Post-Op Instructions
These instructions cover your recovery after hip arthroscopy. Read through them before surgery and reference them during your recovery. The full Wolff Orthopaedics Surgery Packet is also available as a PDF: download the complete Surgery Instructions PDF.
Many patients also find a few simple recovery accessories (a raised toilet seat, a wedge pillow, a long-handled shoe horn) make the first weeks much easier. For medical (non-billing) questions about your surgery and recovery, please reach our Physician Assistant Grey Davenport through the Spruce App. For urgent issues, call or text 202-838-8837.
Things to Watch Out For
It is normal to have soreness around your hip after surgery. Varying degrees of soreness and sometimes numbness throughout the surgical leg from the traction used at surgery are also normal and will gradually resolve on their own. It is also not uncommon to have numbness on the side of your thigh after surgery from surgical irritation of a sensory skin nerve (the LFCN). This is normal, usually resolves with time, and has no bearing on your muscle function or recovery.
Contact Dr. Wolff at 202-838-8837 if you experience any of the following:
- A large amount of bright red bleeding through the dressing
- Excessive dizziness
- Excessive vomiting
- Fever over 101.5 degrees
- Foul-smelling or pus-like discharge
- Your medications do not stop your discomfort
- Chest pain or shortness of breath
If you are unable to reach Dr. Wolff or one of his associates, please go to the nearest emergency room.
Bandages
Your hip will have a waterproof bandage on it after surgery. You may shower with this on. It is not uncommon for the bandage to become soaked from the inside out with reddish/pink fluid — this is fluid that was continuously pumped through the hip during surgery leaking out afterwards.
If the bandage becomes too wet, either from the inside out or the outside in, you may remove it and place a dry bandage or band-aids over your incisions. Otherwise remove the dressing 3 days after surgery and cover the incisions with band-aids and gently pat them dry after showering. Do not scrub them.
Do not submerge your hip in water (no bathtubs, hot tubs, swimming pools) until wounds are fully healed (usually 10-14 days AFTER stitch removal). Do not use antibiotic ointment on your incisions — you may use vaseline or aquaphor for wound protection after the bandage is removed. If you are concerned about how the incisions look, please reach out to us with a picture. Once incisions are fully healed, some patients use a silicone scar treatment — see our recommended scar care products.
Ice and Compression
The most effective way to control pain and swelling following surgery is the use of ice and compression. If you ordered the Proventus hip wrap, you have the option of picking it up at our office or having it brought to the surgery center. If you requested a GameReady machine, it will be shipped to you directly — as soon as you get home you may begin using it at any level of temperature and compression that is comfortable.
If you have questions about the settings or working of the GameReady machine, please contact the GameReady representative directly. If you do not find it comfortable, you may remove it and use a bag of ice or alternative ice wrap. Keep a layer of clothing between the device and your skin. In general, the more you can ice your hip the less pain you will have in the first few days after surgery. As more time passes following surgery, cooling becomes less helpful — after the immediate post-operative period you will likely find it most helpful after therapy exercises or exertion at the end of the day. See our recommended cold compression wraps and accessories.
Getting Around: Crutches
You should begin putting weight on the leg which had surgery immediately post-op while walking. Use crutches to assist with weight for a minimum of 4 weeks (this may be longer depending on your exact surgical procedure) outside of the house.
Around the house, you may begin to go without crutches sooner (1-2 weeks post-op) if you are not having pain or limping when you walk. Do not limp. If you are limping, you must stay on crutches until you can walk without a limp. Using 1 crutch around the house is helpful to allow for a free hand — the crutch goes on the non-operative side.
When you use crutches, try to walk as normally as possible while putting less weight on your operative leg than you ordinarily would — the rest should be on your hands and the other leg. Do not hop on the crutches. Keep your operative-side foot flat on the ground and use it to walk — just put less weight through the leg. It is easier on your hip to rest your leg on the floor than to use all of the muscles around your hip to hold your foot/leg off the floor. Unless we specifically instruct you otherwise, you will be weight-bearing as tolerated after surgery (no less than 30% weight bearing on the operative leg).
The crutches are not solely for decreasing weight bearing — they slow you down and help prevent overuse of the muscles around the hip, which is the most common problem post-op.
Padded crutch grips and accessories can also make life on crutches significantly more comfortable — see our recommended accessories. Please take the time to review our videos on how to use the crutches: Crutch Training.
Hip Flexion
One of the most common complications after hip arthroscopy is hip flexor tendinitis — an irritation and inflammation of the muscles and tendons that lift the leg. These muscles are particularly at risk after hip arthroscopy because of their location and function. If hip flexor tendinitis develops, it can be very painful and significantly slow down recovery.
To minimize the risk, avoid actively lifting your surgical leg when possible. Use your hands or non-surgical leg to support and lift the surgical leg when getting in and out of the car, bed, the bathtub, etc.
The goal is not to avoid all hip flexor activity, just to minimize it and avoid overuse. You will typically need to assist all leg lifting for the first month or so but should do it until you are able to lift it on your own without pain. This will be further discussed in the PT protocol, but hip flexor strengthening should NOT be part of your rehab.
Bed Mobility and Transfers
When moving around in bed, the car, couches, and chairs you may find it painful and difficult to maneuver your surgical leg at first. Using your arms and non-surgical leg to help support and lift your surgical leg will improve your mobility and comfort.
Sitting
Sitting upright can be uncomfortable for a while after hip arthroscopy, especially for long periods. Try not to sit perfectly upright with the hips at a 90-degree angle, and try not to sit with your back unsupported. If you need to sit for long periods, try reclining slightly and having good back support to take pressure off your hips. With time, you will be able to sit for longer amounts of time without discomfort — it typically takes months to have no discomfort with prolonged sitting.
Sleep Positioning
Sleep is an important part of recovery — our bodies do most of their healing when we’re resting, so getting a good night’s sleep is essential. Like sitting, sleeping can be (and often is) difficult after hip surgery.
There are no strict guidelines, but we recommend sleeping on your back with pillows underneath your whole surgical leg, or on your non-surgical side with a long pillow between your legs/knees. Sleeping on your stomach is also OK if it doesn’t feel like it pulls too much in front of your hip. While we do not recommend sleeping on your surgical side for several weeks, don’t panic if you inadvertently end up that way in your sleep — it may result in some increased pain and discomfort, but it doesn’t ruin the surgery.
Bracing
Bracing is only used for patients who undergo gluteal or hamstring repairs. If you require a brace, you will be fit for it before or on the day of surgery. Wear the brace when you are up and around for an extended period — this protects the repair and unloads pressure from your hip. You do not need to wear it while sitting or in bed. You may also forgo the brace for short distances around home or office.
CPM Machine
We do not use these — they tend to be quite cumbersome and have not provided additional benefit in our experience.
Sequential Compression Devices (SCDs)
You may be given SCDs at the surgery center to prevent blood clots. These go on your lower legs after surgery. They come with a charger and need to be charged after about 8 hours of use. Wear them when you will be immobile for a prolonged period in the first 2 weeks after surgery. You can wear them at night if you wish, however it’s not required (they can be a bit noisy and we want you to get good sleep!).
Ankle Pumps
Ankle pumps are to be done primarily during the first 2 weeks when you are relatively sedentary. They improve circulation and can help relieve some of the pain and stiffness in the foot and ankle that is common after surgery.
They can be done with the leg elevated, lying down, or sitting: flex the ankle of the operative leg toward the knee as far as possible and hold for five seconds, then push the ankle down like stepping on the accelerator pedal of a car and hold for five seconds. Repeat ten times and do these in sets of ten as often as possible during the day (at least ten times a day).
Driving
Assuming you have a driver’s license, you may drive as soon as you have stopped taking narcotic pain medications and can safely control your leg (typically 1.5 to 2 weeks after surgery).
Particularly if you have had surgery on your right leg, you should practice driving in an empty parking lot prior to driving on a street to be sure you are safe to be on the road. If you drive a stick shift, it may be a few additional days before you can drive — just try it out first and see how you feel. If you have pain or feel like you’re not up to controlling the vehicle, wait and try again a few days later.
Post-Operative Medications
The following prescriptions will be e-prescribed to the pharmacy you provided in your intake forms. If you prefer a different pharmacy than the one we have on record, please reach out to us at least a week prior to surgery. These are all for AFTER surgery.
Percocet (oxycodone-acetaminophen) 5/325mg
Post-op pain medication to be taken as needed. You should only need this for 2 to 4 days following surgery and may not need it at all. Regular Tylenol (acetaminophen) can also be taken with this or instead of this.
Keep in mind that the maximum dosage of acetaminophen per day is 4,000mg, and each Percocet tablet contains 325mg.
A common side effect of narcotics is constipation, so it’s helpful to also use a stool softener like MiraLAX or Colace to combat this. Percocet may also cause nausea, vomiting, and sedation, which is why we do not recommend taking it “pre-emptively.”
Mobic / Meloxicam 15mg (with food)
Once a day for 30 days following surgery. You may start the day of surgery once you get home and have eaten. It may cause an upset stomach or GERD/acid reflux-like symptoms — let us know if they are not resolved with the antacid (Prilosec or Omeprazole).
We also give 1 refill of this prescription. Once you finish the first 30 days, see how you feel. If you have pain after stopping the anti-inflammatory, refill the medication and start taking it again. You may try to decrease the dose slowly (skipping daily doses).
Alternatively, you may be prescribed a different anti-inflammatory (Ibuprofen, Celebrex, Naproxen, etc.). Use this as directed. Do not take more than one of these different medications at a time.
Prilosec (omeprazole) 20mg
Antacid to be taken for 14 days to prevent possible side effects (acid reflux) caused by taking meloxicam AND aspirin. If you are already prescribed an antacid, you may continue your prescription and disregard any that we may have called in for you.
Zofran (ondansetron) ODT 4mg tablets
Anti-nausea medication to be taken as needed immediately following surgery to prevent nausea and vomiting that may occur after anesthesia. If your pain medication causes nausea, you may also use this medication to help reduce the effects.
Enteric-coated Aspirin 81mg
An anti-coagulant to be taken starting THE DAY AFTER SURGERY for a full 14 days after surgery to prevent blood clotting. If you are 25 or under and have no risk factors (no personal or family history of blood clots, are not taking oral contraceptives, non-smoker, etc.), you may not be given this. Alternatively, if you believe you are at increased risk for whatever reason, please let us know.
Losartan Potassium 25mg
To be taken for 6 weeks postoperatively for the prevention of adhesions/scar tissue formation in your hip. Losartan is commonly used as a blood pressure medication, but this is a low dose and should have minimal effect on blood pressure. If you are already taking any type of blood pressure medication, please let us know before starting the losartan. We recommend taking this one at night before going to bed.
Please contact our Physician Assistant Grey Davenport at grey@andrewwolffmd.com if you have any questions regarding the use of these medications.
Additional Resources
We are committed to doing everything we can to get you back to your lifestyle. Contact us if you have any questions.
Additional resources to help your recovery: