(702) 383 2663 (BONE)

Total Knee Instructions

1. Surgical Incision

You have a surgical wound that has been closed with sutures covered with skin tape (Steri-strips). The sutures will dissolve and do not need to be removed. You may shower may shower 48 hours after the surgery with the wound uncovered as long as there is no drainage. Pat the incision dry after showering. The patient should avoid submerging the surgical incision in standing bodies of water for a period of at least 6 weeks. This entails no baths, hot tubs, or swimming pools. The steri-strips should be left on for two weeks.

After dismissal, the incision should be monitored at least twice daily for signs/symptoms of possible wound infection. These include, but are not limited to; increased redness, warmth, pain, tenderness, swelling, or drainage from the incision. This also includes, but is not limited to, nausea and vomiting, shakes or chills, or fever greater than 101.5 degrees F. If any of these occur, the patient should notify Dr. Hansen’s office.

It is normal for patients who have had knee surgery to have swelling, redness, and bruising on the inside of their thigh after surgery. An ACE bandage should be kept around the knee for the first 2-4 weeks after surgery to minimize swelling and discomfort.

2. Deep Venous Thrombosis (DVT) Prophylaxis

After an orthopedic procedure the patient is at risk for a blood clot in the leg veins. This is called a Deep Venous Thrombosis, or DVT. Some of the symptoms of a possible DVT include, but are not limited to increased extremity pain, tenderness, swelling, and redness. A potential complication of a DVT is a Pulmonary Embolism (PE). Signs of a possible PE include, but are not limited to increased chest pain, shortness of breath, and rapid heart rate. If the patient experiences any of these possible signs of a DVT or PE, he/she should notify his/her local primary care provider, emergency room, or Dr. Hansen’s office at (573) 882-2663.

The patient will require a total of six weeks of DVT prophylaxis. This will include the use of TED stockings and foot pumping exercises during this entire time. The TED stockings are to be worn day and night for the first 3 weeks (the patient may remove them for three 30 min intervals during the day. For the second 3 weeks the TEDS should be worn during the day but may be removed at night. The patient may also remove the TED stockings for hygiene care.

The patient will also be on a blood thinning medicine for four weeks after surgery. This medication will be Coumadin, Aspirin, or Xarelto. If you are on Coumadin, a blood test (called INR) will be necessary to determine the safe dose. This test will be done twice a week once the patient has left the hospital. During this 4 week period the patient is at increased risk for gastrointestinal bleeds, and prolonged bleeding after trauma. If you have a history of stomach ulcers or bleeding please inform Dr. Hansen so you can discuss alternatives.

3. Joint Prophylaxis

You now have a prosthetic joint in place. Invasive procedures (ie. dental cleanings/procedures, colonoscopies, etc.) should be avoided during the first four months after surgery to help avoid infection in the artificial joint. If in the future the patient will be having invasive procedures or dental procedures, they will likely need antibiotic prophylaxis.

  • Dental or Oral procedures
  • Amoxicillin 2 grams taken orally one hour prior to procedure
  • Genitourinary and Gastrointestinal procedures
  • Amoxicillin 2 grams taken orally one hour prior to procedure

If you cannot take Amoxicillin because you have an allergy to Amoxicillin or Penicillin, please inform your physician or dentist. Alternative antibiotic choices include:

  1. Dental or Oral procedures
  2. Clindamycin 600 mg taken one hour prior to procedure
  3. Cephalexin 2 grams taken orally one hour prior to procedure
  4. Genitourinary and Gastrointestinal procedures
  5. Ciprofloxacin 750 mg taken orally one hour prior to procedure

Any questions regarding this should be directed to Dr. Hansen’s office.

4. Activity

The patient is able to weight bear as tolerated with the assistance of a gait aid such as a walker or crutches. The patient should use his/her gait aid for steadiness. When ambulating with a cane, place the cane in the hand on the side opposite the surgical limb. The patient is safe for travel by land or air upon dismissal. During long trips home, it would be best to have the patient take short walks every two hours if possible. The patient should not operate a vehicle until (s)he is no longer using narcotics during the daytime. The patient must also be able to comfortably ambulate with a cane prior to operating a vehicle.

5. Narcotic Pain Medication

The patient may require narcotic pain medication (percocet, oxycodone, vicodin, etc) for several days after dismissal from the hospital. These medications may cause symptoms such as drowsiness, confusion, nausea, and constipation. The patient is encouraged to not use these medications any longer than necessary, as they may be addictive if used over an extended time period.

The patient should take a stool softener while on narcotic pain medication to help prevent constipation. One option is: Senna-S 2 tablets by mouth twice daily as needed for constipation

In addition, the patient is advised not to operate any motorized vehicles while taking narcotic pain medications.

6. Follow-up Appointment

The patient will see Dr. Hansen at two weeks and six weeks after surgery for regular postoperative appointments. The patient should also be seen 6 months and one year after surgery, then every five years after that to monitor the prosthetic joint. Additional appointments may be made as needed.

For any questions or concerns please contact Dr. Hansen’s office at (573) 882-2663

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