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Knee and Hip Replacement: The 3 week Post-Op Visit

Aug 30, 2019

Richard “Alex” Sweet II, MD

Kate S. Hamilton, PA-C

Richard A. Sweet, M.D.

Blood Thinners: Patients who are at low risk for developing blood clots are typically placed on aspirin 325mg once daily for 6 weeks post op. Patients with bleeding risks may be placed on baby aspirin (81mg) instead. Patients at higher risk for blood clots may be placed on more aggressive blood thinners such as Plavix, Coumadin, Xeralto, or Eliquis for varying lengths of time. A higher risk patient not on blood thinners prior to surgery will often be placed on one of these more aggressive drugs for 3 weeks or more and may have to take aspirin after this.

TED Stockings: Studies now show that use of compression stockings do not lower the risk of blood clots. Thus their routine use has been discontinued.

Wound Care: With a PICO wound VAC, showering is permissible immediately as long as the battery pack remains dry. The entire PICO dressing is removed on post op day 7. After this, showering can be continued as long as the wound remains clean and dry with no drainage. With a Zip-Line closure, showering is permissible 1 week post op if the wound is clean and dry. By 3 weeks post op, if there is no redness or drainage, a moisturizing cream or lotion can be applied to treat dry skin. Some patients apply vitamin E ointment in an attempt to improve scarring.

Ambulation: You may transition off of a walker and onto a cane and then off of all ambulatory aids as tolerated.

Range of Motion (ROM): Expected range of motion at 3 weeks post op from a Total Knee is from less than 5° short of full extension to 90° or more of flexion. Many factors are involved in meeting this goal. Patients with poor pre-op motion, patients with large girth knees, those with prior knee surgery, and those with significant preoperative deformity or bone loss might struggle to meet these early range of motion goals. Additionally, younger patients tend to form more early inflammation and scar tissue and tend to progress slower with range of motion. Regaining hip range of motion after Hip Replacement surgery is not as crucial early and naturally returns.

Driving: The time to return to driving is a decision that each patient must make. For liability reasons, we are not able to tell you when it is “safe” to return to driving. In general, most patients return to driving 2-4 weeks after left leg surgery and 4-6 weeks after right leg surgery. You must be off all narcotic pain medicine (that’s a DUI) and have good strength/mobility.

Pain Medication: The amount of pain medication needed varies from patient to patient. Some patients never finished their first postoperative prescription. Others seem to require pain medication much longer. Though it is our goal to keep our patients comfortable, it is well known that the sooner patients are off narcotic pain meds post op, the quicker they recover. In addition, due to the national opioid crisis, there is a great deal of governmental scrutiny and oversight of narcotic prescription usage. However, if you do need a refill at 3 weeks post op, we will be happy to provide it. We expect all patients to begin weaning off of prescription pain medicine by 6 weeks post op and to no longer need them by 12 weeks.

Return to Work: Our motto is that “we are not the work police.” You can return to work when you think you can handle the rigors of your job. In general, this is about 4-6 weeks for sedentary jobs, and 8-12 weeks for physical jobs. We will be happy to provide a return to work note when you need it.

Exercise/Recreational Activities: In addition to formal physical therapy, patients should initiate use of a knee friendly exercise program as soon as tolerated. This includes use of an exercise bike, progressive walking, leg lifts, and an elliptical trainer. The only restrictions regarding returning to recreational activity center around what a patient can tolerate due to soreness and swelling.

Follow Up Appointment: If everything is going as planned, we will see you back in 12 weeks for routine check and follow-up x-rays. If there are concerns over your range of motion, functional, or wound healing, we may see you back sooner for an interval check.

What our patients are saying
Shaun H.
I was able to get a office visit on short notice. It seemed to be a very busy day. Rebecca took the time to listen to all of my issues and discuss a plan for additional treatment. I have always been impressed with her knowledge and bed side manner.
Reviews from Google
Joanna S.
Dr Goodin has replaced both of my knees this year with excellent results. He and Carly listen to my concerns, act promptly and work hard to make this journey the best it can be. Carly and Dr Goodin both have GREAT bedside manner and I feel I am in expert care with them.
Reviews from Facebook
Carolyn K.
Dr. Yakkanti did my knee replacement in June. He is an excellent surgeon with a great bedside manner. I have recovered nicely and plan to have my other knee replaced within the next year. I would highly recommend Dr. Yakkanti to anyone thinking about knee replacement!
Reviews from Facebook
Juanita S.
The New Albany office of Louisville Orthopedic is full of terrific people who know what excellent customer service is about! From the front desk to the lab, they are great. Doctor Lewis is my surgeon and I love him. He’s good at what he does and he’s compassionate. I would recommend him to anyone.
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Erin Z.
This was my first time at Louisville Orthopaedic Clinic and I saw Melissa Parshall PA-C. I was very impressed with how fast I got in, had x-rays, and met with her. She was very thorough and extremely friendly. So glad A friend told me to come see you guys! Thank you!
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Louisville Orthopaedic Clinic

4130 Dutchman's Lane,
Suite 300,Louisville 40207
(502) 897-1794

Northgate Medical Center

3605 Northgate Court,
Suite 207,New Albany 47150
(812) 920-0408

Locations
*MAIN LOCATION
Louisville Orthopaedic Clinic
4130 Dutchman's Lane
Suite 300
Louisville, KY 40207
Northgate Medical Center
3605 Northgate Court
Suite 207
New Albany, IN 47150