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.
Many surgeries are done without general anesthesia. This allows you to resume a diet quicker with less nausea.
Managing the pain:
There’s no two ways about it, knee surgery is painful. I am going to describe the best ways I have found to try to manage that pain. The first 1-2 days are the hardest. Don’t worry, it will improve.
Before surgery you will be offered a nerve block which helps greatly with pain control and decreases your need to take narcotic medications. I would strongly encourage you to have the block as it does significantly help with pain after the procedure. Additionally, during surgery I will often inject a numbing medicine like novocaine that will give some pain relief for several hours after surgery.
It is important to begin taking your pain medication before this medicine wears off. This is usually about 6 to 8 hours after the procedure. However, it may be as little as 2 hours or (if you’re lucky) it could be 12 to 16 hours. It is important to stay on top of the pain as it is more difficult to catch up.
I do not use a “pain pump” which drips the numbing medicine continually into the joint for several days after the surgery. Several recent studies have shown an increased risk of damage to the joint cartilage and subsequent arthritis as a result of prolonged exposure to this medication.
I believe in using multiple different ways to reduce pain. Our goal is to reduce the amount of narcotics required to control the pain. Narcotic medications (morphine, Percocet (oxycodone), Vicodin (hydrocodone), codeine and Dilaudid) have significant side effects. They can easily become addictive. They can be overdosed, especially in patients already taking other sedating medication such as sleeping pills. Narcotics decrease the body’s trigger to breathe and I may prescribe a medication to reverse this narcotic side effect (Narcan) if you are currently taking anti-anxiety or sleeping medication. It is best to avoid these drugs (and alcohol) while on pain medication. Narcotics cause constipation. They alter your ability to concentrate, cause drowsiness and should not be taken while driving. They can cause hallucinations. They frequently cause constipation and a stool softener, such as Metamucil of Sennokot DS, should be taken daily while on them. They often cause nausea and a medication for nausea, such as Phenergan or Zofran, is often prescribed with them. If you have a history of prolonged nausea you are likely going to be prescribed an anti-nausea 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 covered by many insurance formularies.
If you experience itching, take over the counter Benadryl one half hour before your narcotic.
Surgery pain stems from multiple factors and you should address each of these to control the pain. Below is a chart to explain our multimodal pain control plan.
Preoperative pain management
Postoperative pain management
Ice (see below) is very helpful
Physical therapy – stiffness is a common source of pain and therapy is often started several days postop
Bandages & Sling:
place band-aids and a small gauze pad over the incisions.
Washing & Bathing:
Ice & Activity:
straighten out. This is very important and should be done at least four times a day for
twenty minutes if tolerated.
avoid increasing your risk of developing blood clots.
Follow up appointment:
procedure. They help you feel comfortable with your surgery and make sure you aren't
afraid to start doing things. Your therapist will start range of motion and strengthening exercises on your first visit.
What to watch out for: