AMERICAN ORTHOPEDICS & SPORTS MEDICINE, PLC
Steven B. Larson, M.D., F.A.A.O.S.
740 Conference Drive, Suite 2, Goodlettsville, TN 37072
Telephone: (615) 851-2673 · Fax: (615) 851-2675
► Date of Surgery:____________ Arrival Time at Hospital: __________
When you arrive at the hospital, check in at the Registration Desk.
Knee Arthroscopic Surgery Post-Operative Instructions
From Dr. Steven B. Larson, M.D.
The following information is designed to answer some of the frequently asked questions regarding
what to expect after knee arthroscopic surgery and post-operative care. These are general guidelines. If you
have any questions or concerns; please give Dr. Larson’s staff a call.
FIRST POST-OPERATIVE APPOINTMENT:
This will be scheduled anywhere from 2-14 days depending on your surgery. At this appointment,
Dr. Larson will go over what he did and found in surgery, your prognosis, and plans for rehabilitation.
►Your first post-operative appointment with Dr. Larson is on DATE: __________________
DRESSING AND WOUND CARE:
►
Remove your dressings in □ 3 or □ 4 days unless told otherwise by Dr. Larson. Dressings should be
changed at least daily after the first dressing change. It is normal when you do your first dressing change for
your knee to be very swollen, bruised, and dried blood on the skin. You may wipe the dried blood off with
Hydrogen Peroxide on a cotton ball or Hydrogen Peroxide on a cotton swab. Do not let the Hydrogen
Peroxide get inside the wound as it will keep the wound from closing up and it will keep the wound draining.
The longer your wounds drain, the more chance they have of getting infected. Keep your dressings dry.
You may shower the day after surgery by keeping your dressings covered with a waterproof covering. A
large plastic waterproof garbage bag may be used. Seal the open end of the plastic bag with medical tape or
electrical tape. Do not soak your knee wounds (e.g. take a bath) until after you have followed up with Dr.
Larson. Do not get your knee wounds wet in the shower until after sutures are removed and no wound
drainage for 24 hours and no stain on the dressings for 24 hours. Always keep wounds covered with a
dressing until after sutures have been removed by Dr. Larson’s staff. Do not touch the wounds with your
bare fingers. Do not get the wounds wet. Do not leave the dressings off for the wounds to air out. Use the 6
inch elastic wrap applied at time of surgery to keep your gauze dressings in place. The elastic wrap also helps
decrease swelling. Dr. Larson recommends using 4 inch by 4 inch sterile gauze dressings if there is a lot of
wound drainage. Use 2 inch x 2 inch sterile gauze dressings for mild drainage. Use large waterproof bandaids if drainage is none or minimal. Always keep the wounds covered.
AMBULATION:
Dr. Larson will give you specific instructions on weight bearing depending on the extent of your
surgery.
►
□ Weight bearing as tolerated
□ Non-weightbearing for six weeks
□ Touch foot lightly to floor weight bearing
□ No painful weight bearing
ICE AND ELEVATION:
During the first 48 hours, ice can be very helpful to decrease pain and swelling and is especially
important during the first 48 hours. Ice bags/packs should never be applied directly to the skin. Apply ice
every 20-25 minutes on, 5-10 minutes off at a time. Swelling is normal after surgery and is also related to
the amount of your activity. In the first 48 hours, elevate your knee above your heart as much as possible.
This will decrease swelling and the pain and discomfort associated with it. Your level of discomfort will
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AMERICAN ORTHOPEDICS & SPORTS MEDICINE, PLC
Steven B. Larson, M.D., F.A.A.O.S.
740 Conference Drive, Suite 2, Goodlettsville, TN 37072
Telephone: (615) 851-2673 · Fax: (615) 851-2675
most often be your best guide in determining how much activity is allowed. It is very easy to “overdo” it in
the first days after surgery, and you will notice a direct relationship between the amount of your activities
and swelling in your operative knee. Try as hard as possible to decrease swelling, at least until your wound
stops draining for 24 hours.
MEDICATIONS:
You will be given prescriptions for pain medications when you leave the hospital. You will need to
stop on the way home at your pharmacy to get the prescriptions filled. Check the prescription bottle for
directions on how to take the medicine. Meperidine or Oxycodone is given for moderate pain.
Hydrocodone is given for mild pain. Phenargan is given for nausea. Normally the amount of pain medicine
Dr. Larson prescribes for you should last you until your first post-operative visit. Check with the nurse if
you have any known drug allergies prior to taking the medication.
If you have any itching, nausea, or other adverse side effects, please call Dr. Larson’s office.
Pain medication can often cause drowsiness. Therefore, we advise you not to drive or operate
machinery. If you experience constipation as a side effect of your pain medication, you may use over the
counter Milk of Magnesia as directed on the bottle for relief. Two tablespoons of Milk of Magnesia at
bedtime (30 ml) usually helps with having a bowel movement the next morning.
We are unable to call in prescriptions after office hours and on the weekends. If you need a refill,
please call your Dr. Larson’s office early in the day so that your prescription can be filled reviewed by Dr.
Larson prior to close of business each day. Someone from Dr. Larson’s office will call you when the refill
prescription has been approved by Dr. Larson and called in to your pharmacy by Dr. Larson’s staff.
*It is not possible to be “pain free”, but we want you to be comfortable. If despite ice, rest, elevation,
and taking your pain medicine, you have severe, persistent pain, please notify Dr. Larson.
LUNGS and BREATHING AFTER SURGERY
It is common to develop some mucous in the lungs during general anesthesia. If this happens to you,
for the first three days after surgery take deep breaths and try to cough up the mucous. You may do this up
to every 10 minutes. If you develop a fever during the first three days after surgery, it is usually due to too
much mucous build-up in the lungs, also known as atelectasis.
It is normal to have a low-grade fever the first few days after surgery. If you have any signs of
infection in the knee, such as redness, fever, and chills and a fever greater than 100.5 degrees Fahrenheit,
please contact Dr. Larson at 615-851-2673. Wound infections, if they occur, do not usually appear until
about a week (7 days) after surgery.
PREVENTION OF WOUND INFECTIONS.
The number one cause of wound infections is patients touching the wounds with bare fingers. Do
not touch the wounds with bare fingers, do not pick at scabs or the incisions. Do not touch the sutures with
your bare fingers. The number two cause of wound infections is patients getting their wounds wet with
water. Please do not do this. The number three cause of wound infections is patients leaving the dressings
off for the wounds to “air out”. Please keep you wounds dressed at all times, except when changing the
dressings of course.
The longer your wounds drain, the more chance they have of getting infected. If drainage can get
out of your knee, germs can get in and cause infection. The more swelling you have in your knee, the longer
your wounds will drain. Dr. Larson’s first goal after surgery is to get the drainage to stop. Do this by trying
to get the swelling down. Try to get the swelling down by resting your knee, decrease your activity, ice bags
to the knee, wear the 6” ace wrap, and elevate the knee above your heart. After all of the wound drainage
stops for 24 hours, you may increase your activity level.
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AMERICAN ORTHOPEDICS & SPORTS MEDICINE, PLC
Steven B. Larson, M.D., F.A.A.O.S.
740 Conference Drive, Suite 2, Goodlettsville, TN 37072
Telephone: (615) 851-2673 · Fax: (615) 851-2675
KNEE IMMOBILIZER BRACE WEAR.
If Dr. Larson gave you, or told you to wear a knee immobilizer brace post op, wear it for four days.
During your surgery, Dr. Larson cauterized all of the bleeding blood vessels. If you bend your knee too far
within the first four days after surgery, you could knock a clot off a blood vessel and your knee could start
bleeding again. So wear the knee immobilizer for 4 days post-operatively. If your knee does start bleeding,
it will usually stop once your knee joint is filled up with blood. It may take a few weeks for your body to reabsorb the blood. This will slow down your progress in physical therapy and recovery. Re-bleeding does
not usually require a return to the operating room or needle aspiration.
You should practice doing straight leg raising exercises during the first 4 days after surgery. If on
the fourth post-op day, you can do a straight leg raise for 10 seconds, then you do not need to wear the knee
immobilizer brace any more. If you can not do a 10 second straight leg raise, then you leg is too weak to
support your weight. If you walk without the knee immobilizer brace on and your knee is too weak, your
knee could get a sharp pain causing the knee to go out, or buckle. If your knee is weak when it goes out, you
could fall down causing injury such as a dislocated kneecap or meniscal cartilage tear. Physical therapy will
usually be started after you have seen Dr. Larson for your first post-op visit.
BENDING THE KNEE AFTER SURGERY:
Try not to bend your knee the first four days after surgery. If you have to remove the brace to get in
the car on the way home from the hospital, that is fine. It you have to remove the immobilizer brace so you
can bend your knee to sit on the toilet, that is fine. Minimize bending the knee for the first four days after
surgery so that your knee does not start bleeding. After the first four days, you may bend your knee a little
bit as long as it does not increase your pain. Painfull bending of your knee will cause more swelling of the
knee and more wound drainage, increasing the risk of infection. After your knee wounds have stopped
draining (usually takes 3-5 days to stop draining) then you may bend the knee more as long as it does not
make your knee hurt more. Don’t worry about getting the stiffness out of your knee until Doctor Larson has
checked your wounds during your first post-operative visit. If your wounds are healing well when Dr.
Larson sees you for your first postoperative visit, he will send you to physical therapy where you will work
on getting the stiffness out of your knee.
DRIVING AFTER SURGERY.
Tennessee State Law does not allow you to drive if your knee surgery impairs your driving. It is up
to you to decide when you can safely operate a motor vehicle. Driving will not mess up your knee surgery,
but your knee surgery might mess up your driving. It is also illegal to drive in Tennessee if your pain
medicine impairs your driving. Meperidine, Oxydocone, Hydrocodone, and Phenargan can all impair your
driving. You can not safely drive if you have a knee immobilizer on your right knee. You can not drive
safely if your car has a clutch and you have a knee immobilizer on either knee. If you are unsure whether
you can drive safely or not, do not drive.
COMMUNICATION:
If you have any problems related to your surgery, contact Dr. Larson or his staff right away. There is
always a doctor on call after hours and on weekends. You can page Dr. Larson at 615-761-0188 if you have
an emergency that can’t wait until the next business day.
FURTHER QUESTIONS
If you have any further questions, please call Dr. Larson’s office during business hours. We will try
to get back to you within 24-48 hours. How soon we get back to you also depends on Dr. Larson’s busy
surgery schedule. Note that Dr. Larson is only in the Goodlettsville office on Mondays, Tuesdays, and
Thursdays, to respond to your questions. Dr. Larson’s medical office phone number is 615-851-2673
Thank you. Dr. Steven Larson
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