
- Discuss follow-up care
Continued Follow-up Care
Annual check-ups are extremely important; we will be reminding you at the below intervals, please plan on scheduling these appointments as soon as you receive the reminder.
If you have any questions or concerns before your needed follow-up appointment; please do not hesitate to call the office at 720-372-0926.
Annual Follow-ups in most cases are as follows (if you are participating in a study your timeframes could vary):
- 1 Year
- 2 year
- 5 Year
- 8 Year
- 10 Year
- 15 year
- 2 weeks (with Physician Assistant)
What to expect from your appointment with the hospital:
- We have a wing of the hospital that is dedicated to joint replacement patients and nurses that specialize in your care
- You will be up and moving around on the day of your surgery, if your surgery is in the morning you will have your first physical therapy that afternoon/night
- You will have physical therapy and occupational therapy multiple times before you leave the hospital; this will ensure you are able to perform needed daily functions when you return home
- If you have dietary restrictions or requests our kitchen staff will make the necessary changes to accommodate these
- You will be staying in a single patient room and there is a couch/bed that can be used for a loved one to stay with you overnight
- Please feel free to bring reading material or something to make your stay more comfortable
- On the day of discharge you will need someone to drive you home and help listen to the discharge instructions
Pain is common and to be expected after this type of surgery. Night pain may occur and if possible medication should be scheduled prior to sleeping to assist with pain management.
- The oral pain medication may cause nausea, constipation and a light-headed sensation. If symptoms occur, call the office, and the medication can be changed. You should not drink alcohol or drive while on narcotic medications.
- Ice packs
- In general ice may be applied to the affected area 3-4 times per day for about 20 minutes at a time to assist with pain management. Please be sure there is a layer between the ice and the body part to decrease the risk of skin breakdown or ice burns.
- If you are having concerns with your pain management please call your doctor to discuss.
- Continue with pain medication as needed. Wean off pain medication as you are able by cutting down on the dosage, extending the time between doses or both. Do not stop pain medications abruptly.
- Take stool softeners and laxatives as needed while on narcotics and stay hydrated.
- Maximum Tylenol in a 24 hour period is 3000MG (6 extra strength Tylenol), please remember there may be Tylenol in the pain medication you are taking.
- Do not drive while taking pain medication and until you have control of your leg. Typically this is around 3-5 weeks from surgery.
- Stay on your crutches or walker for total 2-3 weeks unless instructed differently.
- Attempt to ambulate one time every hour while you are awake.
- Continue to ice and elevate at home for at least 3 hours a day. Each session should last 20-30 minutes. (ankle and knee above the heart – “KEEP YOUR TOES ABOVE YOUR NOSE”)
- Continue ted stockings for two weeks.
- Remove the Aquacel bandage as directed.
- After your staples/sutures are removed, wait until the next day to shower. If you have steri-strips applied, you many remove them after two week if they are still on.
- Do not submerge wound until 6 weeks post-operatively. Shower normally, don’t scrub wound.
- Please do not put any lotion, cream or scar reduction agent on your wound until cleared by your physician.
- Feel free to eat whatever is in your typical diet. Good nutrition helps in healing. If you do not have much of an appetite, try protein shakes.
You will have 2 pre-op appointments one with Colorado Joint Replacement and one with CMC the doctors that will be following you while you are staying here at the hospital. Please plan to spend about 3 hours between these two appointments.
What to expect at Colorado Joint Replacement:
- You will sign authorizations and consents for surgery
- You will fill out a questionnaire for our research department
- In most cases you will have x-rays taken
- You will be seeing the physician assistant and will have the opportunity to ask any questions you might have regarding the surgery (we recommend you bring a list and bring the person who will be caring for you after surgery)
- You will receive a list of your post-operative appointments
What to expect from your appointment with the hospital:
- This will be scheduled directly after your appointment at Colorado Joint Replacement, we will give you directions You will register with the hospital
- You will sign any needed paperwork for the hospital
- You will be asked to show your insurance cards and ID
- You will have blood work, a urine sample and EKG done (you can eat and drink as normal- these are not fasting blood tests)
- You will need to bring a list of your medications
- Other tests could be performed based on your health history
It is also Mandatory that you take the corresponding joint class with your surgery. These classes are approximately 3 hours and are free of charge.
Note: If you plan to have your pre-operative appointment done with your Primary Care provider arrangements must be made ahead of time.
Please plan at least 2 days in advance if you are in need of a medication refill; as, many prescriptions must be picked up at our office and can no longer be called into the pharmacy.
Please note that the office closes at 5:00 pm Monday - Thursday and at 2:00 pm on Friday’s, prescriptions will not be filled after hours or on the weekends.
If you need a prescription refill please call the office at 750-524-1367 and leave a message for your medical team with the following:
- Your name
- Date of birth
- Medication name
- Name of pharmacy/ phone number
- Number to call you back
Sleep deprivation following a joint replacement is not uncommon; some factors that may affect your sleep pattern are:
- Reflux disease
- Restless leg syndrome
- Pain and swelling
- Depression and anxiety
- Pre-existing sleep disturbances or medical conditions
- Braces or other mechanical factors
We continue to investigate reasons for sleep deprivation. We are in contact with other groups such as: Porter’s Sleep Center, Pharmacy Department and Centura Medical Consultants to create a consistent effort in treating these symptoms. Together, we have come up with some recommendations:
- Avoid caffeine after 12:00 pm
- Avoid napping throughout the day
- Keep your bedroom dark without distractions (television, computer or other electronics)
Taking Care of your Replacement
Total replacement is a predictable and durable procedure. How you treat your new replacement will influence its longevity. Therefore, it is important to know which activities are permissible and which are not following total knee replacement.
The benefits of an active lifestyle have been well documented and we want you to be active. You will be instructed about limitations and should have good self-control and self-awareness when returning to recreational sports.
- Low-impact activities (examples)
- Skiing (green/blue)
- High-impact activities (examples)
- Rock climbing
- Tennis (singles)
- You will leave the hospital with an Aquacel dressing covering your wound, please remove this on the date marked on the dressing
- If there is excessive drainage from your wound please call the office at 720-372-0926 and do not remove the dressing.
- Once the Aquacel is removed you do not need cover the wound (unless clothing is uncomfortable or if there is drainage).
- If you would prefer coverage you can use ABD pads, these will be given to you at discharge from the hospital.
- Do not put ointments or creams on your wound.
- Do not submerge your wound (bath, swimming pool, hot tub, lake etc.) until you have been cleared by your doctor and the wound is entirely healed.
- You can shower and use soap as normal.
- Slight itching is normal before the staples or stiches are removed.
If the wound has drainage, redness or appears infected, contact us for instructions.