Post-Operative Instructions & Guidelines

/Post-Operative Instructions & Guidelines

Do I need to quit smoking prior to surgery?

We encourage all tobacco users to quit 6 weeks prior to surgery. Tobacco use not only increases your risk for infection, but also delays bone growth and soft tissue healing.  It is also highly important to remain tobacco-free for a minimum of 6 months after surgery to increase your chances of success post-operatively.

How can I reduce swelling after the surgery?

There are multiple methods to help you reduce swelling after your surgery. They include the following:

  • Elevating your affected limb at or above heart level.
  • Ankle pumps (rotating your ankle, as well as, moving your foot up and down).
  • Continuous use of TED hose stockings.
  • Game Ready Ice Machine.

How long do I have to wear the TED hose (surgical stockings)?

TED hose stockings are essential for preventing lower extremity swelling and decreasing your risk for a DVT (deep vein thrombosis- also known as a blood clot). These stockings are worn on both legs while on crutches for the first 2 weeks as there is still risk of getting a blood clot in the non-surgical leg. You may remove the TED hose stocking on the non-surgical leg at the two week mark; however, the affected limb is to have a stocking until you are full weight-bearing.  Stockings may be removed daily to wash and dry; however, be advised that they should be placed back on the lower extremities as quickly as possible.  Additional sets of TED hose may be purchased at the pharmacy.

How often do I use the Game Ready Ice Machine?

Icing is an important part to reducing swelling and pain after your surgery. We recommend using the Game Ready ice machine 5-6 times daily for 20-30 minutes sessions for 2-6 weeks post-operatively. When icing, we recommend 30 min -1 hour breaks between icing sessions and wearing a protective layer between your skin and the ice machine.  If you have questions regarding rental fees, when to return the machine or any other questions, please feel free to contact the company representative at (970) 471-6267.

How often do I do dressing changes at home?

Dressing changes are a vital part of your post-surgical process. You will be supplied with the needed dressing change materials and provided with hands-on instruction.

  • For the first 2 weeks, change the 4×4 gauze pads at least every other day or if they become wet/soiled. Keep them in place with the tubigrip provided.
  • Do not touch, remove or apply ointment to the steri-strips (tape) that are over the arthroscopic portals or skin incisions. Steri-strips are to remain on the incision sites for 2 weeks. If they fall off before the 2 week time period is up, please reapply them with the extras that you have been given.

At each dressing change, evaluate the incision sites for any purulent drainage (pus), excessive redness, increased warmth or pain. These signs may indicate an infection. Contact a team member immediately if these symptoms occur.

When do I have my sutures (stitches) removed?

Our surgical team typically uses dissolvable sutures in scope portals and surgical incisions (unless otherwise specified). These require no special care because the sutures are underneath your skin and will dissolve on their own. If you do have an incision, extra suture material may be on the outside of the skin. These sutures will need to be cut at 2 weeks post-operatively which can be done in our office during your follow up visit or at home by a family member/friend. A suture removal kit will be provided upon request. For clear sutures, clip any extra suture at both ends of the incision. The remaining suture under the skin will dissolve.

When can I bathe/shower or get my incision wet?

In order to reduce the risk of infection, it is crucial that you maintain a dry environment for your incisions for the first 2 weeks. A shower bag has been provided to you in your dressing change kit. If the shower bag’s elastic band does not fit well, you may use another rubber band or tape to secure it. Please use the shower bag for 2 weeks until you have your incisions evaluated by a medical provider.  After two weeks, patients may get the incision site briefly wet in the shower but are still advised to avoid soaking in a pool, hot tub or bath for up to a month after the surgical procedure.

 Why do I have to take a blood thinner and for how long?

Any orthopedic surgery is a risk factor for developing a blood clot, also known as a DVT (deep vein thrombosis). Our team is highly attentive to this risk and proactive at preventing blood clots. In order to decrease the chance of a blood clot, patients are placed on one of two blood thinners depending on their weight bearing status post-operatively. The type of medication you will be placed on will be discussed during your pre-operative visit. Please notify our providers if you are on any hormone medications (including birth control) or if you have any personal or family history of blood clots or blood clotting disorders as these also increase your risk for blood clots.

What are signs of a blood clot and what do I do if I suspect one?

Signs of a blood clot include the following:

  • Severe calf/leg swelling or diffuse redness.
  • Severe calf pain with moving foot up/down or when squeezing the calf.

If these symptoms arise, please contact our office immediately. We will need to order an ultrasound of your leg to rule out a blood clot. Our team is available Monday-Friday 9 am to 4 pm. If you are calling after business hours, please contact our main line at (970) 476-1100 to reach our on-call fellow physician.  NEVER massage calf pain!

*If you develop chest pain or difficulty breathing, call 911 IMMEDIATELY.

What are signs of an infection and what do I do if I suspect one?

While infection is not common, there is always a risk with any type of surgery.  Contact our office immediately as directed above in question “6” if you develop the following signs:

  • Fever of 101.5 degrees F or higher
  • Purulent drainage (pus), excessive redness or swelling around the incision site(s).

What if I need a refill on a medication?

Pain medication prescriptions are provided on the day of discharge for inpatient surgeries or the day of the pre-operative visit for outpatient surgeries. All other medications (anti-nausea, anti-constipation and blood thinners) are prescribed day of surgery. If you require a refill on any of these medications, please contact our office during business hours. Of note, some pain medications require by federal law a written prescription that needs to be picked up from our office and taken to your pharmacy. If you are not within driving distance, we recommend you see your primary care provider or an urgent care clinic for further evaluation.

*While our team takes your pain concerns very seriously, we are devoted to the national effort in decreasing the opioid addiction epidemic. We abide by strict guidelines provided by the CDC and have created a pain medication agreement plan with a link below.

May I take anti-inflammatory medicines after the surgery?

Unless otherwise directed by Dr. LaPrade, all patients are to avoid anti-inflammatory medicines (NSAIDs – such as ibuprofen, naproxen, etc.) after surgery as these delay bone healing and interfere with ligament graft healing. While we provide you pain medication for the first weeks after surgery, we recommend that patients transition to Tylenol for pain relief. Tylenol is not to be taken in conjunction with Norco, Vicodin or Percocet because these medications contain the same ingredient (acetaminophen). The maximum daily dosage for Tylenol should not exceed 4000mg (or 4grams) per day as this can cause permanent liver damage.

How much weight can I bear on my leg after surgery?

Weight bearing status is dependent on both the type of surgery and anesthesia you will undergo.  If you decide to have a nerve block during surgery, you will be automatically placed in a knee immobilizer with non-weight bearing status until the nerve block is removed.  We will discuss your weight bearing limitations during your pre-operative visit and again after your surgery. The physical therapists will also help instruct you on the proper use of your crutches to ambulate.

How do I obtain braces/crutches and for how long am I supposed to wear my brace/knee immobilizer?

Details regarding the duration you are to wear your brace will be discussed during your pre-operative visit as well as along your recovery process during post-operative clinical visits. Any required post-operative braces or crutches will be fitted and provided the day of your surgery. If you have any issues with your brace/crutches, we have an in-house team that will help you with any adjustments you may need upon your next clinical visit with us.

How soon do I start physical therapy?

Physical therapy is started the day after surgery! In general, our practice recommends twice daily sessions up to the first 10-14 days (including weekends) or as long as you are able to stay in Vail and depending upon the type of surgery you undergo. After this time, your physical therapist will schedule you with 3-5 sessions per week with specific exercises for you to perform daily at home. Your physical therapy protocol will detail what specific activities you can perform at different time frames during your rehab. Follow these instructions carefully and DO NOT ADVANCE or let your Physical Therapist advance your protocol beyond the normal time frames unless directed so by Dr. LaPrade.

Do I need a prescription for physical therapy at HHSM?

We send orders for all physical therapy sessions that occur at Howard Head Sports Medicine immediately after the surgery.  A prescription will be provided during your pre-operative visit in your packet for a Physical Therapist when you return home. This script prescribes 3-5 sessions weekly for up to a total of 3 months and will be renewed upon your next post-operative visit with our clinic.

When is my first post-operative visit with the team?

Dr. LaPrade’s team performs rounds on all patients the day after surgery. The team will meet you at Howard Head Sports Medicine at 7:30 am to monitor your progress, perform dressing changes, discuss activities of daily living and obtain post-operative x-rays. There will be an opportunity to have any further questions answered, although we will be available throughout your recovery process to address your concerns.

What is the expected timeline for post-op office visits with Dr. LaPrade?

Dr. LaPrade would ideally like to see each of his patients for post-operative office visits with the following timeline below:

  • 1-2 weeks (At 2 weeks suture removal is performed. If you are not able to make this visit, we recommend you follow up with your primary care provider for post-op wound care.)
  • 6-8 weeks (Depending on procedure type.)
  • 5 months
  • 6 months
  • 12 months
  • Annually (for osteotomies, meniscal transplants, fresh allografts, and ligament reconstructions)

You can schedule a clinic visit with Dr. LaPrade from 9:00am -3:30 pm on Mondays or Wednesdays. Please contact Amanda Peña below to schedule.

How do I obtain a handicap parking pass?

Patients are eligible for temporary handicap parking passes based on the type of surgery they undergo. If you are in need of a handicap parking pass and are eligible, we will provide you with an application that will need to be completed and sent by you to your state DMV.

How do I get FMLA/Disability paperwork completed?

If you need FMLA (Family & Medical Leave Act) or Disability paperwork completed, the two forms (with links on the Pre-Operative webpage) should be completed and brought in with any required forms to your pre-operative visit. FMLA/Disability paperwork is completed after your surgery with a fee of $25 and will be directly faxed to your place of work.

What is your phone policy?

You will be provided with direct contacts for the providers on Dr. LaPrade’s team to answer any concerns or questions.  Our office hours are Monday – Friday 9 am to 4 pm.  If you require assistance after hours, holidays or weekends, please call (970) 476 – 1100 to reach our on-call fellow physician.