Dos and donts after hip arthroscopy

Medications: (Prescription given to patient)

• Oxycodone/acetaminophen –10 mg/325 (Percocet®)
  Take as directed for pain (with food)
• Hydrocodone/acetaminophen – 5 mg/325 (Norco®)
  Take as directed for pain (with food)
• Oxycodone Hydrochloride –10 mg (OxyContin®)
  Take as directed for pain (with food)
• Oxycodone – 5mg
  Take as directed for pain (with food)
• Promethazine (Phenergan®)
  Take as directed for nausea
• Zolpidem (Ambien®)
  Take as directed for sleep
• Ondansetron (Zofran®)
  Take as directed for nausea

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Diet: Advance diet as tolerated.

Constipation is common with the use of pain medication. This can be avoided by increasing both dietary fiber and water intake.

Dressings: Keep dressings clean and dry for 3 days after surgery. You may then remove the dressing, apply waterproof bandages, and shower. After showering, replace the waterproof bandages with dry ones. No soaking or scrubbing, no bath, no swimming, no hot tubs, etc.

Ice: Apply an ice pack to the hip to minimize pain and swelling. Use Cryo/Cuff® as directed.

Office Appointment: If you do not already have a post-op appointment with your doctor, please call our office to make one.

Call your surgeon if

You develop a fever about 101 degrees.

The pain is severe and unrelieved with medication.

You have any questions or problems.

The subtle effects of general anesthesia or sedation with regional/local anesthesia can last more than24 hours. Rest on the day of surgery. Although you may feel normal, your reflexes and mental ability may be impaired. You may feel dizzy, lightheaded, or sleepy for 24 hours or longer. Do not consume alcohol, drive, operate machinery, or make important personal or business decisions for 24 hours. After a general anesthetic, it is normal to feel generalized aching and sore muscles for 24 hours. A sore throat may occur.

Hip Arthroscopy Post-Surgery FAQ

Ice

How much ice and for how long?

There is no right or wrong answer to this question.

Ice simply helps with the swelling and can help to decrease pain after surgery. For the first few days after the surgery, “the more, the better.” We recommend icing for approximately 30 minutes 3–5 times per day. The first night and first day following surgery, you should ice as much as possible.

Will the ice penetrate through the dressing?

Yes, it will. It might not feel like it, but it does.

Will the moisture from the ice get my incision wet?

No. There are many layers under the tape.

Dressing/Bandage

Leave the original dressing in place for 3 days. After that, you may remove the dressing and place large bandages over the incision. Please wash your hands before changing bandages.

My appointment is not for over a week; do I need to keep the dressing on?

We would like the operative dressing to be left in place for 3 days. After that, you may follow the above instructions. We recommend removing the dressing and placing large band-aids over the incisions.

When can I shower?

Day number 3, you may remove the dressing and cover with waterproof bandages. After showering, replace with new dry bandages.

How much activity should I do?

Once again, no right answer. We suggest taking it easy the day of surgery. Expect to be groggy and tired due to the anesthesia and medicines given during the procedure. You should also take it easy the first couple of days after surgery.

Should I stay in bed?

No! Aside from the first day/night after surgery, staying in bed usually causes more problems. While at home, it is usually better to sit upright in a chair/bed (when you are not resting/sleeping) with leg elevated for comfort.

Can I walk?

Yes, please do.

I have stairs in my house. Can I go up/down them?

Yes, but be careful and hold onto the side rail. Do not use crutches on the stairs.

Swelling/Bruising

The procedure is done with water to expand your joint to see and maneuver the camera. You will have swelling and bruising. Most of this you won’t see due to the bandage.

I have had a slight fever after the surgery; is this normal?

Yes, a slight low-grade fever (up to 101.0 degrees) is normal after surgery. This is usually due to your lungs, which act like radiators for our bodies. Due to anesthesia and shallow breathing, the lungs don’t fully expand and thus don’t remove or breathe off the heat in our bodies. This usually can last for the first few days after surgery.

Is there anything I should do to help this?

Yes, take deep breaths to expand your lungs several times in an hour, sit upright, and don’t stay in bed all day.

I am very nauseated/I have vomited.

Once again, unfortunately, for the first couple of days, this is common/normal. Anesthesia and the pain medicine commonly cause nausea and possible vomiting. The anesthesia will wear off fairly quickly. The pain medicine is then the culprit. Make sure you take the pain medicine with some food in your stomach. Narcotic pain medicine can make anyone nauseated on an empty stomach. Remember, nausea is not an allergic reaction.

I’m in pain, but I can’t take the pain medicine due to the nausea.

The first things we ask people are 1) how bad is the pain, and 2) how bad is the nausea? If the pain isn’t that bad, cut down and try to take less of the pain medicine. If the pain is bad, and the nausea and vomiting are bad, then please call our office with the name and number of your pharmacy, and we will call in an anti-nausea medicine

The pain medicine makes me itch; should I still take it?

Itching is common with pain medicine. Take over-the-counter Benadryl®.

The pain medicine doesn’t last long enough, but the bottle says “take every 3–4 hours.” Can I take it more often?

People vary in how much and how often they need to take pain medicine. Pain pills take a good 30–45 minutes to be absorbed and start giving pain relief. We suggest trying to anticipate and stay ahead of the pain the first several days after surgery.

Don’t be a clock-watcher. If the pain medicine only lasts 2.5 hours instead of 3–4 hours like the bottle says, simply take it a little more often. If you are in pain, take medicine. Don’t suffer. Some people never take a pain pill after surgery and other patients take them for a week or so. We are all different. If you have a history of drug or alcohol use, you will probably find that you will require more medications.

Can I take Tylenol® or ibuprofen (Advil®/Motrin®)?

The pain medicine is mixed with Tylenol®, so do not take any additional Tylenol®. You may take ibuprofen along with your prescribed pain medications.

When do I need to see my doctor in the office?

Our surgery scheduler usually makes your first appointment in advance. You should have received an appointment card in your pre-op packet. If you don’t know when that appointment time is, please call the office to confirm the day and time. Your first appointment is probably a week or so after your surgery. We have an open-door policy: if you have any concerns or problems before your first appointment, just call the office, and someone will see you. (415) 492-1600 or use the patient portal in the electronic medical record.

When can I start physical therapy?

You may start the following week. If you have already seen a therapist before surgery, or know where we plan to start therapy after surgery, we suggest setting up your appointments in advance. Most of the therapy places are very busy, so setting up your appointments in advance will allow you more choice of times to attend.

Can I drive? When?

While you are on pain medication, do not drive.

When can I return to work?

It depends on the type of job you have. If you do mainly desk work or sedentary work, you may return when you feel up to it. Most people return within 3–5 days. If you have a physical/labor-intensive job, then expect to take at least a couple of weeks off. We will then discuss it as you progress postoperatively. Most people return to regular activities/sports anywhere between 4–8 weeks after surgery. This is usually sport-dependent and depends on your level of activity (e.g., high school, recreational, college, professional).

Remember that you will have little aches and pains in different parts of your body after surgery.

If you have questions or concerns, please call our office. If it is after hours or on the weekend, follow the instructions on the answering service to leave a message. Someone will call you back as soon as possible.

If you have a history of serious medical problems and start having difficulty breathing, chest pain, etc., please call our office and/or your primary care doctor, present to a local emergency room, or call 9-1-1.