Insall Scott Kelly Institute for
Orthopaedics & Sports Medicine
Michael A. Kelly, MD
Yair D. Kissin, MD
210 East 64th Street
New York, NY 10021
Phone- (212) 434-4306
360 Essex Street, Suite 303
Hackensack, NJ 07610
Phone- (201) 336-8867
Fax- (201) 336 8873
Post-Operative Instructions for Total Knee Replacements
Post-op:
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Call the office to make an appointment for the staples to be removed approximately 2 weeks after surgery. If you
are in a rehabilitation center, they may remove the staples (although we prefer to do it), but not before two weeks, and
you should follow up with your surgeon at 4-6 weeks after surgery. If you do not have staples, I need to inspect the wound
by the 4th week following surgery or if you have leakage or redness of the incision at any point following surgery. You can
email me a picture of the wound at any time at ykissin@humed.com if you are concerned.
Medication:
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Lovenox is a blood thinner to help prevent blood clots after surgery. Lovenox is one injection every 12 hours for 14
days starting the morning after surgery. Please note that it will be given twice a day. The nurse will show you how to
inject the Lovenox before you are discharged from the hospital. You may get an oral form of lovenox, called Xarelto,
which is a pill taken once daily for the 14 days following surgery. These medications do not require any follow-up blood
work. Start Aspirin 325 mg twice a day for 6 weeks after completion of the Lovenox or Xarelto regimen.
Some patients may be on coumadin (warfarin) instead of Lovenox. This medication requires follow-up blood work
to be done at least once a week for at least 6 weeks. Based on the blood work results, the doctor may change the dose of
coumadin you are taking. If no one comes to take your blood within the first four days after you are discharged from the
hospital or rehab please contact the nurse from the homecare agency you have been assigned to (the number is on the
discharge paper work). If you get no response, or if you do not hear back from the doctor the day after your blood was
drawn, please call the office.
Some patients may be sent home on Aspirin alone. The usual dose is 325mg by mouth twice a day, unless told
otherwise, and is continued for 6 weeks following the day of surgery.
If you go straight home from the hospital, a home care agency will arrange for a physical therapist to come to your
home at least 3 times a week. If the therapist does not call or show-up within the first 2 days after you have been
discharges, please call the number on your discharge paperwork. If there is no resolve, please call the office. If you go
from the hospital to a rehabilitation center, the center will arrange for home therapy if your insurance approves, otherwise
you will go straight to outpatient therapy after being discharged from the rehabilitation center.
Vicodin, percocet (or other pain killer) as directed. You may add an anti-inflammatory medicine like advil, motrin,
aleve if you need an extra boost of pain medicine or if the other medicines are too strong. Always take these with meals.
Celebrex is an anti-inflammatory (not to be combined with other antiinflammatories like advil, motrin, aleve) that
you may receive a prescription for the 30 days following surgery. This should be taken daily with meals.
STOP THESE MEDICATIONS IF YOU DEVELOP SIGNIFICANT ABDOMINAL PAIN and call the office.
Showering:
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You may shower when your wound is dry, usually at about post-op day #5.
No immersing the knee, like Baths, jaccuzzi, pools, beaches! Do not scrub the incision.
Let water/soap run over it and then pat it dry. Do not apply any lotions or oils until the staples have been removed.
Surgical Stockings:
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The surgical stockings stay on for 6 weeks (day and night). You may remove them to shower and when the
stockings need to be washed.
Range of Motion:
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Place a rolled towel under your ankle to help with extension (straightening of the leg). Never place anything under
your knee. Extension is just as important as flexion (bending). Begin therapy immediately and exercise at home on your
own when you are not in a therapy session to gain as much range of motion as possible. Gaining full range of motion
within the first few weeks after surgery is vital, especially extension.
2.
Ice:
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Ice your knee as needed for 20 minute intervals on/off as needed as long as your knee is swollen or painful.
3.
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Swelling:
Your knee is going to be warm and swollen for a long time (9 months to 1 year). Call the office immediately if the
incision site becomes markedly red, has pus draining, red streaks, you have persistent fevers, or if you are experiencing
severe or debilitating pain.
4.
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Prophylaxis:
You will need prophylactic antibiotics for any future surgical procedures to protect you knee against infection. You
will also need these antibiotics for dental cleaning and other invasive dental procedure, colonoscopies, and many
gynecological procedures. If the doctor who is performing these procedures will not or does not provide you with
antibiotics please call the office and we will give you a prescription.
MRI’s/CT’s:
5.
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It is OK to have an MRI or CT after a knee replacement, once the staples have been removed. Please be sure to
inform the radiologist or radiology technician you have had a knee replacement.
Misc. Questions and Concerns
10.
There will be an area of numbness to the front/side of the knee as expected with this type of surgery. A “clicking”
sound may or may not be audible, as this is an artificial joint. Do not expose the surgical site to excessive sunlight for the first
year.
If there are any questions or problems, please call the office and we will be happy to discuss them with
you.
Patient’s Name:________________________
Patient’s Signature:____________________
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The Insall Scott Kelly Institute for
Orthopaedic Surgery & Sports Medicine
Joint Replacement
Medical Alert
Name _
__ _
Surgery:_ Total Knee Replacement
implantation of a metal prosthesis within the
body may cause a metal detector to alarm.
Dental, Oral or upper Respiratory Tract procedures
Amoxacillin 2gms P.O. 1 hr before procedure
If allergic to Penicillin/Amoxacillin
Give one of the following orally instead:
Azithromycin 500mg
Clarithromycin 500mg
It is important that all physicians and dentists caring for you
know that you have a joint prosthesis and therefore are at risk
for infection.
Antibiotics should be used for:
1. All dental procedures, including professional cleaning.
2. All procedures involving the gastrointestinal or genitourinary tract.
3. Upper respiratory tract conditions or procedures.
4. Any serious infection.
If you, your physician or your dentist have any questions,
please contact your orthopaedic surgeon. (201) 336-8867