CenterforMusculoskeletalCare333E.38thSt,NewYork,NY10016Tel:(646)501-7223/Fax:(646)754-9505/www.NewYorkOrtho.com
Laith M. Jazrawi, MD AssociateProfessorofOrthopaedics Chief-DivisionofSportsMedicineTel:(646)501-7223
INSTRUCTIONS FOR SURGERY Inordertomakeyouradmissionandhospitalstaysmoothandmorepleasant,pleasecomplywiththefollowinginstructions:
c IfyoursurgeryisonMONDAY,pleasereportto:
NYUHospitalforJointDiseases301East17thStreetNewYork,NY10003
Ifindicatedbyyourphysician,scheduleyourpre-surgicaltesting,locatedat
3032ndAvenue,1stFloorSuite16
NewYork,NY10003
c IfyoursurgeryisonFRIDAY,pleasereportto:
NYULangoneOutpatientSurgeryCenter339East38thStreetNewYork,NY10016
Ifindicatedbyyourphysician,pleasecall212-263-5985toscheduleyourpre-surgicaltesting,locatedat
240East38thSt.
NewYork,NY10016MezzanineLevel
*Onebusinessdaypriortoyoursurgery,hospitalstaffwillcontactyoutofinalizeyoursurgerytime.
A. Bringjogging/warm-uppants,shorts/skirtifhavingkneesurgery.
B. Bringashirt/blousethatbuttonsopeninfrontinsteadofapulloverifhavingshoulder/elbowsurgery.
C. Ifyouowncrutches,bringthemwithyou,ifhavingknee,ankleorhipsurgery.
D. Bringallmedicationsoralistofcurrentmedicationsyouaretakingwithyou.Alsobringalistofany
allergies.
E. Bloodpressuremedicationshouldbetakenasusualwithasipofwaterthemorningofsurgery.DONOTtakeadiureticorfluidpill.Seizuremedicationsmaybetakenbeforesurgery.
F. DONOTtakeoraldiabetesmedications(pills)thenightbeforeorthedayofsurgery.Ifyouareoninsulin,
DONOTuseinsulinthemorningofsurgeryunlessyouarea"problemdiabetic"inwhichcaseyouneedtoconsultyourphysicianregardingtheproperinsulindoseforyoutousepriortosurgery.
CenterforMusculoskeletalCare333E.38thSt,NewYork,NY10016Tel:(646)501-7223/Fax:(646)754-9505/www.NewYorkOrtho.com
Laith M. Jazrawi, MD AssociateProfessorofOrthopaedics Chief-DivisionofSportsMedicineTel:(646)501-7223
G. PleaseDONOTwearmakeupornailpolishthedayofsurgery.Youwillneedtoremovecontactlens(includingextendedwear),denture,orbridgespriortosurgery.Pleasebringyourowncontainersforstorage.
H. Leavealljewelryandvaluablesathome.Thehospitalwillnottakeresponsibilityforlostormissingitems.
I. Youneedtoreportanyskinirritation,fever,cold,etc.,toDr.Jazrawi.
J. Youwillneedtobringyourinsurancecard/informationwithyou.
K. DONOTeat,drink(includingwater),chewgum,candy,smokecigarettes,cigars,usesmokelesstobacco,etc.,aftermidnightthenightbeforesurgeryorthemorningofyoursurgery.Theonlyexceptionisasipofwatertotakenecessarymedicationsthemorningofsurgery.
L. Youmustarrangesomeonetodriveyouhomewhenreadytoleavethehospital.Youwillnotbeallowedto
driveyourselfhomeaftersurgery.Wecanassistyouifyouneedtransportationtotheairportorhotel,however,youneedtoletusknowinadvance(ifpossible)sowecanmakethearrangement.
M. NOTE:DONOTtakeanyaspirin,aspirinproducts,anti-inflammatories,CoumadinorPlavixatleast5days
priortosurgery.YouareallowedtotakeCelebrexuptoyourdayofsurgery.Ifyourmedicaldoctororcardiologisthasyouonanyoftheabovemedications.Pleasecheckwithhim/herbeforediscontinuingthemedication.YoumayalsotakeTylenolorExtra-StrengthTylenolifneeded.
NonsteroidalAnti-Inflammatory(Arthritis)Medications:
SomeofthemostcommonnamesforfrequentlyusedNSAID'sinclude:Motrin,Indocin,Nalfon,Naprosyn,Naprelan,Arthrotec,Tolectin,Feledene,Voltaren,Clinoril,Dolobid,Lodine,Relafen,Daypro,Advil,Aleve,Ibuprofen.Yourfirstfollowupappointmentisusuallyscheduledforapproximately2weeksafteryoursurgeryatthe333
East38thstreetoffice.Thedateandtimeofyourfollow-upis__________________________.
Ifyoucannotmakethisappointmentorneedtochangethetime,pleasecontacttheoffice.Ifyouhaveanyquestionsregardingyoursurgery,pleasecontacttheofficeat646-501-7223option4,option2orviatheinternetatwww.newyorkortho.com
Laith M. Jazrawi, MD Associate Professor of Orthopaedics Chief - Division of Sports Medicine Tel: (646) 501-7223
Home Supplies For Your Surgery Laith M. Jazrawi M.D.
Open Surgery
A. Open knee surgery (ACL reconstructions, ALL (Anterolateral ligament) reconstructions, Autologous
Chondrocyte Implantation, PCL reconstructions, High tibial osteotomy, Distal femoral osteotomy,
Posterolateral corner reconstruction, MCL reconstruction, OATS (osteochondral autograft), Osteochondral
allograft,)
a. You will need 4x4 (or similar size) waterproof bandages for fourteen days. Bandage changes for
open knee surgery done post-op day #3.
B. Open shoulder surgery , (Biceps Tenodeis, Latarjet, Open capsulorrhaphy, Glenoid reconstruction using
Distal tibial allograft):
a. You will need 4x4 (or similar size) waterproof bandages for fourteen days. Also, a box of Bandage
changes for open shoulder surgery are done post-op day #3.
C. Open Ankle Surgery (Achilles Tendon Repair, Os Trigonum Excision, Ankle OCD, Modified Brostrom-
Gould Procedure, Peroneus Longus/Brevis Repair)- You do not have to worry about dressing changes as
your leg will be in splint/cast for the first two weeks
D. Open Elbow surgery (Distal Biceps Repair, LCL Reconstruction, Radial Head or Capitellum ORIF, Radial
Head Replacement/Resection, Triceps Repair, UCL Reconstruction – Tommy John Surgery)- You do not
have to worry about dressing changes as your arm will be in splint/cast for the first two weeks. For Tennis
Elbow surgery (lateral epicondylitis) and Golfer’s Elbow Surgery (medial epicondylitis), dressing
changes are are started on post-op day #3. You will need 4x4 (or similar size) waterproof bandages for
fourteen days.
E. Hamstring repair You will have a special dressing placed on at the time of surgery that will be kept
on for the first 2 weeks after surgery. You will then need 4x4 (or similar size) Tegaderm or Telfa
waterproof dressings. Also, a box of 4" by 4" gauze sponges if there is bleeding at the incision site.
Arthroscopic Surgery
A. For Arthroscopic shoulder, elbow, knee, or ankle surgery:
a. Regular adhesive bandages (“Band-aids”) can be used for arthroscopic portals x 2 weeks.
b. If biceps tenodesis was performed, use 4x4 (or similar size) waterproof bandages on
wounds.
c. In general, dressing changes for arthroscopy are done on post operative day 3
Center for Musculoskeletal Care 333 E. 38th St, New York, NY 10016
Tel: (646) 501-7223/ Fax: (646) 754-9505 / www.NewYorkOrtho.com
Post-OperativeMedicationAdministration
KneeArthroscopy
• Pain-Motrin800mg.1tabthreetimesdaily,asneeded• Adjunctivepain:Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursas
neededforadjunctivepain
KneeLigamentReconstruction
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• BreakthroughPain–Dilaudid(Hydromorphone)2mg;2-3tabsevery8hoursasneededfor
adjunctivepain.• Antibiotic–Keflex500mg;Onetab4timesdailyx4days
o Keflexallergy–Clindamycin300mg;Onetabtwicedailyx7days.• Constipation–Docusate(Colace)100mg;1tabtwicedailyasneeded.• DVTprophylaxis-Aspirin81mg;2tabsdailyx14days• ****AntibioticsandAspirinstartpost-operativeday#1
Non-weightbearingLowerExtremitySurgery(MeniscalRepair,MeniscalRootRepair,DistalFemoralOsteotomy,HighTibialOsteotomy,TibialTubercleOsteotomy,CartilageTransplant)
• Antibiotic–Keflex500mg;Onetab4timesdailyx4dayso Keflexallergy–Clindamycin300mg;Onetabtwicedailyx7days.
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• AdjunctivePain–Dilaudid(Hydromorphone)2mg;2-3tabsevery8hoursasneededfor
adjunctivepain.• Constipation–Docusate(Colace)100mg;1tabtwicedailyasneeded.• DVTprophylaxis-Aspirin81mg;2tabsdailyx14days• ******AntibioticsandAspirinstartpost-operativeday#1
Shoulder/ElbowSurgery
• Antibiotic–Keflex500mg;Onetab4timesdailyx4dayso Keflexallergy–Clindamycin300mg;Onetabtwicedailyx7days.
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• AdjunctivePain–Dilaudid(Hydromorphone)2mg;2-3tabsevery8hoursasneededfor
adjunctivepain.• Constipation–Docusate(Colace)100mg;1tabtwicedailyasneeded.• DVTProphylaxis-Aspirin81mg;2tabsdailyx14days
Post-OperativeMedicationAdministration
KneeArthroscopy
• Pain-Motrin800mg.1tabthreetimesdaily,asneeded• Adjunctivepain:Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursas
neededforadjunctivepain
MeniscalRepair,MeniscalRootRepair
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• AdjunctivePain–Dilaudid(Hydromorphone)2mg;2-3tabsevery8hoursasneededfor
adjunctivepain.• Constipation–Docusate(Colace)100mg;1tabtwicedailyasneeded.• DVTprophylaxis-Aspirin81mg;2tabsdailyx14days• ******Aspirinstartspost-operativeday#1
KneeLigamentReconstruction
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• BreakthroughPain–Dilaudid(Hydromorphone)2mg;2-3tabsevery8hoursasneededfor
adjunctivepain.• Antibiotic–Keflex500mg;Onetab4timesdailyx4days
o Keflexallergy–Clindamycin300mg;Onetabtwicedailyx7days.• Constipation–Docusate(Colace)100mg;1tabtwicedailyasneeded.• DVTprophylaxis-Aspirin81mg;2tabsdailyx14days• *****AntibioticsandAspirinstartpost-operativeday#1
Non-weightbearingLowerExtremitySurgery(DistalFemoralOsteotomy,HighTibialOsteotomy,TibialTubercleOsteotomy,CartilageTransplant)
• Antibiotic–Keflex500mg;Onetab4timesdailyx4dayso Keflexallergy–Clindamycin300mg;Onetabtwicedailyx7days.
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• AdjunctivePain–Dilaudid(Hydromorphone)2mg;2-3tabsevery8hoursasneededfor
adjunctivepain.• Constipation–Docusate(Colace)100mg;1tabtwicedailyasneeded.• DVTprophylaxis-Aspirin81mg;2tabsdailyx14days• ******AntibioticsandAspirinstartpost-operativeday#1
Shoulder/ElbowSurgery
• Antibiotic–Keflex500mg;Onetab4timesdailyx4dayso Keflexallergy–Clindamycin300mg;Onetabtwicedailyx7days.
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• AdjunctivePain–Dilaudid(Hydromorphone)2mg;2-3tabsevery8hoursasneededfor
adjunctivepain.• Constipation–Docusate(Colace)100mg;1tabtwicedailyasneeded.• DVTProphylaxis-Aspirin81mg;2tabsdailyx14days
Anklefracturesurgery&AchillesTendonSurgery
• Antibiotic–Keflex500mg;Onetab4timesdailyx4dayso Keflexallergy–Clindamycin300mg;Onetabtwicedailyx7days.
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• AdjunctivePain–Dilaudid(Hydromorphone)2mg;2-3tabsevery8hoursasneededfor
adjunctivepain.• Constipation–Docusate(Colace)100mg;1tabtwicedailyasneeded.• DVTProphylaxis-Aspirin81mg;2tabsdailyx14days• ****AntibioticsandAspirinstartPOD#1
Anklearthroscopy+/-MicrofractureandAchillesrepair
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• DVTProphylaxis-Aspirin81mg;2tabsdailyx14days• ****Aspirinstartspost-operativeday#1
Hamstringrepair
• Antibiotic–Keflex500mg;Onetab4timesdailyx4dayso Keflexallergy–Clindamycin300mg;Onetabtwicedailyx7days.
• Pain-Percocet(Oxycodone/Acetaminophen)10/325;Onetabevery6hoursasneeded.• AdjunctivePain–Dilaudid(Hydromorphone)2mg;2-3tabsevery8hoursasneededfor
adjunctivepain.• Constipation–Docusate(Colace)100mg;1tabtwicedailyasneeded.• DVTProphylaxis-Aspirin81mg;2tabsdailyx14days• ****AntibioticsandAspirinstartPOD#1
CenterforMusculoskeletalCare333E.38thSt,4thFloor,NewYork,NY10016Tel:(646)501-7223/Fax:(646)754-9505/www.NewYorkOrtho.com
Laith M. Jazrawi, MD AssociateProfessorofOrthopaedics Chief-DivisionofSportsMedicineTel:(212)598-6784
Post-Operative Instructions Open Elbow Surgery, Golfers Elbow Surgery
DayofSurgery
A. Dietastolerated.B. Painmedicationasneededevery6hours.C. Icingisimportantforthefirst5-7dayspost-op.Whilethepost-opdressingisinplace,icingshouldbedone
continuously.Oncethedressingisremovedonthefirstorsecondday,iceisappliedfor20-minuteperiods3-4timesperday.Caremustbetakenwithicingtoavoidfrostbite.
D. Ifyouhaveasplintorhalfcast,youwillstartPTafterthesplintisremovedintheofficeatyourfirstpostoperativeappointmentwhichisusuallyat2weeks
FirstPost-OperativeDay
A. ContinueicingB. Youwillneedtokeepyourincisiondrywhentakingashower.Dothisforabout2weeksaftersurgery.If
youhaveasplintorhalfcast(hardshell)leaveitdry.Noneedtododressingchangesuntilyourfirstfollow-upvisitat2weekspost-op.
SecondPost-OperativeDay
A. ContinueicingThirdPost-OperativeDayUntilReturnVisit
A. Continueicepackasneeded.B. Ifyoudon’thaveasplitorhalfcast,youmayremovesurgicalbandageafteryoushowerandapplya
waterproofbandage(maybepurchasedatyourlocalpharmacy)tothewounds.Pleaseensurethatthebandageislargeenoughtocompletelycovertheincision.Applyafreshwaterproofbandageaftereachshower.Ifyouhavesplintyoudonotneedtochangeanything.Keepextremitydry
Callouroffice@646-501-7223option4,option2toconfirmyourfirstpostoperativevisit,whichisusuallyabout1-2weeksaftersurgery.Ifyouareexperiencinganyproblems,pleasecallourofficeorcontactusviatheinternetatwww.newyorkortho.com.
Laith M. Jazrawi, M.D. Chief, Division of Sports Medicine Associate Professor of Orthopaedic Surgery
Tel: (646) 501-7223 option 4, option 2 Fax: (646) 501-7234 Web: newyorkortho.com
Center for Musculoskeletal Care • 333 East 38th Street, New York, NY 1001 • (646) 501-7070 • cmc.med.nyu.edu
Post-Operative Rehabilitation Following Golfers Elbow Surgery
Name: Date:
Diagnosis: DateofSurgery:
PhaseI–Days1-7
• Goalso Improve/regainofrangeofmotiono Retardmuscularatrophyo Decreasepain/inflammation
• Day1-7o Movementofwristandfingersfor2minutes
§ 3-5x/dayo IceandNSAIDsusedforpaincontrolo Lookforsignsofwoundinfection:
§ Excessiveswelling,warmth,redness,oozingfromtheincision,fevero Day3:Showeringisallowed,withbandagesoffo Gentlepain-freeelbow,wristandshoulderROMisstartedo Compression/ice4-5timesdaily
• Day7-17o MoreaggressiveROMencourageinandoutofshowero Goalforday17are80%ofnormalelbowROMo Resumelightelbowactivitiesonlyo continueisometricsandgrippingexerciseso continueuseofice
• Day18-21o Submaximalisometricsarestartedo Beginantigravitywristflexion,extension,supinationandpronationwithoutpain
§ Ifpainful:utilizecounterforcebraceduringexerciseo Oncepatientcanperform30repswithoutpaintheycanprogresstoa1-poundweight
orlightresistanceband.§ Allexercisesareperformedwiththeelbowbentto90⁰andrestingonatableor
lowerextremityo Overpressureintoextension(3-4timesdaily)
Laith M. Jazrawi, M.D. Chief, Division of Sports Medicine Associate Professor of Orthopaedic Surgery
Tel: (646) 501-7223 option 4, option 2 Fax: (646) 501-7234 Web: newyorkortho.com
Center for Musculoskeletal Care • 333 East 38th Street, New York, NY 1001 • (646) 501-7070 • cmc.med.nyu.edu
o Continuejointmobilizationtechniqueso Biceps,triceps,wristflex/ext,sup/pronatorso Continueuseoficepost-exercise
PhaseII–IntermediatePhase
• Goalso Increaserangeofmotiono Improvestrength/power/enduranceo Initiatefunctionalactivities
• Week3to6o Therapeuticexercises:
§ Rotatorcuff,elbowandscapularstabilizationtrainingwithlightresistance§ Aerobicconditioningonstationarybikeortreadmill
o Overpressureintoelbowextensiono ContinuePREprogramforelbowandwristmusculatureo Initiateshoulderprogram(Thrower’sTenShoulderProgram)o Continuejointmobilizationo Continueuseoficepost-exercise
PhaseIII–AdvancedStrengtheningProgram
• Goalso Improvestrength/power/enduranceo Gradualreturntofunctionalactivities
• CriteriatoEnterPhaseIIIo Fullnon-painfulROMo Nopainortenderness
• Week8to12o ContinuePREprogramforelbowandwristo Continueshoulderprogramo Continuestretchingforelbow/shouldero InitiateIntervalprogramandgraduallyreturntosportingactivitieso Patientisallowedtoreturntoathleticsoncetheirgripstrengthisnormal.
Comments:
Frequency: timesperweek Duration: weeks
Signature: Date:
Laith M. Jazrawi, MD AssociateProfessorofOrthopaedics Chief-DivisionofSportsMedicineTel:(646)501-7223
PHYSICALTHERAPYLOCATIONS**Pleasescheduleyourpost-operativephysicaltherapyappointmentsBEFOREyoursurgery**
ManhattanSportsandManualPhysicalTherapy
10East33rdStreet,2ndFloorNewYork,NY10016(646)487-2495www.msmpt.com
CenterforMusculoskeletalCarePT
333E38thSt,5thFloorNewYork,NY10016(646)501-7077
OtherLocations:BROOKLYN R.P.T.PhysicalTherapy�
335CourtStreet� CobbleHill 11231
(718)855-1543
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HealthSOS� 594Broadway� NewYork 10012 (212)343-1500Occupational&IndustrialOrthopaedicCenter
63DowningStreet
NewYork
10014 (212)255-6690
Promobility� 401Broadway NewYork 10013 (646)666-7122MANHATTAN–EASTSIDE HarknessCenterforDance(PTService)
614SecondAve NewYork 10003 (212)598-6054
RUSKattheMen'sCenter�� 555MadisonAve NewYork
10022 (646)754-2000
RUSKPhysicalTherapy� 240E.38thStreet NewYork
10016 (212)263-6033
STARPhysicalTherapy� 160E.56thStreet NewYork 10022 (212)355-7827
Laith M. Jazrawi, MD AssociateProfessorofOrthopaedics Chief-DivisionofSportsMedicineTel:(646)501-7223
TherapeuticInspirations 144E.44thSt NewYork
10017 (212)490-3800
MANHATTANUPPEREASTSIDE
HealthSOS� 139E.57thStreet NewYork 10022 (212)753-4767
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RuskPTatWomen'sHealthCenter
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10028 (646)754-3300
SPEARPT 120E.56thStreet NewYork 10022 (212)759-2211
SportsPTofNY� 1400YorkAve NewYork 10021 (212)988-9057
MANHATTANUPPERWESTSIDE
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SportsPTofNY� 2465Broadway NewYork 10025 (212)877-2525
MANHATTANWESTSIDE
SportsMedicineatChelsea 22West21stStreetSuite400
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ChelseaPhysicalTherapy&Rehabilitation
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SPEARPhysicalTherapy 36W.44thStreet NewYork 10036 (212)759-2280
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SusanSchiliro,PT(Hand&UpperExtremityonly)
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LONGISLAND
HealthSOS� 375DeerParkAve Babylon� 11702 (631)321-6303
Laith M. Jazrawi, MD AssociateProfessorofOrthopaedics Chief-DivisionofSportsMedicineTel:(646)501-7223
HandinHandRehabilitation(Hand&UpperExtremityonly)�
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HomePTSolutions 111W.OldCountryRd.
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WestchesterSportsPhysicalTherapy,PC
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