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Diet:

• You may resume clear liquids and light foods after surgery (jello, soup, etc.)
• Progress to your normal diet as tolerated as long as you are not nauseated.

Medications:

• The first medication I typically prescribe is the extra strength form of Vicodin (Hydrocodone/Tylenol) or Oxycodone. This is a strong narcotic pain medication. It will begin to work within 15 minutes after taking it with a maximal effect in one to two hours. Normally, Vicodin is taken every 6 hours. If the pain is severe, it can be used every 4 hours. You will probably need 2 pills at a time to start unless you are smaller in size or elderly.
• If you are allergic to codeine or Vicodin, I may prescribe Dilaudid (hydromorphone). This is also a strong narcotic that does not contain Tylenol. It is usually taken the same way as noted above for the Vicodin. It may also cause nausea and other side effects because it is a morphine based medication.
• Patients with significant reactions to all narcotics, may benefit from a newer drug called Nucynta (tapentadol) that does not typically have the same side effects. However, it may not be part of many insurance formularies.
• Common side effects of these medications are nausea, constipation, itching, and drowsiness.
• The best way to prevent nausea is to take the medicine with a little food. I may prescribe an anti-nausea medication called Phenergan (promethazine) to be taken if you have persistent nausea after surgery. If you have a history of prolonged nausea you are likely going to be prescribed an anti-nausea medication.
• If you experience itching, take over the counter Benadryl one half hour before your narcotic.
• You may take an anti-inflammatory medication such as Aleve or Advil. Two Aleve twice a day will help with the pain.
• Transition from Vicodin to Tylenol or Motrin as your pain subsides. Pay attention to the dosage as Vicodin has 325 mg of Tylenol in each pill. Patients with normal liver function should not consume more than 3000 mg of Tylenol per day.
• Do not drive or operate heavy machinery while taking narcotics.
• You should take 325 mg Enteric coated Aspirin twice a day for three weeks to help prevent blood clot formation.

Bandages:

• Your post-operative dressing is a large, white fluffy dressing and absorbent pads that are held in place with an Ace bandage.
• Unless directed otherwise, remove this dressing 2 days after surgery and place band-aids and a small gauze pad over the incisions.
• Because the surgery is performed arthroscopically, occasionally there will be water with a small amount of blood on this dressing. This is nothing to worry about. However, if you see a lot of bleeding, please call Dr. Payne.

Washing & Bathing:

• You should be careful to keep the wound clean and dry for the first 7 days after surgery.
• Beginning on the third day after surgery, it is OK to shower as long as the incisions are kept dry with plastic wrap. Remove the wrap after showering.
• Do not go into a swimming pool until 3 weeks after the surgery and do not go in lakes or the ocean until six weeks after surgery.

Ice & Activity:

• One important goal following surgery is to minimize swelling around your surgery site. The best way to achieve this is with the frequent application of ice. This is most important the first 48 hours following surgery. The ice pack should be large (like a big zip-lock bag or bag of peas) and held firmly on the area of your surgery. Apply for 20 minutes three to four times per day if possible.
• Unless there was a meniscal tear repair, you may put weight on the operated leg as tolerated. There are no restrictions on your activity. In fact, I encourage you to try to move around after surgery. This helps avoid blood clots and knee stiffness.
• If the meniscus was also repaired, you will be on crutches for 4 weeks and can only touch the weight of the leg to the ground (not your full weight). You will be in the brace for about 4 weeks to protect the meniscal repair.
• Do not place pillows under the operated knee as this can lead to stiffness. Insted place any pillows under your heel to keep the knee straight.
• Place a towel roll under your ankle and tighten your thigh muscles to get your knee to  straighten out. This is very important and should be done at least four times a day for twenty minutes if tolerated.
• Move your ankle back and forth many times during the day to help your circulation.
• You may return to sedentary work only or school in 3-4 days after surgery if your pain is tolerable.
• Avoid long distance traveling in cars or by airplane during the first week after surgery to avoid increasing your risk of developing blood clots.

Follow up appointment:

• We try to give all of our patients a follow-up office visit at the same time we schedule your surgery.
• Typically I want to see my patients in the office 10-12 days after surgery.

Physical Therapy:

• Frequently, physical therapy is not required after surgery. You may resume your activities as tolerated as the pain improves.

What to watch out for:

• Pain that is increasing every hour in spite of the pain medication
• Drainage from the wound more than 2 days after surgery
• Increasing redness around the surgical site
• Fever greater than 101.5degrees
• Unable to keep food or water down for more than one day