Microsoft word - hip_scope_postop_instructions.doc
Dominic S. Carreira, M.D. 300 SE 17th St First Floor, Fort Lauderdale, FL 33316 (954) 764-2192 Medications:
Today: Pain medication prescribed is: _________________________________________________________ Take this every 4-6 hours as needed for pain. You may find that if you alter one tablet every 2-3 hours this may be beneficial. Post-op day one:
Start this in the morning, take with food. You will take this medication two times daily
Over the counter. Take one pill daily while taking naproxen.
Robaxin 750mg 1 pill every six hours as needed for spasms.
Over the counter stool softener. Take on a daily basis until regular bowel movements.
Supplement that Dr. Carreira recommends:
Glucosamine Chondroitin (minimum double strength). We recommend that you begin
this supplement the day following your surgical procedure.
You will be given a start up kit and video to watch. You will be prescribed this
injection for a seven day period of time.
After Surgery Patient Care and Information:
Risk: There are several risks to any surgery that must be taken into account. Infection is decreased with a sterile operating environment and antibiotics, as well as careful handling of the incision sites following surgery. DVT (deep vein thrombosis, blood clot) is decreased by instituting early motion (CPM), mechanical means (foot pumps and Ted Hose) and medication. With any surgical procedure there is a potential complication of pain. Medication, ice, rest, compression, elevation and therapy reduce post-operative pain. Following the pre-operative and post-operative instructions will reduce the risk of infection and deep vein clots. With hip arthroscopy, there is a small chance of numbness in the genitalia region for a brief time postoperatively. Also, you may have some numbness of the upper outer portion of the thigh on the operative leg after surgery. The lateral femoral cutaneous nerve is close to the surgical area, and it may be stretched or bruised during the procedure. The numbness will resolve over time. HIP ARTHROSCOPY POSTOPERATIVE INSTRUCTIONS Dominic S. Carreira, M.D. (954) 764-2192
Touch Down weight-bearing for: ____________ weeks
After surgery, you will be touch down weight bearing with the aid of crutches from two days to possibly up to twelve weeks with a goal of returning to full activity as soon as possible. The length of flat foot weight bearing status will be determined by what procedure/s have been done. Sleeping Sleeping in a prone position (on your belly) is recommended one to two hours per 24 hours to stretch out the hip flexors. Post-op Week Seven At this time you may take Naproxen with omeprazole if you need a medication for inflammation as needed. Driving and Flight Information: While Sitting Move your legs, pump your feet up and down. Do not cross your legs. While in the air you do not need to have the brace on. You can get up and use your crutches and move about to increase your circulation. Do this every hour. Legally, you are not allowed to operate heavy machinery (this includes cars!) while on narcotics. Our rehabilitation protocol requires strict compliance for optimal results. We will be in close contact with your physical therapist during your rehabilitation process to answer questions and to monitor your progress. In physical therapy, you will be taught a home exercise program during you first week. These exercises should be done as directed. If you have any questions when performing these exercises at home contact your physical therapist or our office. When returning to full activity, preference is placed upon biking and swimming for cardiovascular exercise. Use of a tread mill is strongly prohibited from this point on. This activity places increased load on the anterior (front) of the hip increasing the force placed on the labrum. First Week Post-Operative Instructions: Many questions arise during the first week after surgery. There are many new sensations felt in the body, especially in the operative hip and leg. The following will help answer many of your questions to help relieve normal anxiety. Pain Control: A prescription for pain medication will be given to you upon discharge from the hospital. Pain medication should be taken as prescribed until you pain is under control. It will help to take your pain medication thirty minutes before therapy if you are experiencing a lot of pain. Addiction to narcotics should not occur during the initial phase post-operatively unless there has been an abuse prior to surgery. Please a return follow-up appointment for approximately 3 weeks after your surgery. HIP ARTHROSCOPY POSTOPERATIVE INSTRUCTIONS Dominic S. Carreira, M.D. (954) 764-2192
Applying ice and elevating the leg as much as possible will help with the pain. Try to relax and allow other people to help you out as much as possible the first week. Dressing Changes: The original dressing should be removed 24 hours after surgery. Apply a band aid or a sterile gauze dressing over the incision site. The stitches should be removed approximately 3 weeks after surgery. Op sites must be used for showering until the portal sites have completely closed and the wound is dry. Use one per incision. If the incision is wet, pat it dry and apply a clean, dry dressing or Band-Aid. CPM (Continuous Passive Motion): _________________ Weeks
You will be given a CPM within 36 hours after surgery. You will use this machine while you are in bed; if you're not in the CPM you will need to be in the rotational prevention "Boots." Make it a goal to be in the CPM while you sleep at night, so that you will not need to get into the machine during the day. In a 24 hour period, the CPM should be used ideally for four to six hours if no microfracture has been performed, and for 6- 8 hours if a microfracture has been performed. If you cannot sleep in the CPM you will need to be in the rotational prevention brace (boots and round pad with Velcro straps, strapped securely). Use the Boots for _______________ days.
Following breakfast and morning P.T. exercises, it may be best to collect your things, including the cooler and foot pumps. Lie back and get comfortable with a book, newspaper, or laptop and start the CPM. Use the machine for three hours, have lunch and repeat the process. You will need assistance to get into the CPM.
Do not exceed a total of 90 degrees of hip flexion while in the CPM. If the head of your bed is elevated you will need to decrease the flexion of the CPM. For example, if the head of your bed is at 45 degrees, then your CPM maximum flexion needs to be set at 45 degrees for a total of 90 degrees. Change this accordingly throughout the day. To prevent lower back pain, maintain proper back alignment while in the CPM.
Ted Hose & Foot Pumps: Use These For 4 Weeks Ted Hose help increase the blood flow in your legs by compression. Wear these at all times. You will be given a second pair to alternate for washing. Foot pumps increase blood flow in your legs and should be used any time that you are at rest. Use these pumps while you are in the CPM and place them prior to getting into the CPM. Walking: You will need to wear the hip brace for _______________ days.
Put this on as you are getting up from resting and place it securely around your waist and thigh. It serves as a reminder not to flex your hipmore than 90 degrees. You may begin moving about once the brace is in place.
HIP ARTHROSCOPY POSTOPERATIVE INSTRUCTIONS Dominic S. Carreira, M.D. (954) 764-2192
Suture Removal: Keep your sutures clean and dry. The dressing should be changed within 24 hours after surgery. You may shower starting on post-operative day #2 with an Op-site dressing covering the wounds and use one per incision. Continue to use the Op-sites until the wounds are fully closed. If the incision is wet, pat it dry with a sterile dressing and apply a clean dressing or Band-Aid. The sutures should be removed 21 days after surgery. Please make this appointment as soon as possible. Physical Therapy: Therapy will begin your first day after surgery. It is imperative that you follow this program on a daily basis. During this time you will be taught a home exercise program. Returning To Work or School: You may return to work one or two days after surgery, as long as the pain is tolerable. However, you must take the time to honor your commitments to therapy and to your office visits, and you must follow all postoperative instructions carefully while at work. Returning to heavy labor will be determined by your progression through physical therapy and by the extent of damage in your hip. Call our office at (954) 764-2192 or present to your private doctor's office or an emergency room IMMEDIATELY if any of the following occur:
A. Fever, chills, or sweats (temperature greater than 101.5°)
B. Increased redness, swelling, or warmth around the incision(s), non-clear drainage from the
incision, or increased pain in or around the incision
C. Calf swelling, redness, pain or warmth
D. Chest pain, difficulty breathing, or persistent cough
Follow up Appointments: Desired appointment intervals for Dr. Carreira's patients are 3 weeks, 6 weeks, 12 weeks and 6 months.
ALWAYS FEEL FREE TO CONTACT US WITH YOUR CONCERNS AND QUESTIONS. (954) 764-2192
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