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1. Weight Bearing
Dr. Matthews will instruct you after surgery as to how much weight you may put on your
leg.

2. Ice and Elevation
Ice is your friend for the first several days after surgery. Icing the operative site will help to
decrease swelling and relieve pain and discomfort. A bag of ice or frozen vegetables
wrapped in a towel works well. You can apply ice for 20-30 minutes at a time if tolerable,
and try do so four times per day.

3. Pain Medications
You will be prescribed multiple medications to help with pain management after surgery. Below
is a list of a typical post-operative pain protocol.
• Tylenol (acetaminophen): Unless otherwise directed, take 1000mg every 8 hours. This is
a mild pain reliever that works in two ways. First, it relieves pain on its own. Second, it
makes other pain medications work better because it is synergistic. This is the pain
medication you should cut back on last.
• Ultram (Tramadol): Take 1-2 pills every 8 hours (3 times daily). This is a moderatestrength
narcotic pain medication that is also synergistic with other pain medications.
This is the pain medication you should cut back on second.
• Oxycodone (Roxicodone): Take 1-2 pills every 4-6 hours as needed. This is a strong
narcotic pain medicine, and these pills are meant for pain relief after major surgery. You
should avoid driving while you take narcotics. This is the pain medication you should cut
back on first.

4. Blood Thinners
You will be placed on a blood thinner after surgery to decrease the risk of blood clots associated
with surgery. If you do not have a history of blood clots or bleeding disorders then you will be
prescribed 81mg of Aspirin to be taken twice daily for 35 days after surgery. Some patients who
have medical problems that prevent them from being able to take aspirin, or those who have a
history of blood clots may be prescribed a different blood thinner, such as Xarelto or Lovenox.

5. Nausea
Pain medication can cause nausea. A prescription for nausea medication, either Phenergan or
Zofran, will be provided to be taken as needed.

6. Swelling and Bruising
Swelling and bruising are normal after surgery. Your thigh, knee, calf, ankle, and foot will swell
after surgery and it may take several months for swelling to completely resolve. Most swelling
will resolve somewhat with rest, ice, and elevation. If you experience swelling that does not go
down despite rest, ice, and elevation over a period of 36-48 hours, please call Dr. Matthews’s
office to have the swelling evaluated. Bruising varies in severity from patient to patient and is
typically noted on the thigh and then later in the calf and/or ankle. While not all patients develop
bruising after joint replacement surgery, it can be severe in some patients and that is normal.

7. Constipation
Narcotic pain medication taken after surgery causes constipation. To help alleviate constipation,
adhere to the following protocol until your bowel habits normalize:
• Stay well hydrated. Drink lots of water and electrolytes. Gatorade or other types of
hydrating drinks can be very helpful.
• Stool softeners such as Colace or Senokot will be prescribed and these can greatly help
with constipation. They are also available over the counter.
• Milk of Magnesia may be taken once or twice a day and is available over the counter.

8. Surgical Dressing
If you have an ace wrap on and it feels too tight you should try elevating your leg and
applying ice. If it still feels too tight then you can loosen it. If you are in a cast or splint do
not remove it unless instructed to do so by Dr. Matthews.

9. Showering
Showering in a cast or splint (even with a bag over it) should be avoided for the first two
weeks after surgery. Sponge baths are recommended for the first two weeks. When you do
shower it is important to not allow your cast or splint to get wet. If it does get wet, call Dr.
Matthews’s office.

10. Driving
To drive after surgery, you need to be able to control your vehicle and react to normal driving
conditions, and you should no longer be taking narcotic pain medication, as these can cause
drowsiness. Some patients are ready to drive within a few weeks after surgery while others need
longer. You should not drive if you have a cast or splint on your right leg/foot. Wait to drive
until cleared to do so.

11. Fevers
Low-grade fevers (less than 101 degrees Fahrenheit) are common after surgery and generally last
only a short period of time. These fevers are most often caused by mucus in your lungs. Deep
breaths, coughing, and walking around can be helpful for resolving these low-grade fevers. If
you have a fever greater than 101 or a fever that persists despite these measures, you should call
Dr. Matthews’s office.

12. Call Dr. Matthews’s office (757-827-2480) if you notice the following:
• Pain that is increasing every hour despite the pain medication.
• Drainage from the wound that begins more than 5 days after surgery.
• Increasing redness around the surgical site that is not resolving.
• Fever greater than 101.5 degrees that lasts longer than one day.
• Inability to keep food or water down for longer than one day.
• If you experience any emergent problems such as chest tightness, difficulty breathing or
inability to swallow, etc, call 911 immediately.