a. Stop taking any anti-inflammatories (aleve, ibuprofen, aspirin, motrin, etc) 1 week prior to surgery, as these medications increase your risk of bleeding. You MAY take Tylenol as needed for pain. If you are on a prescribed blood thinner (Plavix, Coumadin, Xarelto, etc), you should consult the prescribing provider prior to discontinuing these medications.

b. Stop any capsule supplements, such as fish oil, as these increase your risk of bleeding.

c. Stop any estrogen hormone treatment – if possible – two to four weeks prior to surgery, as estrogens increase the risk of blood clot (DVT) after surgery. We recommend not restarting these medications until approximately 2 weeks after surgery. Please consult Dr. Ranawat’s team and/or your medication prescriber if there are any concerns with stopping current medication.

d. For clarification of prescription medications you should or should not take on the day of surgery, please call your prescribing provider.

a. You will get a call from the hospital call center after 2pm on the business day before surgery. They will provide you with the following information:
i. Instructions for eating and drinking the day of surgery
ii. Time of arrival to the hospital
iii. What to bring and wear to go

b. The number to the call center is 212-606-1710. Please do not call them unless you have missed their phone call or have an additional question. They will not be able to tell you any information about your surgery time prior to 2 pm.

c. While we will try our best to honor requests for a certain time frame for your procedure, we cannot make any guarantees, as surgery order is determined by multiple factors such as type of surgery, patient age, comorbidities, etc.

a. Time of arrival is generally two hours prior to the scheduled surgery time. You will check in at registration and then proceed to the OR waiting area.

b. You will then be called in to the pre-operative holding area, where you will have a general work-up by a nurse and physician assistant. An IV will be placed. If necessary, the area to be operated on will be shaved and cleaned. You will also meet the anesthesiologist and Dr. Ranawat prior to going to the OR. The surgical site will be confirmed multiple times and initialed by Dr. Ranawat.

c. After surgery, you will recover in the post-anesthesia care unit (PACU). You will be here for about 2 hours, but this can vary depending on your response to anesthesia and recovery. Once you are ready for discharge, you will be wheeled out to the hospital entrance by a patient care assistant where you will be helped into your vehicle.

d. While you may arrive by yourself, you must have an escort to take you home from the hospital after surgery.

a. We recommend regional anesthesia. This is where the anesthesiologist performs a nerve block or spinal which will numb the area where surgery will be performed. You will also get medication to let you go to sleep; however, you will still be able to breath on your own. This is different from traditional general anesthesia where multiple medicines are used to keep you from moving, feeling, and reducing pain during surgery, and you are also put on a breathing machine.

b. Benefits of regional anesthesia include better pain control post-surgery, less medication side effects such as nausea, lower risk of pneumonia or other airway issues. It has a lower overall risk profile when compared to general anesthesia.

c. You will be able to meet with the anesthesiologist the day of surgery and discuss options and ask questions. Regional anesthesia may not be indicated for everyone, but we do try to use it in most cases.

d. If you have prior issues with anesthesia or want to meet with the anesthesiologist prior to surgery, please let Dr. Ranawat’s team know so we can schedule a pre-operative anesthesia consultation.

a. This varies widely depending on the type of procedure you are having. When you meet with Dr. Ranawat and are indicated for surgery, you will be given a sample therapy protocol to review. This will let you know approximately how long you will be in a brace, be on crutches, and be in therapy.

b. If you did not receive a protocol, or if you lost your copy, feel free to reach out to Dr. Ranawat’s office for another copy of the sample post-operative protocol for your specific surgery.

a. This varies vastly based on each individual’s commute, type of work, and ability of the job to make accommodations. Some general guidelines are listed:
i. Basic arthroscopic debridements: downtime is generally minimal. You can return to work as early as a day or two after surgery, but some people prefer to take 4-5 days. If you have a heavy duty job, you may want to consider up to 4-6 weeks off, unless your job can make modifications.
ii. Reconstruction or repair surgeries: generally, these surgeries will require a brace and/or assistive device for 4-8 weeks. This is often the determining factor for return to work. If you can commute to work with a brace or crutches and have a sedentary job, you could potentially return to work as early as a week after surgery, but many people prefer to wait until they are more mobile. Of note, if you have a shoulder surgery, you can type and write while in a sling.
iii. Osteotomy surgeries: these procedures have the longest recoveries. Consider taking off 2-3 months unless your job can make accommodations for limited mobility.

b. Considerations:
i. Do you drive to work? Are there alternate means of commuting to work if you cannot drive? (Car service, bus, carpool, train, etc)
ii. Does your work have light duty or can they make other accommodations to allow for post-surgery limitations?
iii. Does your work allow working from home?

a. This depends on several factors, such as the type of surgery, necessity of an assistive device after surgery, and whether surgery is on the right or left leg.
i. As a general rule for driving after surgery, you should be off assistive devices or out of your sling, off narcotic medication, and feel confident in your ability to respond in an emergency situation.
ii. If you have surgery on your left leg and you drive an automatic vehicle, you may be able to drive as early as 2-3 weeks after surgery as long as you are off narcotics and feel confident in your ability to respond in an emergency situation.

b. When beginning to drive again, start with short distances and routes that are familiar.

a. You will be given wound care instructions upon discharge after surgery. A general rule for bathing is you should not get a non-arthroscopic (longer than a centimeter) incision wet until the sutures are removed, and you should not submerge or soak in water for three weeks after any surgery.

b. You can shower while keeping the incision or dressing dry by using a cast cover bag, saran wrap, or garbage bag to cover the surgical site.

c. Some incisions are amenable to a waterproof dressing that will let you shower immediately. You will be notified if this is the case.

a. For the majority of our procedures, we recommend starting outpatient physical therapy within 3-5 days of your surgery. You are provided with a physical therapy script upon discharge which you will need to take to your therapist on your first visit.

b. You can go to any therapist that is convenient for you and takes your insurance. If you are having a hip arthroscopy, we do recommend that you try to see a hip-certified therapist if possible (we can provide a list). If you are unable to see one regularly, please set up an appointment with an HSS hip therapist on the same day as your follow-ups with Dr. Ranawat.