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Bowling Orthopaedics

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Surgery Education

Your initial post-op visit is usually scheduled two weeks after your surgery with Ryan Murphy, PA-C, or James Bennet, PA-C. This visit may include:

  • Removing stitches or staples
  • Assessing your incision
  • Reviewing your pain medication needs
  • Writing an order for outpatient physical therapy

It is your responsibility to choose your physical therapy location. Patients in a skilled nursing facility or rehab center will receive physical therapy services at the facility. Once you are discharged home from rehab, you will begin outpatient physical therapy. Your subsequent post-op visit is eight weeks after surgery. This appointment is generally scheduled with your surgeon.

Frequently Asked Questions

WHY DOES MY KNEE OR HIP CLICK?

Your knee or hip replacement is made from metal, plastic, or possibly ceramic. The click you hear or feel is the bearing surface contacting each other during activity. Your normal joint surfaces (pre-surgery) usually separate and re-contact in normal activity. However, the normal joint surface is covered with a soft substance called cartilage that does not make any perceivable noise. It is normal to hear or feel this clicking sensation, especially early after your surgery.

HOW LONG SHOULD I TAKE PAIN MEDICATION?

Pain medication and pain control is an integral part of your recovery from surgery. You should use the pain medication prescribed by your doctor until you are able to function well without it. The duration of pain medication usage can vary widely between individuals after surgery, but in general, most people are able to decrease the use of pain medication over the first few weeks and rarely require narcotic medications longer than 3 months after surgery. Narcotic medications can be addicting. Therefore, your surgeon would like you to utilize non-narcotic pain medication (Tylenol) when appropriate.

DO I NEED TO TAKE ANTIBIOTICS WHEN I HAVE A DENTAL OR OTHER MEDICAL PROCEDURE?

Yes. You will be given a letter explaining this in detail in your pre-operative folder that is either given to you in the office or mailed to you prior to surgery. Avoid any dental cleaning and other non-urgent procedures for 3 months following joint replacement.

IS IT NORMAL TO FEEL DEPRESSED?

It is not uncommon to have feelings of depression after joint replacement surgery. This may be due to a variety of factors, such as limited mobility, discomfort, increased dependency on others, and medication side effects. Feelings of depression will typically fade as you begin to return to regular activities. If your feelings of depression persist, consult your primary care physician.

WHEN CAN I DRIVE?

If you had surgery on your RIGHT knee or hip, you should not drive for at least 6 weeks. After this time, you may return to driving as soon as you feel comfortable. If you had surgery on your LEFT knee or hip, you may return to driving as soon as you feel comfortable, if you have automatic transmission. Do not drive if you are taking narcotics (pain medication).

WHEN CAN I GET MY INCISION WET?

If an Aquacel Dressing is used, you may shower when you feel safe to do so after you are discharged from the hospital. We ask that you keep the incision dry until 2 weeks after your surgery.

CAN I USE CREAM ON MY INCISION?

It is important to keep the incision dry for 2 weeks. As the incision heals, and the small scabs resolve, cream or lotion may be applied to the incision. Most commonly used creams include Vitamin E, cocoa butter and Mederma. There is not a lot of specific evidence to show that this makes a significant difference in the healing of your incision; however, the moisturizers alone may help avoid chafing and cracking and make range of motion exercises easier to perform.

WHAT ARE THE SIGNS AND SYMPTOMS OF INFECTION?

Infection is a very serious complication after joint replacement. As such, it is important to be aware of the signs and symptoms of infection. Patients may experience persistent fever (>101), chills or night sweats. In addition, it is important to closely monitor your incision. Be aware of any redness and drainage from your surgical incision. If these develop, let your surgeon know immediately.

HOW LONG DO I NEED WALKING AIDS SUCH AS CRUTCHES, A WALKER, OR A CANE?

The time that you may need a walking aid after total joint replacement is variable. In general, if your surgeon allows you to place as much weight as tolerated on your total joint replacement, most patients use a walker for approximately 2 weeks and then a cane for another 2 weeks. You should use a walking aid until you feel comfortable walking. Your physical therapist will help guide you through this transition.

WHEN CAN I TRAVEL LONG DISTANCES IN A CAR OR PLANE?

You can travel when you feel comfortable. This is generally between 4-6 weeks after surgery. However, when traveling, it is important to take some measures to prevent blood clots. It is recommended that you get up to walk and stretch at least once every 1-2 hours during extended travel.

HOW LONG WILL I EXPERIENCE PAIN?

How long you will experience pain after a total joint replacement is variable. Your pain should gradually diminish over time after surgery. You will initially require stronger narcotic pain medication for the first 4-6 weeks after surgery. In general, you should be able to switch to over the counter medications such as an anti-inflammatory or Tylenol. Minor discomfort related to a replaced joint may on occasion linger for six to nine months.

WHAT CAN I USE ON MY SCAR TO MINIMIZE SCARRING?

Many patients found scar creams helpful in reducing scarring. Creams with high Vitamin E content are most effective. For raised scars you can consider Mederma which is available over the counter.

WHEN WILL MY INCISION LINE BECOME LESS RED?

Physical therapy is an integral part in your recovery following a joint replacement surgery. If your physician feels you need to see a physical therapist following your operation, your progress will determine the duration of that therapy. The therapist will additionally instruct you in exercises that you can perform on your own without supervision.

HOW LONG DO I NEED TO GO TO PHYSICAL THERAPY?

This depends on your profession. Typically if your work is sedentary you may return after approximately 1 month. If your work is more rigorous you may require 3 months before you can return to full duty. In some cases more or less time is necessary.

WHEN CAN I GO BACK TO WORK?

Swelling around the incision area varies post-operatively from patient to patient. For most patients, this area will stay perceptively swollen for 3-6 months after surgery. Don’t worry. This will subside with time. However, if the swelling of the entire leg occurs that does not go down with elevation and ice or after resting overnight, this may be a sign of a blood clot. Contact your surgeon’s office immediately if this should occur.

WHEN WILL THE SWELLING GO DOWN?

All incisions fade at different rates. This varies according to your own skin tone. It is advisable to keep the incision out of direct sunlight as this will prolong the process. Most incisions fade by 6 months.

Primary Sidebar

Pain Management

Today, we face an epidemic of prescription narcotic abuse. The United States alone accounts for 80% of prescription opioid use in the world. At Bowling Orthopaedics, we are committed to appropriate opioid utilization for the acute pain of injury or surgery. In our pursuit of this goal, we will educate our community on the proper expectation of pain control and how and when opioids are beneficial. We pledge to work with our colleagues in primary care, as well as other specialists, to provide the best care to our patients. Legislative and regulatory efforts, as well as best practice guidelines, will continue to provide support to us, as we strive to provide outstanding health to our community.

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5220 Oleander Dr., 2nd Floor
Wilmington, NC 28403
T: 910-395-8333
F: 910-395-8473
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Our Mission

We are your source for personalized orthopaedic care. We offer a complete approach to arthroscopic surgery, joint replacement of the hip, knee and shoulder, occupational injuries, sports injuries, and general orthopaedics.

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Journey II XR Bi-cruciate Retaining Knee System

The XR is a new concept in knee replacement surgery. Traditional knee replacement designs did not allow for the preservation of the cruciate ligament (ACL), which in the normal knee is responsible for anterior/posterior stability. Without this knee ligament, traditional knee replacement designs have not been kinematically (how the knee functions) normal.

Specifically, the femur (thigh) bone will translate or shift anteriorly on the tibia (leg) bone causing pain and instability in activities such as stairs, squatting or stooping. This has been shown by the fact that on average only 15 % of total knee replacement patients can squat comfortably.

The XR knee system features an anatomically shaped femur (identical to the traditional Journey II knee options) and a new U-shaped tibial component with a mid section of preserved bone (where the ACL/PCL ) attach. This U shape allows for appropriate resurfacing of the worn tibial cartilage without forcing resection of these critical ligaments.

The technique is identical to traditional knee replacement steps and, therefore, does not add time or difficulty to the standard procedure. Our early experience has shown excellent results with respect to patient outcomes, satisfaction and return to activities.