P 816.252.7300
F 816.836.8435
19550 East 39th St, Ste. 205
Independence MO 64057

After Surgery Information

 

Post-Op Expectations and Issues: Total Joints

 

Swelling:

Present for 3-4 months gradually/progressively decreasing.

 

Treatment: 

Ice and elevation. Continued use of Ted hose for lower extremities post-op the first six weeks as long as there is swelling compared to the opposite limb.

 

Call if:
Significant calf pain is persistent, swelling that does not resolve especially with heat to the calf by elevation or resolve by next morning after bed rest.

 

Increasing redness beyond the immediate incision, any drainage.
Marked increase in pain.

 

Band-like feeling:

Will resolve over 3-4 months.

 

Solution:
Ice, Massage and Stretching

 

 

Bruising

May occur at the thigh from the tourniquet or down to the foot secondary to subcutaneous bleeding and dependency.

 

Duration of crutch or walker use:

For Total Knees: 2-4 weeks AFTER surgery until minimal swelling and comfortable ability to walk without any tendency toward limping are present.

 

For Total Hips: 4-6 weeks until there is no limp and the ability to stand on the affected leg is equal to balance to the opposite limb, may then go to the use of a cane in the opposite hand until all tendencies toward limping or feelings of weakness are gone from the leg.

 

 

Anticoagulation/Coumadin:

Will use for 6 weeks AFTER surgery remembering to have this monitored every Monday morning by a blood test. Take your Coumadin on Monday. If you do not hear by 5 p.m. Monday, call the office Tuesday morning at 9am.

 

 

Antibiotic Prophylaxis: Use of Antibiotics After Total Joint Replacement


All total joint replacement patients require protection against infection.

 

Antibiotics should be prescribed in the following circumstances:

 

1. Infection in any area of the body.
2. Any surgical procedures done following your surgery.
3. Any dental work (including routine cleanings) following your surgery.

 

The physician or dentist performing the surgery/procedures should prescribe the appropriate antibiotic. Infections and abscesses generally require seven days of antibiotic treatment and simple surgery or dental work require three days starting the day before the procedure.

The need for antibiotics in these instances is for the rest of your life!!!

Please call the office if you have any questions regarding antibiotics or if you require a prescription for antibiotics.



Late infection:

This can occur with dental cleaning, dental work or surgical procedures at any time after your surgery. This can also occur during colonoscopy or endoscopy. You will need to have oral antibiotics started one day before any such procedure and continued for three days. Please call the office for prescriptions.

 

 

Activity / Exercises:

For Total Knees: Continue the rehab exercises especially the bicycling and chair slides. Do the chair slides every waking hour for 5-10 minutes to increase your flexion. Three times a day for 2 minutes, lay on your stomach with the edge of the bed at the mid thigh and the rest of your leg hanging off the end or side of your bed and place a 1-2 lb. weight at the ankle to increase you extension stretching as you perform this.

 

For Total Hips: Work on single leg stance on the affected leg while balancing at the counter with the opposite hand. Work on lifting the leg to the side, behind and in front of you while standing up. Lay on your back, bend the hip up to a 75-degree angle and let the leg slowly lay over to the outside of the body so that the knee is falling away from the other knee.

 

Avoid any strenuous sports such as tennis, jogging, and basketball until cleared by your physician.

WHEN IN DOUBT, PLEASE CALL THE OFFICE TO ASK. 816.252.7300

 


Wrist Surgery / Carpal Tunnel Recovery

When your dressing has been changed; follow the printed information we will provide and please note the following:

 

You may remove the splint and the "outer sleeve" (keeping the underlying dressing intact). Through this (as desired), you may use a hairdryer set on maximum intensity, but cold temperature, to "blow dry: through the gauze keeping the hand and/or wound area somewhat dry.

 

DO NOT remove the dressing under any circumstances.

 

Finger range of motion as tolerable while wearing the splint is encouraged.

 

It is important to remove the splint for daily wrist and finger exercises AFTER your sutures are removed, to hasten your recovery.

 

To hasten your recovery, squeeze a washcloth or sponge while immersing the hand in a tub or basin of warm water.

 

As you progress in your ability to do this comfortably, you may progress to "wringing" a washcloth or sponge dry from the water.

 

This will help to improve your grip strength; which may still require a minimum of six weeks to re-achieve a nominal level of normal function. It is not uncommon to have some incisional tenderness and/or tightness that may persist for up to three months. Full recovery of strength often does not occur until six months following surgery.

 

Formal occupational/hand therapy may be prescribed in addition to the above in which case this can be added to your formal therapy program.

 

Massage your incision frequently with lubrication cream and stretch the palmar area.

 


Knee Arthroscopy

Until you have your kneed dressing changed in the office, maintain as much elevation as is possible with ice applied to the knee (over the top of the dressing) until swelling and/or pain have resolved.

 

Keep the dressing dry and use the case guard for showers. Do NOT change dressing. You may loosen the ace wrap and re-warap if it's too loose or too tight creating foot swelling.

 

After your sutures are removed in the office, you may begin showering or bathing that evening.

 

Massaging the wound areas with an ice cube as often as desired (at least four times a day) will help to diminish some of the tenderness and swelling.

 

Perform the exercises including quadriceps sets, straight leg lifts, "T" writing and wall slides/stair step exercises as instructed and per the instructions provided to you in the office.

 

Maintain your crutch use until you can perform at least 10-15 wall slides and/or stair step exercise lifts.

 

A slight amount of clear drainage may occur from the wound sites for the first three(3) to four(4) days. However, if this turns pustular or is associated with increasing pain or redness, please notify Dr. Hummel immediately.

 

It is not uncommon for some discomfort and/or "noise" be present in the knee for up to the first three(3) to four(4) weeks.

 

By persisting with exercises and not "pushing it" before your knee muscles are adequate, your recovery will be quickened and problems lessened significantly.

 



Ankle Sprain Protocol

1. Practice standing flatfooted on the injured leg lifting the good foot off the floor and maintaining your balance on the injured limb.

 

When you can perform this without discomfort and equal duration to the opposite (normal) side, then perform the same exercise with your eyes shut. When you can perform these with the ankle brace in place comfortably then start the exercises without the ankle brace.

 

2. To help resolve swelling and tenderness, begin a contrast soak technique by drawing, slightly warmer than bath water temperature, hot water in the bathtub soaking the injured ankle and foot in the water while writing letters of the alphabet in as large a fashion with the injured foot and ankle. When you have finished the alphabet, plunge the injured limb into a tub or bucket of ice water next to the bathtub for approximately 30 seconds to a minute. Then repeat the "alphabet writing cycle". Do this for 15-20 minutes at least three times daily.

 

3. Continue using the gel cast until instructed to discontinue or until all swelling is gone, no discomfort occurs with everyday walking and your balance ability is equal to the opposite, uninvolved limb.

 

4. Follow the stretching and strengthening exercises provided by Dr. Hummel.

 

 


Shoulder Arthroscopy

If rotator cuff repair IS performed: The immobilizer stays on for the first two(2) weeks. Keep a pillow behind the elbow when in a chair or bed to help keep the arm pushed towards the front of your body.

 

When looking down the wrist should be immediately beneath the chin alignment. If the arm starts to rotate, a family member will need to loosen the Velcro behind and reposition the arm by pulling the wrist back under the chin alignment. Do NOT remove the dressing until sutures have been removed at two(2) weeks.

 

When instructed, you will start passively having the arm move by using the other arm, a wand can be an assistance to the arm or pendulum exercises such as an elephant trunk and finally use of the shoulder pulley (reference the enclosed instruction booklet in the pulley).

 

If the rotator cuff repair is NOT performed: The sling can be removed when sedentary immediately post operatively and you may drive the next day using the involved arm for simply, everyday activities, but no heavy use until instructed.