Avoid slippery surfaces (icy sidewalks, wet floors, slippery grass hills, etc).

Be careful getting in and out of the shower.

Use a walker until your balance has returned to normal.

Using a walker helps prevent falls better than using a cane.

Using a cane helps prevent falls better than not using any support devices.

Ask for help from your support person when you need it.

Do not try to go to the bathroom by yourself at 2 am in the dark without your walker

Eating a healthy diet with plenty of protein after surgery can promoting good wound healing.

High fiber diets and drinking plenty of water can help prevent post-operative constipation.

Avoid processed foods. Food that comes in a box or bag is typically processed carbohydrates which temporarily spike your blood sugars. An hour or two later, your blood sugar falls, and you crave more processed carbohydrates. Obtaining your necessary calories from proteins, lipids, and naturally occurring carbohydrates helps smooth out your blood sugar curve and limits the high spikes in blood sugar that can harm wound healing.

Try to eat mostly whole foods (fruits, vegetables and proteins).

Drink mostly water and low-calorie electrolyte drinks. Avoid sugary soda drinks.

If you are a diabetic, make sure to keep your blood sugars below 140 to promote good wound healing.

Avoid drinking excessive alcohol while taking narcotics as this can increase falls.

Most patients can weight bear as tolerated with a walker, and then slowly wean it as tolerated. This typically takes 1-2 weeks for hips and 2-3 weeks for knees

If there are any precautions, we will provide explicit instructions

Ancef (cefazolin) is the most common antibiotic used to prevent infections. We will administer this prior to surgery

Most penicillin allergies are not true allergies to this class of medicine

Vancomycin is an alternative in case of a true allergy or concerns for MRSA

For some high risk patients we will prescribe a week of antibiotics (typically Keflex) to help prevent infections

Mepilex: Waterproof dressing. Safe to shower with it. Can remove 7 days after surgery and leave open to air. Cover with clean dry dressing if desired

Do NOT soak wound for at least 4 weeks after surgery, until the incision is healed

Wound vac: In some patients, will use a wound vac device. The machine will turn off when the batteries die (~5 days) and then a clean dry dressing can be placed

Aspirin 81 mg twice a day for 4 weeks - lower risk patients

Xarelto 10 mg daily for 4 weeks - high risk patients, normal kidney function

Eliquis 2.5 mg twice a day for 4 weeks - high risk patients, impaired kidney function

Tylenol 1000 mg three times daily (for pain) for up to 6 weeks

Celebrex 100 mg twice daily (anti-inflammatory) for 6 weeks

If you prefer you can take an alternative anti-inflammatory instead of celebrex. Pick one that has worked best for you and take it regularly. But only use ONE anti-inflammatory at a time

Lyrica 75 twice daily (for nerve pain) for 3 weeks

Pantoprazole 40 mg daily (protect stomach while taking anti-inflammatory)

Zofran 4 mg every 8 hours as needed (for nausea)

Senna/colace (senokot) daily (for constipation)

Oxycodone 5 mg tablet (take 1-3 every 4 hours)

If you maximize the non-narcotic options in the section above, ice aggressively (20 minutes on, 20 minutes off) and elevate the affected limb above the level of the heart, then can minimize the amount of narcotics needed

No surgery is pain free. But we hope to minimize pain and discomfort to keep you functional as you recover

We will prescribe narcotic pain medications for the acute surgical period only (up to 6 weeks). There will be no refills of narcotics after this time period.