INSTRUCTIONS FOR SURGERY

Transcription

1 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) INSTRUCTIONS FOR SURGERY In rder t make yur admissin and hspital stay smth and mre pleasant, please cmply with the fllwing instructins: c If yur surgery is n MONDAY, please reprt t: NYU Hspital fr Jint Diseases 301 East 17 th Street New Yrk, NY If indicated by yur physician, schedule yur pre-surgical testing, lcated at nd Avenue, 1 st Flr Suite 16 New Yrk, NY c If yur surgery is n FRIDAY, please reprt t: NYU Langne Outpatient Surgery Center 339 East 38 th Street New Yrk, NY If indicated by yur physician, please call t schedule yur pre-surgical testing, lcated at 240 East 38 th St. New Yrk, NY Mezzanine Level *One business day prir t yur surgery, hspital staff will cntact yu t finalize yur surgery time. A. Bring jgging/warm-up pants, shrts/skirt if having knee surgery. B. Bring a shirt/bluse that buttns pen in frnt instead f a pullver if having shulder/elbw surgery. C. If yu wn crutches, bring them with yu, if having knee, ankle r hip surgery. D. Bring all medicatins r a list f current medicatins yu are taking with yu. Als bring a list f any allergies. E. Bld pressure medicatin shuld be taken as usual with a sip f water the mrning f surgery. DO NOT take a diuretic r fluid pill. Seizure medicatins may be taken befre surgery. F. DO NOT take ral diabetes medicatins (pills) the night befre r the day f surgery. If yu are n insulin, DO NOT use insulin the mrning f surgery unless yu are a "prblem diabetic" in which case yu need t cnsult yur physician regarding the prper insulin dse fr yu t use prir t surgery. Center fr Musculskeletal Care 333 E. 38 th St, New Yrk, NY Tel: (646) / Fax: (646) /

2 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) G. Please DO NOT wear makeup r nail plish the day f surgery. Yu will need t remve cntact lens (including extended wear), denture, r bridges prir t surgery. Please bring yur wn cntainers fr strage. H. Leave all jewelry and valuables at hme. The hspital will nt take respnsibility fr lst r missing items. I. Yu need t reprt any skin irritatin, fever, cld, etc., t Dr. Jazrawi. J. Yu will need t bring yur insurance card/infrmatin with yu. K. DO NOT eat, drink (including water), chew gum, candy, smke cigarettes, cigars, use smkeless tbacc, etc., after midnight the night befre surgery r the mrning f yur surgery. The nly exceptin is a sip f water t take necessary medicatins the mrning f surgery. L. Yu must arrange smene t drive yu hme when ready t leave the hspital. Yu will nt be allwed t drive yurself hme after surgery. We can assist yu if yu need transprtatin t the airprt r htel, hwever, yu need t let us knw in advance (if pssible) s we can make the arrangement. M. NOTE: DO NOT take any aspirin, aspirin prducts, anti-inflammatries, Cumadin r Plavix at least 5 days prir t surgery. Yu are allwed t take Celebrex up t yur day f surgery. If yur medical dctr r cardilgist has yu n any f the abve medicatins. Please check with him/her befre discntinuing the medicatin. Yu may als take Tylenl r Extra-Strength Tylenl if needed. Nnsteridal Anti-Inflammatry (Arthritis) Medicatins: Sme f the mst cmmn names fr frequently used NSAID's include: Mtrin, Indcin, Nalfn, Naprsyn, Naprelan, Arthrtec, Tlectin, Feledene, Vltaren, Clinril, Dlbid, Ldine, Relafen, Daypr, Advil, Aleve, Ibuprfen. Yur first fllw up appintment is usually scheduled fr apprximately 2 weeks after yur surgery at the 333 East 38th street ffice. The date and time f yur fllw-up is. If yu cannt make this appintment r need t change the time, please cntact the ffice. If yu have any questins regarding yur surgery, please cntact the ffice at ptin 4, ptin 2 r via the internet at Center fr Musculskeletal Care 333 E. 38 th St, New Yrk, NY Tel: (646) / Fax: (646) /

3 Laith M. Jazrawi, MD Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) Hme Supplies Fr Yur Surgery Laith M. Jazrawi M.D. Open Surgery A. Open knee surgery (ACL recnstructins, ALL (Anterlateral ligament) recnstructins, Autlgus Chndrcyte Implantatin, PCL recnstructins, High tibial stetmy, Distal femral stetmy, Psterlateral crner recnstructin, MCL recnstructin, OATS (stechndral autgraft), Ostechndral allgraft,) a. Yu will need 4x4 (r similar size) waterprf bandages fr furteen days. Bandage changes fr pen knee surgery dne pst-p day #3. B. Open shulder surgery, (Biceps Tendeis, Latarjet, Open capsulrrhaphy, Glenid recnstructin using Distal tibial allgraft): a. Yu will need 4x4 (r similar size) waterprf bandages fr furteen days. Als, a bx f Bandage changes fr pen shulder surgery are dne pst-p day #3. C. Open Ankle Surgery (Achilles Tendn Repair, Os Trignum Excisin, Ankle OCD, Mdified Brstrm- Guld Prcedure, Perneus Lngus/Brevis Repair)- Yu d nt have t wrry abut dressing changes as yur leg will be in splint/cast fr the first tw weeks D. Open Elbw surgery (Distal Biceps Repair, LCL Recnstructin, Radial Head r Capitellum ORIF, Radial Head Replacement/Resectin, Triceps Repair, UCL Recnstructin Tmmy Jhn Surgery)- Yu d nt have t wrry abut dressing changes as yur arm will be in splint/cast fr the first tw weeks. Fr Tennis Elbw surgery (lateral epicndylitis) and Glfer s Elbw Surgery (medial epicndylitis), dressing changes are are started n pst-p day #3. Yu will need 4x4 (r similar size) waterprf bandages fr furteen days. E. Hamstring repair Yu will have a special dressing placed n at the time f surgery that will be kept n fr the first 2 weeks after surgery. Yu will then need 4x4 (r similar size) Tegaderm r Telfa waterprf dressings. Als, a bx f 4" by 4" gauze spnges if there is bleeding at the incisin site. Arthrscpic Surgery A. Fr Arthrscpic shulder, elbw, knee, r ankle surgery: a. Regular adhesive bandages ( Band-aids ) can be used fr arthrscpic prtals x 2 weeks. b. If biceps tendesis was perfrmed, use 4x4 (r similar size) waterprf bandages n wunds. c. In general, dressing changes fr arthrscpy are dne n pst perative day 3 Center fr Musculskeletal Care 333 E. 38 th St, New Yrk, NY Tel: (646) / Fax: (646) /

4 Pst-Operative Medicatin Administratin Knee Arthrscpy Pain- Mtrin 800mg. 1 tab three times daily, as needed Adjunctive pain: Perccet (Oxycdne/Acetaminphen) 10/325; One tab every 6 hurs as needed fr adjunctive pain Knee Ligament Recnstructin Pain- Perccet (Oxycdne/Acetaminphen) 10/325; One tab every 6 hurs as needed. Breakthrugh Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain. Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT prphylaxis- Aspirin 81mg; 2 tabs daily x 14 days ****Antibitics and Aspirin start pst-perative day #1 Nn-weight bearing Lwer Extremity Surgery (Meniscal Repair, Meniscal Rt Repair, Distal Femral Ostetmy, High Tibial Ostetmy, Tibial Tubercle Ostetmy, Cartilage Transplant) Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Pain- Perccet (Oxycdne/Acetaminphen)10/325; One tab every 6 hurs as needed. Adjunctive Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain. Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT prphylaxis- Aspirin 81mg; 2 tabs daily x 14 days ******Antibitics and Aspirin start pst-perative day #1 Shulder/Elbw Surgery Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Pain- Perccet (Oxycdne/Acetaminphen)10/325; One tab every 6 hurs as needed. Adjunctive Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain. Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT Prphylaxis - Aspirin 81mg; 2 tabs daily x 14 days

5 Ankle fracture surgery & Achilles Tendn Surgery Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Pain- Perccet (Oxycdne/Acetaminphen)10/325; One tab every 6 hurs as needed. Adjunctive Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain. Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT Prphylaxis - Aspirin 81mg; 2 tabs daily x 14 days ****Antibitics and Aspirin start POD #1 Ankle arthrscpy +/- Micrfracture and Achilles repair Pain- Perccet (Oxycdne/Acetaminphen) 10/325; One tab every 6 hurs as needed. DVT Prphylaxis - Aspirin 81mg; 2 tabs daily x 14 days ****Aspirin starts pst-perative day #1 Hamstring repair Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Pain- Perccet (Oxycdne/Acetaminphen)10/325; One tab every 6 hurs as needed. Adjunctive Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain. Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT Prphylaxis - Aspirin 81mg; 2 tabs daily x 14 days ****Antibitics and Aspirin start POD #1

6 Assciate Prfessr f Orthpaedics Chief, Divisin f Sprts Medicine Tel: (646) Pst-Operative Instructins Mdified Brstrm-Guld Prcedure Day f Surgery A. Diet as tlerated. B. Pain medicatin as needed every 6 hurs. C. Icing is imprtant fr the first 5-7 days pst-p. Ice is applied fr 20-minute perids 3-4 times per day. Care must be taken with icing t avid frstbite. D. Set up yur physical therapy appintment fr 4 weeks after surgery E. Keep leg elevated abve heart First Pst-Operative Day A. Cntinue icing B. Yu will need t keep yur cast/splint dry when taking a shwer. D this fr abut 4 weeks after surgery. Secnd Pst-Operative Day until return vist A. Cntinue icing B. Leg elevatin as much as pssible Ankle Supprt A. Weeks 0-2: psterir slab/splint B. Weeks 2-4: shrt leg cast C. Weeks 4-6 Aircast walking bt weightbearing as tlerated. ROM exercises in PT D. Weeks 6-8: wean ut f bt Call ur ptin 4, ptin 2 t cnfirm yur first pstperative visit, which is usually abut 1-2 weeks after surgery. If yu are experiencing any prblems, please call ur ffice r cntact us via the internet at Center fr Musculskeletal Care 333 E. 38 th St, New Yrk, NY Tel: (646) / Fax: (646) /

7 Dr. Laith M. Jazrawi Chief, Divisin f Sprts Medicine Assciate Prfessr Department f Orthpaedic Surgery Rehabilitatin After Brstrm-Guld Prcedure th St. New Yrk, NY (646) newyrkrth.cm

8 Rehabilitatin After Brstrm-Guld Prcedure th St. New Yrk, NY (646) newyrkrth.cm

9 Rehabilitatin After Brstrm-Guld Prcedure Phase I (Surgery t 4 weeks after surgery) Gals Prtect healing tissue Decrease pain and inflammatin Retard muscular atrphy Cntrl weight-bearing frces Precautins Weight-bearing: partial weight-bearing in cast with 2 crutches fr first 4 weeks Range f Mtin Exercises Therapeutic Exercises Nne NO INVERSION EXERCISES N strengthening fr first 4 weeks Begin submaximal ismetrics at 4 weeks Hip abductin/adductin Straight leg raises int flexin Remve cast week 4 and place in cam walker Phase II (4 weeks t 12 weeks fllwing surgery) Gals Prtect healing tissue Retard muscular atrphy Prgress weight-bearing tlerance Begin prpriceptive drills Precautins Weight-bearing as tlerated in cam walker weeks 4-8 Discntinue cam walker at end f week 8 Place in air cast fr 3 additinal weeks Range f Mtin Exercises Therapeutic Exercises Begin passive drsiflexin, plantar flexin and eversin N active INVERSION past neutral fr 12 weeks Begin strengthening exercises PRE s at 75% f ppsite LE (Theraband) Emphasize eversin and perneal strengthening (Theraband) Cntinue abve exercises and begin bicycle Week way Theraband istnics (drsiflexin, plantarflexin, eversin) Seated prpriceptive drills Leg press Knee extensin Week 8-9 Vertical squats Side and frnt lunges Lateral step-ups Week Standing prpriceptin drills Stair climbing machine Pl Prgram Swimming week 6-8 Fast-paced walking week 8-10 Running in pl week th St. New Yrk, NY (646) newyrkrth.cm

10 Rehabilitatin After Brstrm-Guld Prcedure Phase III Advanced Mtin and Strengthening Phase (12 weeks t 20 weeks fllwing surgery) Gals Prgress t full mtin Advance prpriceptive drills Increase strength, pwer, and endurance Gradually initiate sprting activities Therapeutic Exercises Cntinue strengthening exercises Theraband strengthening inversin/eversin, drsi/plantarflexin Twel gathering Standing te-calf raises Bicycle Stairclimber Vertical squats Frnt lunges Prpriceptive training Initiate Plymetric prgram Running prgram Agility drills Sprts specific training and drills Phase IV Return t Activity Phase (5 t 6 mnths after surgery) Gals Cntinue t increase strength, pwer, and endurance f lwer extremity Gradual return t sprts activities Therapeutic Exercises Begin light running prgram Cntinue iskinetic (light speed, full ROM) Cntinue eccentrics Cntinue mini squats/lateral step-ups Cntinue clsed kinetic rehabilitatin Cntinue endurance exercises Phase V Return t Activity (ver 6 mnths after surgery) Gals Advance rehabilitatin t cmpetitive sprts Achieve maximal strength and further enhance neurmuscular crdinatin and endurance Therapeutic Exercises Cntinue Strengthening prgram Clsed chain strengthening prgram Plymetric prgram Running and agility prgram Accelerate sprt specific training and drills th St. New Yrk, NY (646) newyrkrth.cm

11 Assciate Prfessr f Orthpaedics Chief, Divisin f Sprts Medicine Tel: (212) Pstperative Rehabilitatin Fllwing Mdified Brstrm-Guld Prcedure Name: Diagnsis: Date: Date f Surgery: IMMEDIATE PROTECTION PHASE (week 0-4) Gals Prtect healing tissue Decrease pain and inflammatin Retard muscular atrphy Cntrl weight-bearing frces Weight-bearing: partial weight-bearing in cast with 2 crutches fr first 4 weeks ROM: nne NO INVERSION EXERCISES Exercises N strengthening fr first 4 weeks Begin submaximal ismetrics at 4 weeks Hip abductin/adductin Straight leg raises int flexin Remve cast week 4 and place in cam walker Phase II INTERMEDIATE PHASE (Week 4-12) Gals: Prtect healing tissue Retard muscular atrphy Prgress weight-bearing tlerance Begin prpriceptive drills Weightbearing: Weight-bearing as tlerated in cam walker weeks 4-8 Discntinue cam walker at end f week 8 Place in air cast fr 3 additinal weeks ROM: begin passive drsiflexin, plantarflexin and eversin N active INVERSION past neutral fr 12 weeks Begin strengthening exercises PRE s at 75% f ppsite LE (Theraband) Emphasize eversin and perneal strengthening (Theraband) Cntinue abve exercises and begin bicycle Week way Theraband istnics (drsiflexin, plantarflexin, eversin) Seated prpriceptive drills Leg press Knee extensin Week 8-9 Vertical squats Side and frnt lunges Lateral step-ups

12 Assciate Prfessr f Orthpaedics Chief, Divisin f Sprts Medicine Tel: (212) Week Standing prpriceptive drills Stair climbing machine Pl Prgram Swimming week 6-8 Fast-paced walking week 8-10 Running in pl week Phase III ADVANCED MOTION AND STRENGTHENING PHASE (Week 12-20) Gals: Prgress t full mtin Advance prpriceptive drills Increase strength, pwer, and endurance Gradually initiate sprting activities Exercises Cntinue strengthening exercises Theraband strengthening inversin/eversin, drsi/plantarflexin Twel gathering Standing te-calf raises Bicycle Stairclimber Vertical squats Frnt lunges Prpriceptive training Initiate Plymetric Prgram Initiate: Running prgram Agility drills Sprt specific training and drills Phase IV RETURN TO ACTIVITY PHASE (Mnth 5-6) Gals: Cntinue t increase strength, pwer, and endurance f lwer extremity Gradual return t sprt activities Exercises Begin light running prgram Cntinue iskinetic (light speed, full ROM) Cntinue eccentrics Cntinue mini squats/lateral step-ups Cntinue clsed kinetic rehabilitatin Cntinue endurance exercises

13 Assciate Prfessr f Orthpaedics Chief, Divisin f Sprts Medicine Tel: (212) Phase V Return t Activity (Mnth 5-6) Gals Advance rehabilitatin t cmpetitive sprts Achieve maximal strength and further enhance neurmuscular crdinatin and endurance Exercises Cntinue Strengthening prgram Clsed chain strengthening prgram Plymetric prgram Running and agility prgram Accelerate sprt specific training and drills Cmments: Frequency: times per week Duratin: weeks Signature: Date:

14 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) PHYSICAL THERAPY LOCATIONS **Please schedule yur pst-perative physical therapy appintments BEFORE yur surgery** Other Lcatins: Manhattan Sprts and Manual Physical Therapy 10 East 33rd Street, 2nd Flr New Yrk, NY (646) Center fr Musculskeletal Care PT 333 E 38 th St, 5 th Flr New Yrk, NY (646) BROOKLYN R.P.T. Physical 335 Curt Street Cbble Hill (718) Therapy One n One PT 2133 Ralph Ave Flatlands (718) One n One PT 17 Eastern Parkway Prspect Heights (718) One n One PT th Ave Bay Ridge (718) One n One PT 1390 Pennsylvania Ave Canarsie (718) One n One PT 1715 Avenue T Sheepshead Bay (718) MANHATTAN- DOWNTOWN Health SOS 594 Bradway New Yrk (212) Occupatinal & Industrial 63 Dwning Street New Yrk (212) Orthpaedic Center Prmbility 401 Bradway New Yrk (646) MANHATTAN EAST SIDE Harkness Center fr Dance 614 Secnd Ave New Yrk (212) (PT Service) RUSK at the Men's Center 555 Madisn Ave New Yrk (646) RUSK Physical Therapy 240 E. 38th Street New Yrk (212) STAR Physical Therapy 160 E. 56th Street New Yrk (212)

15 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) Therapeutic Inspiratins 144 E. 44th St New Yrk (212) MANHATTAN UPPER EAST SIDE Health SOS 139 E. 57th Street New Yrk (212) Premier PT 170 E. 77th Street New Yrk (212) Rusk PT at Wmen 's 207 E. 84th Street New Yrk (646) Health Center SPEAR PT 120 E. 56th Street New Yrk (212) Sprts PT f NY 1400 Yrk Ave New Yrk (212) MANHATTAN UPPER WEST SIDE Premier PT 162 W. 72nd Street New Yrk (212) Sprts PT f NY 2465 Bradway New Yrk (212) MANHATTAN WEST SIDE Sprts Medicine at Chelsea 22 West 21st Street New Yrk (646) Suite 400 Chelsea Physical Therapy & 119 W. 23rd Street New Yrk (212) Rehabilitatin SPEAR Physical Therapy 36 W. 44th Street New Yrk (212) QUEENS Erg Physical Therapy P.C. Susan Schilir, PT (Hand & Upper Extremity nly) Queens Frest (718) Blvd Hills th Rad Reg Park (718) STATEN ISLAND One n One PT One n One PT 31 New Drp Lane 1 st, Flr 33 Richmnd Hill Rd Staten Island Staten Island (718) (718) LONG ISLAND Health SOS 375 Deer Park Ave Babyln (631)

16 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) Hand in Hand Rehabilitatin (Hand & Upper Extremity nly) Hme PT Slutins Bi-Cunty Physical Therapy & Rehabilitatin Bi-Cunty Physical Therapy & Rehabilitatin 346 Westbury Ave Carle Place (516) W. Old Cuntry Rd. Hicksville (516) Hillside New Hyde (718) Ave Park Willis Ave Willistn (516) Park WESTCHESTER Health SOS 1015 Saw Mill River Ardsley (914) Premier PT 223 Katnah Ave Katnah (914) PRO Sprts PT f 2 Overhill Rad Scarsdale (914) Westchester Westchester Sprts 672 White Plains Scarsdale (914) Physical Therapy, PC Rad Rye Physical Therapy and 411 Thedre Fremd Rye (914) Rehabilitatin Rye Physical Therapy and Rehabilitatin Ave 15 Nrth Bradway; Suite K White Plains (914) CONNECTICUT Premier PT 36 Old Kings Hwy S Darien (203) NEW JERSEY Jersey Central Physical Rute 27 Edisn (732) Therapy & Fitness Jag PT 34 Muntain Blvd Warren (908) Jag PT 622 Eagle Rck Ave West Orange (973)