Treatment of Knee Arthritis (Part III)
Total Knee Home Discharge Instructions
TABLE OF CONTENTS Table of Contents:
Page 1
How to Get Better the “Fastest”: Do your exercise program 4 times a day.
Normal Things to Expect: You had surgery. Don’t worry about them!
Realistic Expectations: You will not be “All Better” in 8 weeks!
General Warnings: Things to watch out for.
Page 2
General Wound Care: For more see “Wound Care Instructions”.
Edema/Leg Swelling Control: How to decrease swelling in your feet and legs.
Normal Swelling & “Bad Swelling”: Is it a clot or not?
Constipation Prevention: Narcotics & not enough water bind you up!
Showers, Baths Hot Tubs and Pools:
Page 3
Pain Control Program:
Page 4
Follow the medication instructions from Dr. Van Horne’s surgical scheduler or Dr. Van Horne.
• Take Your Primary (Non-Narcotic) Pain Medications for 2 months.
• Narcotic Pain Medications: Come off of them as soon as you can.
• Anti-Nausea/Anti-Itch Medications: Take them 20 minutes before narcotics.
Other New Medications:
•
•
Page 5
Stomach Protectors: Prevent bleeding ulcers. Take for 3 months.
Blood Thinners: Prevent Blood Clots, Phlebitis, and Pulmonary Embolism.
Physical Therapy & Follow Up Appointments:
Exercise Program & Physical Therapy: Start exercise program day of surgery!
•
•
•
•
•
Page 5-7
Knee Flattening (Extension) Program: 15 minutes 4 times a day.
Knee Bending (Flexion) Program: 15 minutes 4 times a day.
Knee Strengthening Program: 15 minutes 4 times a day.
Walking Program: 15 minutes 4 times a day for 2 weeks.
SILAX (Standing, Independent, Low impact, Aerobic eXercise):
6 hours a week starting 14 days after surgery.
THE MOST IMPORTANT COMPONENT OF YOUR EXERCISE PROGRAM.
Precautions: Listen to your body.
Driving: Don’t drive until 6 weeks.
Kneeling: It is OK.
Skin Desensitization Program: Turn off the little skin nerves.
Page 7
Wound Care Instructions:
Page 7-8
General Information
Wound Care & Dressings
Expected “Normal” Drainage
Abnormal “Bad” Drainage
Wound Care Supplies: What and where to get them.
Page 8-9
•
•
•
•
Paragon Orthopedic Center
702 SW Ramsey, Suite 112, Grants Pass, OR 97527
541-472-0603 fax 541-472-0609
Revised 08/29/2014
Page 1 of 9
Treatment of Knee Arthritis (Part III)
Total Knee Home Discharge Instructions
Read this at least 6 times before the day of surgery. There is just too much important
information to know and remember. Don’t expect to learn it the day of surgery, you will be
on “Drugs” & will have a difficult time remembering anything!
How to Get Better the “Fastest”:
•
If you do not follow my exercise programs, don’t expect, by magic, you will get better. I
only did the easy 5%. You still have to do the hard 95%.
•
If you want a rapid recovery and the best motion, start your knee exercise program the day
of surgery and do it 4 hours a day when you go home. See the Exercise section.
o
o
o
o
o
Get your knee flat 15 minutes 4 times a day. When you get it flat, you can stop.
Get your knee bending 15 minutes 4 times a day. When you get 120 degrees by yourself, you can
stop.
Do your knee strengthening exercises 15 minutes 4 times a day. Maximum of 5 exercises at a time. If
your physical therapist tries to give you more, tell them to take an exercise away. Continue for 2
months, and then back off to twice a day for 2 months.
Walk 15 minutes 4 times a day. At home, in the yard or where ever works for you.
At 2 weeks after surgery, resume your Standing Low Impact Aerobic Exercise program 6 hours a
week. Water Walking, Walking on Natural Surfaces, Elliptical Stryder etc. Continue for next 4 months.
Normal Things to Expect: You had surgery. Don’t worry about them!
•
•
•
•
•
•
Drainage from the incision for up to 6 days after surgery. See Wound Care Instructions.
Knee bruising and redness for about 2 weeks. It will get worse for the first 3-5 days. It may go all the way
down to your heel. Blood flows in the fat layer and goes to the lowest point.
Knee swelling for 2-4 months and warmth for 4 to 6 months. Hey you had a big guy with a chain saw in
your knee!
Leg swelling and edema for up to 6 months. See Edema/Leg Swelling Control.
Numbness along the outside of your incision. Little skin nerves are cut with a knee incision. You won’t
notice it in a few months.
Skin Hypersensitivity to touch around your incision scar and discomfort with kneeling. See Skin
Desensitization Program.
Realistic Expectations: You will not be “All Better” in 8 weeks!
•
•
•
You will make rapid weekly progress for the first 8 weeks then it slows down.
You are “just” healing at 8 weeks. Don’t be disappointed that you are not “all better” in 8 weeks. You
know the “It’s the Climate” sign on 6th Street? I often wonder if I should not put a sign at my front door
that sez “It’s Just 8 Weeks”!
It will be 4-6 months before you forget you had a knee replacement. A Total Knee Replacement is not like
a fast food restaurant where you get your food quickly; it is more like fine dining.
General Warnings: Things to watch out for.
•
•
•
•
•
If you have chest pain or shortness of breath (different from your usual), go to the Emergency Room.
You may be having a heart attack or a blood clot going to your lungs.
If you have increasing leg swelling that does not go away with elevation combined with new/different pain
when you squeeze your calf, call Paragon Orthopedics. You may have a blood clot.
If you feel sleepy all the time or feel your thinking is not clear, call Paragon Orthopedics. Your pain
medications may need to be reduced.
Call for temperatures > 101.5 or if your knee becomes more red hot and swollen 6 days after surgery.
Call if you have new greenish pus like drainage or drainage that continues more than 6 days after
surgery.
Paragon Orthopedic Center
702 SW Ramsey, Suite 112, Grants Pass, OR 97527
541-472-0603 fax 541-472-0609
Revised 08/29/2014
Page 2 of 9
Treatment of Knee Arthritis (Part III)
Total Knee Home Discharge Instructions
•
If you cannot sleep, your pain medication may be the problem. With time, narcotic pain medications can
keep you awake. Call Paragon Orthopedics.
General Wound Care: For more see “Wound Care Instructions”.
•
•
•
•
•
Change Dressing every day and as needed.
Contact Paragon Orthopedics if you have drainage beyond 6 days after discharge from hospital.
Contact Paragon Orthopedics for increasing drainage, pus-like drainage, or increasing redness and pain.
You may shower the day after surgery if drainage has stopped. Wash gently with antibacterial soap like
Lever.
You may resume water walking, pool exercise and hot tub fourteen days after surgery if wound is closed,
staples are out, drainage has stopped and your Physical Therapist says it is OK.
Edema/Leg Swelling Control: How to decrease swelling in your feet and legs.
•
•
Leg Elevation: This is what gets the extra fluid out of your legs.
o Elevate feet ABOVE your heart 15 minutes, 4 times a day to reduce swelling in your legs. The
higher the better. Example: on couch with feet propped on a pillow on the couch arm.
o Sitting in a recliner won’t get your legs high enough to get the edema down!
Knee high compression stockings: They help, but it is the elevation that really does the job.
o Wear them for 14 days after surgery.
o You may take them off for showering, skin care and washing of stockings.
Normal Swelling & “Bad Swelling”: Is it a clot or not?
Normal Swelling (After Surgery): You can expect to have leg swelling for 2-6 months.
• Normal Swelling/Edema goes down when you sleep (first thing in the morning you don’t have much
edema) or goes down when you elevate your legs.
• With Normal Swelling/Edema if you squeeze your calves, they are not more painful than usual (you
probably don’t have a clot).
• Swelling of both legs is probably a sign of fluid retention and is probably Normal Swelling.
o If you take a water pill or medications for high blood pressure your body may need some help
to get the extra fluid off, elevate your legs higher/more often and call your PCP. You may
need an adjustment of your medications.
“Bad Swelling”: Could be a sign of a blood clot. If you have either of the below, Call Paragon Orthopedics!
You may need an Ultrasound evaluation of your legs to make sure you don’t have a clot.
• “Bad Swelling/Edema” doesn’t go down when you sleep (you wake up in the morning and you still
have a lot of swelling/edema) and the swelling/edema doesn’t go down when you elevate your legs
above your heart,
• When you squeeze your calf muscles, they hurt more than normal or have a new pain.
Constipation Prevention: Narcotics & not enough water bind you up!
•
•
•
See the “HOW TO AVOID CONSTIPATION WHILE TAKING NARCOTIC PAIN
MEDICATION” handout from Paragon Orthopedics.
Don’t let yourself get constipated while on narcotics.
Have a bowel movement at least every 2-3 days while on narcotics.
Showers, Baths, Hot Tubs and Pools:
•
You may shower when drainage on a 12-hour-old dressing is no more than quarter sized. Generally the day
after surgery.
o Let the water run on the wound. Do not scrub the wound.
o Blot it dry and apply new dressing
Paragon Orthopedic Center
702 SW Ramsey, Suite 112, Grants Pass, OR 97527
541-472-0603 fax 541-472-0609
Revised 08/29/2014
Page 3 of 9
Treatment of Knee Arthritis (Part III)
Total Knee Home Discharge Instructions
•
No bathtubs, hot tubs or pools for 14 days after surgery.
Pain Control Program: Follow the medication instructions given to you by Dr. Van Horne’s
surgical scheduler or Dr. Van Horne.
• Take Your Primary (Non-Narcotic) Pain Medications for 2 months. When you can sleep
through the night without knee discomfort waking you up, you can stop them. Otherwise take them for
another month.
o By using them as directed, you may not need the Narcotic Pain Medications for more than a few
days to a week!
o They are Non Addictive and Non Constipating.
o They work especially well for nighttime pain and types of pain that narcotics don’t help.
Examples:
§ Acetaminophen (Tylenol)
You take 2 (two) 325 mg tabs or 1 (one) 650 mg tab Breakfast, Lunch, Dinner & Bedtime.
This is an over the counter medication.
WARNING: Do Not take more than 3000 mg a day.
If you are taking a combination medicine like Norco or Vicodin, you probably should not take any
scheduled Acetaminophen until you are off of it.
§ NSAIDs
You take them once or twice a day. They are “aspirin like” pain medications.
They are for pain, not for swelling.
Examples: Meloxicam (Mobic), Celebrex, Naprosyn (Aleve), Diclofenac (Voltaren) and Ibuprofen
(Motrin).
•
Narcotic Pain Medications:
Come off the Narcotic Pain Medications as soon as you can (2 days-2 weeks after
surgery).
Many patients never fill their narcotic prescription after surgery and don’t use them at all when they
go home. I recommend you stop all Narcotic Pain Medications as soon as you can. On the other hand,
use them if you need them!
o These are the same medications you used in the Hospital.
o You may take less than prescribed and stop as soon as you want.
o IF you are still taking these medications two weeks after surgery and you still feel like you need them,
stop taking them on a regular schedule. Take them only as you need.
o Narcotics are a necessary evil for many patients.
o Narcotics are Addictive.
o Narcotics cause constipation (follow our directions on how to keep your bowels moving), difficulty
sleeping (your body gets used to them), pain at night (your body starts wanting the Narcotics),
sedation, hallucinations, and confusion.
Examples: Tramadol (Ultram), Oxycodone, Codeine, Hydromorphone (Dilaudid), Morphine Sulfate, and
Hydrocodone with acetaminophen (Norco, Vicodin).
o
•
Anti-Nausea/Anti-Itch Medications:
These medications prevent nausea/itching caused by narcotic pain medicines.
§ For them to work well, take them about 20 minutes before you take the narcotic pain medication.
§ You can stop them when you come off the narcotic pain medications.
Examples: Zofran (ondansetron), Phenergan (promethazine), Atarax (hydroxyzine), Benadryl
(diphenhydramine), & Zyrtec (cetirizine).
Paragon Orthopedic Center
702 SW Ramsey, Suite 112, Grants Pass, OR 97527
541-472-0603 fax 541-472-0609
Revised 08/29/2014
Page 4 of 9
Treatment of Knee Arthritis (Part III)
Total Knee Home Discharge Instructions
Other New Medications:
•
Stomach Protectors: Take these to prevent bleeding ulcers caused by the stress of surgery and
•
Blood Thinners: Helps to Prevent Blood Clots, Phlebitis, and Pulmonary Embolism.
medications (NSAIDs).
o Take them as long as you take NSAIDs.
o If you already take one normally for acid stomach, reflux, GERD, or ulcers, you will take your
regular one unless it conflicts with one of your other medications.
Examples are Omeprazole (Prilosec) and Famotidine (Pepcid).
o
o
Aspirin 325 mg is the most common blood thinner for patients without a history of clots.
If you take a blood thinner regularly, resume it when you go home.
• If you take Warfarin, we resume your regular dose while you are in the hospital and
continue it after discharge. Have your PT/INR checked twice weekly for two weeks at
your regular Warfarin clinic or provider.
• If you are on Plavix, Pradaxa or Xarelto, you resume taking them the morning of the
third day after you go home.
Follow Up Appointments:
•
•
•
My office sent orders to your physical therapist for 6 visits over one month.
o If they have not contacted you, call them.
o You should start your therapy the second or third day after you go home.
You already have a follow-up in Dr. Van Horne’s office with a Physician’s Assistant or Nurse
Practitioner at 4 weeks post-op. We will get X-Rays and renew Physical Therapy if needed.
You have a follow-up with Dr. Van Horne 8 weeks post-op to check your progress.
Exercise Program and Physical Therapy:
•
•
•
•
•
•
Start your exercise program the day of surgery!
Do your exercise program 4 hours/day. What else more important have you got to do?
You don’t go to physical therapy to “do” your exercises. You go to physical therapy for them to observe,
correct and advance your exercise program.
Your physical therapist does not make you better, only you do!
After your first month of physical therapy, I can only order additional physical therapy if your therapist
can validate they are “Doing” something for you that you cannot do on your own. I don’t want you stuck
with a huge bill your insurance won’t pay for!
Knee Flattening (Extension) Program:
Schedule: 15 minutes 4 times a day. When you get it flat and keep it flat, you can stop.
o If you do not get your knee fully flat in the first 7-10 days, you will never get it flat and you may
always walk with a limp. Sitting in a reclining lounge chair is the #1 reason for not getting your
knee into full extension. Even in the very best reclining lounge chairs, when you recline, your knee
bends (is flexed) and you cannot get it fully flat (extended). If you want to sit in your reclining lounger,
do not recline. Place your heel on another chair and work on getting it flat.
o
o
Seated in a chair, rest your heel on another chair leaving the back of your knee unsupported,
§ Turn your toes in until your kneecap points straight up at ceiling (toes internally rotated
10-20°),
§ Sit there and let your knee stretch at least 15 minutes four times every day until you get
your knee fully flat.
§ Weight may be added above your knee if you are not getting your knee flat and you can
tolerate the weight.
In bed, put a pillow under your heel so the back of your knee doesn’t touch the bed,
Paragon Orthopedic Center
702 SW Ramsey, Suite 112, Grants Pass, OR 97527
541-472-0603 fax 541-472-0609
Revised 08/29/2014
Page 5 of 9
Treatment of Knee Arthritis (Part III)
Total Knee Home Discharge Instructions
§
§
•
Roll your hips in a little or turn your toes in until your kneecap points straight up at
ceiling (toes internally rotated 10-20°)
Use this position as much as possible when awake in bed until you get your knee fully
flat.
Knee Bending (Flexion) Program:
Schedule: 15 minutes 4 times a day. Get & keep 120 degrees just hanging to gravity & you can stop.
You will have close to 120 degrees of bend the day of surgery. Keep it!
You will be stiff first thing in the morning. Work your knee right away to get the edema out and keep
your 120 degrees.
If you do not get and keep the Bend (Flexion) early, you will develop scar preventing you from bending.
Your therapist will to try to “Tear” the scar for you! This is very painful and it doesn’t work. Just do it
yourself.
o Lying on your back, cradle your thigh with your hands and flex your hip so your kneecap is pointing
at the ceiling.
§ Let gravity bend your knee as much as you can tolerate (Dr. Van Horne got you to 120
degrees in the OR with your leg just hanging to gravity).
§ Let it hang for two minutes then relax for a minute and repeat. Do a total of five (5) 2 minute
stretches
§ If you cannot get your hands around your thigh, use a towel for extra length.
•
Knee Strengthening Program:
Schedule: 15 minutes 4 times a day for the first 8 weeks, then twice a day for another 2 months.
This is the exercise program that your physical therapist taught you before surgery and the one the
therapist/nurse reinforced the day of surgery.
o If you don’t have a handout of your exercises, call your therapist and get one!
o You should have a maximum of 5 exercises at a time (you cannot do more in 15 minutes).
o Each time you master, or an exercise becomes too easy, your therapist will add a new harder one and
take the easier one away.
•
Walking Program:
Schedule: 15 minutes 4 times a day at home, in the yard or where ever works for you. You do this for the first
two weeks after surgery then you go back to SILAX.
You need to get your walking muscles back
•
SILAX (Standing, Independent, Low impact, Aerobic eXercise).
THIS IS PROBABLY THE MOST IMPORTANT COMPONENT OF YOUR EXERCISE
PROGRAM IF YOU WANT A RAPID AND FULL RECOVERY.
Schedule: 6 hours a week starting 14 days after surgery or the day after you get your staples out, 2
weeks, and continue for 6 months.
o
o
o
o
Resume the Standing, Independent, Low impact, Aerobic eXercise(s) of your choice. Water walking,
walking on natural surfaces (grass, sand, unpacked dirt), elliptical strider/trainer machine, Nordic
track machine, or Stair Climber Machine.
Work up to 6 hours per week and continue this for next 6 months.
Don’t use Treadmills or walk on concrete or asphalt as your primary form of exercise for 3 months.
They cause bursitis, joint pain and back pain.
Don’t use a bicycle or swimming as your primary forms of Standing, Independent, Low Impact,
Aerobic eXercise program (as they are neither). They do not simulate walking, nor encourage
balance training. Do you want to ride the Tour de France, swim the English Channel or do you want
to walk?
Paragon Orthopedic Center
702 SW Ramsey, Suite 112, Grants Pass, OR 97527
541-472-0603 fax 541-472-0609
Revised 08/29/2014
Page 6 of 9
Treatment of Knee Arthritis (Part III)
Total Knee Home Discharge Instructions
Precautions:
•
Listen to your body, if you hurt more than an hour and a half (1 ½) after activity or exercise, you
are overdoing it.
Driving:
Don’t drive until 6 weeks. You are off your walker, off the narcotics & you feel safe.
•
•
•
Studies show it does not matter whether you had surgery on your right or left leg, no driving for 6
weeks!
If you drive before 6 weeks, I cannot defend you in a court of law.
I suggest that you try driving in a parking lot before you actually go out on the road.
Kneeling: It is OK. Just don’t kneel on broken glass, old fish hooks, or other sharp pointy things.
There is no mechanical reason for you not kneel. Your knee is metal and plastic.
•
•
•
•
To let your incision heal, I suggest you don’t kneel for about 4 weeks.
Put a pad down to kneel on.
If your incision/skin is too sensitive, start the Skin Desensitization Program.
Most patient’s major problem with kneeling is not their knee replacement but that they cannot get back
up. Their “core muscles” are too weak. Discuss it with your therapist.
Skin Desensitization Program: Turn off the little skin nerves.
If your incision/the front of your knee is very sensitive or uncomfortable to touch, the little
skin nerves are irritated and hyperactive from surgical “trauma”. You need to reeducate
them & turn them off!
•
Starting about 2 weeks after surgery
o Twice a day squeeze ½ a capsule of vitamin E oil on the incision and massage the incision with
your fingers for several minutes. Use side-to-side, up-and-down, and circular motions.
o Rub the sensitive area 4 times a day just until it feels hot. Then stop. Start with a piece of silky
fabric. When it is no longer sensitive with the silky fabric, more up to rougher and rougher
fabrics until you can tolerate new denim.
Wound Care Instructions: Dressings, Expected Drainage and Abnormal
Drainage Knee.
1.
2.
3.
4.
5.
6.
7.
8.
General Information
Your wound was closed superficially with Dermabond/Prineo (skin glue & elastic mesh tape) or staples.
a. If the Dermabond/Prineo has not fallen off after 14 days, you may peel it off.
b. If you have staples, your physical therapist should remove them around 14 days after surgery.
Expect to have some drainage from your wound for up to 6 days after surgery.
You may shower when drainage on a 12-hour-old dressing is no more than quarter sized. Generally the day
after surgery. Let the water run on the wound. Do not scrub the wound. No bathtubs, hot tubs or pools for 14
days after surgery.
Do not put antibiotic ointments or creams on wound.
Expect normal bruising and redness to progress for 3-5 days after surgery.
If you have drainage, you may “paint” the wound with Iodine (Betadyne) twice a day or with each dressing
change. “Painting,” means putting Betadyne on a 4x4 and blotting it on the wound area. Betadyne helps dry out
wound drainage and reduce the risk of infection.
Island Dressings 4” x 10” (big band aides) are convenient and easy to use.
If you do not have wound dressing materials already, see my “LIST of SUGGESTED PATIENT WOUND
SUPPLIES for KNEES”.
Paragon Orthopedic Center
702 SW Ramsey, Suite 112, Grants Pass, OR 97527
541-472-0603 fax 541-472-0609
Revised 08/29/2014
Page 7 of 9
Treatment of Knee Arthritis (Part III)
Total Knee Home Discharge Instructions
Wound Care & Dressings
1. Most patients will only have only mild drainage from their wound and island dressings 4” x 10” are adequate.
a. Change daily and as needed up to several times a day.
2. Do not pull off the Dermabond/Prineo when doing dressing change. If 4x4s are sticking to it you can wet them
with warm water or Betadyne, then peel them off while holding down the Dermabond/Prineo.
a. If the Dermabond/Prineo has not fallen off by 14 days after surgery, you may peel it off.
3. If you have staples, your physical therapist will remove the staples 14 days after surgery.
4. Do not put antibiotic ointments or creams on wound.
Expected “Normal” Drainage
1. Drainage that is bloody, or yellow bloody is normal and expected for up to 6 days after surgery.
2. Drainage should decrease each day.
3. Sudden large gush of bloody or yellow bloody drainage at 3-5 days after surgery is not uncommon. Old blood is
finding its way out. Dress with large “Bulky” dressing as below. As long as drainage slows down and stops in a
day or so there is nothing to worry about. If drainage does not decrease and continues, you need to contact Dr.
Van Horne’s office on the next business day.
4. If you bleed enough to soak through your dressing the first two days after surgery, don’t panic and don’t
go to the emergency room (You will wait hours. They will look at it, tell you to change your dressing as
needed, and that nothing is wrong. They will charge you an exorbitant fee that your insurance may not pay!).
a. If the blood wants to come out, we want it to come out! You just had surgery.
b. Dr. Van Horne promises you that you are not bleeding to death. There is a pocket of old blood just
under the skin. It is not “active bleeding”.
c. Just wrap it in a towel (so it doesn’t mess up the bed) and place a several pound bag of popcorn seeds
or rice for pressure on the incision for several hours (helps the wound seal up and stop draining
sooner).
d. Change your dressing around 10 or 11 the next morning. If you are still having more drainage than an
Island Dressing will soak up in 12 hours
i. Place a new large “Bulky” dressing on the wound (just like the one you had and your
discharge nurse taught you to do).
1. Fold each sterile gauze pad in half and stack on the incision (10-15 4x4s)
2. Place 2 ABDs over 4x4s
3. Wrap snuggly with 4-inch Ace elastic wrap
e. Again, place a several pound bag of popcorn seeds or rice for pressure on the incision when you are
not doing your walking or strengthening exercises.
f. Change dressing daily and as needed.
g. If you continue to have drainage that soaks through the “Bulky” dressing for more than 2 days after
surgery, call Dr. Van Horne’s office the next business day for a wound check.
h. Start dressing changes with island dressings as soon as drainage slows down enough to handle it.
i. If you did not purchase one of “Dr. Van Horne’s Knee Dressing Care Packages” from Grants Pass
Pharmacy go to a pharmacy (call the pharmacy first to make sure they have what you need) and
purchase what you need for dressing changes.
Abnormal “Bad” Drainage
1. Drainage that continues more than six (6) days after surgery needs to be reported to Dr. Van Horne’s office
on the next business day.
2. Green or foul smelling drainage needs to be reported to Dr. Van Horne’s office on the next business day or
contact the physician on call if it is the weekend.
WOUND CARE SUPPLIES
Most pharmacies and medical supply shops do not carry the wound care supplies you will need when you go home.
The easiest way to get your home wound care supplies is to purchase “Dr. Van Horne’s Knee Dressing Care
Package” from Grants Pass Pharmacy 414 SW 6th St. Grants Pass, Oregon. PH# (541-476-4262). Hours of
operation: 9am-7pm M-F & 9am-6pm Sat. They make these up just for my patients. It is designed to be “one-stop
Paragon Orthopedic Center
702 SW Ramsey, Suite 112, Grants Pass, OR 97527
541-472-0603 fax 541-472-0609
Revised 08/29/2014
Page 8 of 9
Treatment of Knee Arthritis (Part III)
Total Knee Home Discharge Instructions
shopping” and meet your needs for just about every situation. It contains more supplies than the average patient will
need/use.
If you want to do it on your own and just get what you need when you need it, you will save a few bucks, but you
will have to search around for extra supplies if you need them. Call the pharmacy before you go or you may be
frustrated.
1. 14 (fourteen) Island Dressings 4” x 10” or 3.5” x 10” (big band aides)
a. Brand Names include Kendall, McKesson and 3M Medipore
2. 1-2 boxes of sterile gauze 4x4s (10-100 per box - need 10-15 per dressing change).
a. Many brand names including Johnson & Johnson, Kendall, and McKesson.
3. 2 (two) ABD 5”x9” (or bigger) Dressings
a. Brand names Kendall, Medline and others
4. 2 (two) 4-inch Ace elastic wraps
5. 1 (one) Povidone-Iodine Solution 10% (Betadyne Solution) 4 ounce bottle
Paragon Orthopedic Center
702 SW Ramsey, Suite 112, Grants Pass, OR 97527
541-472-0603 fax 541-472-0609
Revised 08/29/2014
Page 9 of 9