This joint replacement pain control protocol from Dr. Sean Gallagher at ATX Orthopedics in Austin, TX uses a multimodal approach to maximize comfort while minimizing opioid use after hip or knee replacement.

After your total hip replacement or total knee replacement surgery in Austin, TX, effective pain management is critical to a fast and smooth recovery. This multimodal pain control protocol from Dr. Sean Gallagher at ATX Orthopedics is designed to minimize narcotic use and maximize comfort using a combination of medications targeting different pain pathways. Dr. Gallagher serves patients throughout Austin, Cedar Park, Round Rock, Westlake, and South Austin.

TOTAL JOINT PAIN CONTROL PROTOCOL

(multi-modal pain management involves taking medications together that target different pain receptors)

BASELINE NON-NARCOTIC PAIN MEDS (take these around the clock)

1. 1. Tylenol (acetaminophen) 1000mg by mouth every 6 hours
   2. Decadron (dexamethasone) 4mg by mouth twice daily starting the evening of surgery (for 5 days ONLY) (if prescribed)
   3. NSAID (Non-Steroidal Anti-Inflammatory Drug)  CHOOSE ONE (take with food for 6 weeks):

1. 1. 1. Advil/Motrin (ibuprofen) 600mg by mouth every 6 hours
      2. Aleve (naproxen) 440mg by mouth twice daily
      3. Celebrex (celecoxib) 200mg by mouth twice daily
      4. Mobic (meloxicam) 7.5mg by mouth twice daily
      5. Voltaren (diclofenac) 75mg by mouth twice daily

     4.  (IF AVAILABLE WITH COUPON)  Journavax (suzetrigine) 50mg by mouth twice daily (TAKE 2 tabs 2-3 hours prior to                                                                                    surgery)

BREAKTHROUGH NARCOTIC PAIN MEDS (take these every 4-6 hours only as needed)

1. Tramadol 50mg 1-2 tabs by mouth every 4-6 hours as needed for pain (no refills after 6 wks postop)
2. Oxycodone (same narcotic in Percocet) 5mg ½ – 4 tabs by mouth every 4-6 hours as needed for pain (no refills after 6 wks postop)

OTHER MEDS

1. Tranexamic Acid (TXA) 650mg 2 tabs by mouth daily starting the evening of surgery (for 5 days ONLY) (decreases bleeding)
2. Aspirin 81mg by mouth twice daily starting the morning after surgery for 30 days (TO PREVENT BLOOD CLOTS (DEEP VENOUS THROMBOSIS (DVT))
3. Cephalexin (KEFLEX) 500mg 1 tab by mouth every 6 hours to complete 24 hour of antibiotics (OK TO TAKE IF ALLERGIC TO PENICILLIN OR SULFA FYI) or possible antibiotic alternative for 24 hours…
4. (optional supplement- not available via prescription) Diosmin 1 tab by mouth twice daily for 2 months (for leg swelling/edema) available online HERE.

WEANING/STOPPING INSTRUCTIONS: STOP NARCOTICS IF PAIN DOES NOT REQUIRE THEM OR IF YOU EXPERIENCE SIDE EFFECTS (NAUSEA/VOMITING/CONSTIPATION/FEELING ‘LOOPY’)

ORDER OF DISCONTINUATION: STOP OXYCODONE FIRST, TRAMADOL SECOND, TYLENOL THIRD.  CONTINUE NSAID IF POSSIBLE FOR 6 WEEKS POSTOP.

DO NOT FORGET TO TAKE YOUR ASPIRIN 81mg BY MOUTH TWICE DAILY FOR 30 DAYS POSTOP TO PREVENT BLOOD CLOTS (DEEP VENOUS THROMBOSIS (DVT) starting the morning after surgery.  Sometimes Eliquis 2.5mg by mouth twice daily for 6 weeks is used instead of Aspirin for high risk patients.

FOR ANY PRESCRIPTION DRUGS, WE STRONGLY RECOMMEND:

https://www.costplusdrugs.com/

Written by Sean Gallagher, MD, Board-Certified Orthopedic Surgeon, Fellowship trained in Hip and Knee Total Joint Replacement

Have questions about your recovery? Learn more about total hip replacement or total knee replacement at ATX Orthopedics, or call 512-960-4590 to speak with our team in Austin, TX.