PREPARING FOR YOUR OPERATION

Scheduling surgery
Arthoscopic surgery will be performed either on an outpation basis or in a hospital, depending on the procedure and the surgeon. All arrangements for your upcoming surgery will be made by our surgery scheduler. This will include hospital reservations, operating room time, anesthesia and assistant surgeon, if needed. You will be contacted by phone when these arrangements have been completed.

Preoperative instructions
You will need to have a friend or relative drive you to the surgery location. During your operation, there is a special room where your family can wait. The waiting room staff will keep them informed on your progress. If your family is unable to stay, you will be able to call them after your procedure. Your family can then meet you in the recovery area when you are ready for discharge.

If you will be staying overnight you should pack a bag including a toothbrush, pajamas and any personal items. Also, bring crutches or a walker with you if you are having knee surgery. We suggest renting crutches if you do not have a pair. Also bring loose fitting clothing to accommodate bulky dressings.

Approximately one hour prior to surgery you will be taken to the preoperative holding area. You will be asked to put on a surgical gown and have your temperature taken and the operative area shaved and cleansed. An I.V. will be started so that medication can be administered as needed. Most surgical procedures last from 1 to 3 hours.

The following guidelines should be followed to successfully prepare for you surger:

• Discontinue taking Advil, lbuprofen, Celebrex, Bextra, Aspirin, or any other anti-inflammatories at least 2 weeks before surgery.
• Do not bring jewelry, credit cards, large amounts of money, or other valuables with you the day of your operation. You will need to have some money with you for prescriptions. The person accompanying you can hold it. Select comfortable clothing to were to the hospital.
• If you were glasses, contacts, dentures or a hearing aid, bring along a case to put them in during surgery.
• Remove all eye makeup and nail polish before coming to the hospital.
• If you smoke, stop or at least reduce your smoking.
• Eat a light supper the day before your operation and do not drink any alcohol for 24 hours before surgery.
• Notify your surgeon of any changes in your physical condition (cold, fever, etc.)
• If the patient is a child, you may bring a favorite doll, toy or book.
• After midnight, you should not drink, eat or take anything by mouth. This includes gum, candy, water, coffee, or food of any kind. And remenber not to swallow water when you brush your teeth before coming to the hospital.

Post operative instruction
You will be taken to the recovery room immediately following surgery. If you are an outpatient, you will be discharged within 1 to 2 hours and can be driven home by a friend or relative. You will need to have an adult stay with you for the first 24 hours following outpatient surgery. If your surgery is more extensive, you will either be transported to a surgical recovery center or admitted to a hospital.

After surgery you may experience some discomfort and be given a mild pain medication. Depending on the nature of your surgery, you may receive some or all of the following post-operative aids to help speed your recovery:

• Knee brace or shoulder sling.
• Compression bandage or TED hose covering the surgical site.
• Ice machine which will surround the area with self-contained, cold water to help reduce swelling.
• Continuous Passive Motion (CPM) machine to help maintain range of motion and speed recovery time.
• Respond II neuromuscular stimulator or TNS unit for pain control and muscle strengthening.
• Hemovac drain to draw blood away from the joint area.

Rehabilitation
After surgery, it is necessary for you to regain muscle strength as soon as possible to help stabilize the affected joint through a rehabilitation program. An exercise and rehabilitaion program will be coordinated between the physician, the physician's assistant and yourself.

You will be seen within a few days after surgery by either the physician or the physicians assistant during which time an exercise and rehabilitation program will be administered. A formal physical therapy program will be prescribed for you. We have an in-house physical therapy department or you may chose an outside therapist. You should contact your insurance company to determine if phsical therapy charges are paid under you plan.

Prolonged walking is not a knee rehabilitaion exercise and should be avoided immediately following surgery because if may cause swelling of the joint.

The Following Guidelines Should be Utilized to Facilitate Proper Recovery:

• Keep operative areas, including dressing clean and dry. Do not remove dressing unless instructed to do so by your physician.
• Periodically unwrap ace bandage and if applicable pull up TED hose making sure stocking does not bind behind the knee. Be careful to not wrap ace bandage too tightly and keep leg elevated to aid in circulation and to reduce swelling.
• Use ice for 72 hours as needed for pain and to help reduce swelling.
• Elevate leg on one or two pillows; whichever is more comfortable for you. Exercise toes to help circulation.
• Low-grade temperatures are quite common after surgery. Please call our office if your temperature exceeds 101.5 or if you begin to have persistent pain in your calf.
• Weight bearing as tolerated unless otherwise specified. You do not need to be confined to bed unless instructed.
• Keep knee covered when outdoors to avoid getting sunburn.