Post-Op Total Joint Protocol

Dressing: Pico dressing must be changed at day 7 and then replaced with a second pico dressing, the suction device should continue to work for 14 days. If drainage occurs, then can replace early, or if no pico can replace with aquacel/mepilex type dressing. Cover dressing for showers, avoid getting wet.

Pain Medication: Most patients are sent home with the following: Take either tramadol or Oxycodone at a given time depending on how severe the pain is

• Tylenol 500mg (take 2 at a time, 3 times a day, scheduled)

• Celebrex 100mg (take 1 at a time, 2 times a day, scheduled)

• Tramadol 50mg (take 1 q6 hours for moderate pain)

• Oxycodone 5mg (take 1 q6 hours for severe pain).

DVT Prophylaxis:

• Compression hose should be worn all the time as much as possible for at least the first 2 weeks post op.

• Aspirin 81mg (take 1, 2 times a day) for 6 weeks

• For patients at higher risk they may be on eliquis 2.5mg, two times a day for 4 weeks as an alternative to Aspirin

Other Medication:

• Pantoprazole to be taken while on NSAIDs (usually for 1 month for stomach ulcer prophylaxis)

• Senna to help with constipation as needed

Physical Therapy:

• Home Therapy for the first 2 weeks to include home eval, guidance with bathing without getting the dressing wet/covering dressing, walking with walker, range of motion, strengthening exercises etc.

• Total Knees:

  • Knee Immobilizer: Wear only when standing/walking until the patient can do 15 consecutive strong straight leg raises. As soon as straight leg raise intact, please discontinue knee immobilizer

• Range of Motion: Begin gentle active/passive ROM therapy immediately, even if the patient is still unable to do straight leg raises.

• Total Hips:

• Precautions: Anterior: no excessive hyperextension and external rotation, Posterior: no flexion beyond 90 degrees and avoid internal rotation

Follow-Up: Patient will follow-up with Dr. Pardi 2 weeks post-operatively in the office for new x-rays, possible suture removal and will begin outpatient physical therapy

Post-Op Things To Know:

• Dental Procedures

  • No Dental intervention such as cleanings or routine dental exams for 6 months after joint replacement

  • Urgent dental issues such as cracked teeth or dental infection can and should be treated urgently

  • All dental procedures including even cleanings should have prophylactic antibiotics before hand. Please call our office and we will prescribe you antibiotics for your dental procedure, and make sure your dentist is aware you have a joint replacement.

  • Dental antibiotic prophylaxis should continue for 2 years post surgery for routine patients and potentially longer for people at higher risk