Total
Knee Replacement Surgery Guidebook
Using This Guide
This guide is designed to educate you and your family about what to expect throughout your surgical experience at UF Health Central Florida. It seeks to prepare you for what’s ahead and to help you understand some of the steps that can be taken to improve your odds of a successful recovery. We encourage you and your caregivers to use this book as a resource for pre-surgical preparedness and post-surgical rehabilitation.
This total knee replacement surgical guide belongs to:
Setup Appointments:
Physician Medical Clearance Required:
Attend Pre-operative Joint Replacement Class:
Surgery Date:
Pre-operative appointment with surgeon:
Post-operative appointment with surgeon:
Total Knee Replacement at UF Health Central Florida
Thank you for choosing UF Health Central Florida (UF Health Leesburg Hospital — The Joint Center and UF Health The Villages® Hospital — The Joint Institute). Here you will have a team of specialists consisting of the area’s most renowned doctors, nurses, therapists, and other health care professionals committed to providing you with the highest standards of care and the best experience possible.
Our Objective
Our objective is to reduce your anxiety and relieve your mind as you prepare for surgery. Most people find it helpful to learn as much as they can about knee replacement surgery. We recommend that you attend our comprehensive, Pre-operative Joint Replacement Education Class to help in the preparation process. Here you will meet some of the team members and have the chance to ask any questions you may have about surgery.
Our Goal
Our goal is to remain on the cutting edge of technology, techniques and recovery. We will take the time required to carefully review each patient’s case to ensure the best approach is taken and optimal results achieved.
Relieve your pain
Restore your prior independence
Ensure the results are lasting
Understanding Your Knee
To understand the benefits and/or necessity of the knee replacement surgery, you need to be familiar with the anatomy of your knee and recognize the changes that have occurred.
A Healthy Knee
The knee is the largest weight-bearing joint in the body and is made up of the lower end of the thigh bone (femur), which moves on the upper end of the shin bone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur. The healthy joint surface where these bones slide on each other is covered with cartilage. This cartilage allows smooth, painless movement of the knee.
A Damaged Knee
Most people who experience knee pain have osteoarthritis. Osteoarthritis is the most common form of arthritis. It is described as the “wear and tear” disease of the joints.
As the smooth cartilage of the knee wears away, you experience changes. The breakdown of the cartilage causes rough, uneven surfaces in the joint, and movement becomes painful. As the cartilage continues to wear away, the bone surfaces of the knee are uncovered and begin to rub together. The result of bone-on-bone rubbing is reduced motion of the joint, chronic pain, continuous swelling and stiffness, and difficulty walking for some people.
Osteoarthritis Risk Factors
Although the cause of osteoarthritis is unknown, the risk for developing osteoarthritis is influenced by many factors, including age; gender; and inherited traits that affect shape, joint alignment and he stability of your joints.
A previous knee injury and/or repetitive strain on the knee generated by work, sports or being overweight are also contributing factors.
Total Knee Replacement Surgery Overview
Your Physician Review
Your physician has reviewed your medical history, evaluated your knee and recommended surgery. The recommendation for surgery is based on the extent of your pain, disability and your overall health. The decision to have knee replacement surgery should be a cooperative one between you, your family and your orthopedic surgeon.
Total Knee Replacement
Total knee replacement surgery replaces an arthritic or badly damages knee joint with man-made parts. The man-made parts are called prosthesis and can be made of many different materials, including metal, plastic or ceramics. The surgery is done to lessen the pain and improve your movement.
During knee replacement surgery, your surgeon makes the incision over the affected knee to expose the knee joint. The surgeon makes the incision deep enough to allow the kneecap (patella) to be moved aside to reach the joint. The joint forms the hinge between the thighbone (femur) and the shin bone (tibia). The surgeon shapes the end of the femur and the upper end of the tibia, in preparation for the prosthetic implants. The implants are inserted into the end of the bones. A drain tube may be placed into the incision and the incision is closed with staples. The incision is then covered with a bandage.
Frequently Asked Questions
When can I walk after surgery?
The goal is to get up and walk with a front wheeled rolling walker the day of surgery. Early ambulation has been shown to reduce the risk of complications following surgery and is an important part of your recovery.
How long will I be in the hospital?
The amount of time you spend in the hospital depends on your unique situation. This is highly dependent upon your condition before surgery, your age, and medical problems which can influence your rehabilitation. A safe discharge plan will be arranged for you by the orthopedic team. You may also have an option to be discharge the same day as surgery.
What if I live alone?
You can return home after surgery if you can safely get in and out of bed and safely walk a short distance with a rolling walker. It is recommended you have a friend or relative available to help.
What equipment will I need at home?
You will need a 2 wheeled rolling walker and you may also need a bedside commode. The bedside commode can be used to increase the height of your toilet, or as a seat in the shower.
Where do I go when I’m discharged from the hospital?
Most patients return home with home health services a few days a week. The surgeon, therapist, nurse, orthopedic navigator and case manager will assist you to determine the best discharge plan.
Will the surgery be painful?
Pain following knee replacement has come a long way over the years with increased use of regional nerve blocks, spinal anesthesia, and various other modalities used for pain control. Early range of motion and rehabilitation protocols are also designed to reduce early stiffness and pain, making the procedure in general much less painful. Keep in mind that while pain management has greatly improved, a pain-free surgery is unlikely. We will work with you to establish a realistic pain goal and to take the medications that have been ordered to manage pain as ordered.
Will I need therapy when I get home?
Yes, when you return home you will have home health physical therapy a few days a week. After you have met your goals with home health you may go to outpatient therapy. The length of time in outpatient therapy varies with each patient.
What are advanced directives?
It is a means of communicating the patient’s wishes regarding health care. Living will- written instructions explaining your health care wishes if you are unable to communicate. Medical power of attorney or health care surrogate- a designated individual that can make medical decisions if you are incapacitated.
Preparing for Total Knee Replacement Surgery
Pre-operative care and preparation can begin several months before surgery or range from several weeks to a few days prior to the procedure. Though the time frame may vary, the days leading up to total knee replacement surgery will be the same for all patients. It is essential to follow the instructions as closely as possible to have a positive surgery and recovery.
All patients should begin pre-operative exercises and stop smoking as soon as possible. Prior to surgery, you should discontinue all anti-inflammatory medications such as Celebrex, Mobic, Aspirin, Ibuprofen and Naproxen, Vitamin E, Fish Oil, etc. as well as herbal supplements. Your doctor will provide you with specific instructions on when to discontinue the use of these medications. These medications may cause increased bleeding. If you are taking a blood thinner, you will need special instructions from your doctor for stopping the medication, it is also recommended that you inform your dentist about your knee replacement surgery to avoid any potential complications.
Optimize Nutrition
Iron is an important mineral for your body to make hemoglobin. Hemoglobin is important because it’s part of the blood that carries oxygen. If your hemoglobin is low, then you may feel fatigued. It is important to increase your iron and protein intake before and after surgery. Eating foods high in Vitamin C with iron rich foods can help your body absorb iron.
Iron Rich Food
Red meat
Egg yolks
Dark green leafy vegetables
Iron rich cereals
Beans, lentils
Dried fruit
Liver
Watermelon
Baked potato
Turkey-dark meat
Protein Rich Food
Egg
Red and white meat
Turkey
Chicken
Fish
Cheese
Low/Nonfat milk
Beans
Nuts/Seeds
Soy protein
Refer to Appendix A for additional nutrition information
Exercises
It is important to be flexible and to be physically prepared before having a total joint replacement. The exercises in this guide should take about 15-20 minutes and it is recommended that you complete them two times a day. It is also important for you to strengthen your arms by doing arm chair push-ups since you will be relying on them to support you when using the walker. DO NOT do any exercise that is too painful or you are unable to perform.
Before Surgery: We encourage you to do 20 repetitions twice daily of exercise numbers one through six. Be sure to do these on both legs. If any exercise causes sharp or shooting pain, do not do that particular exercise. It is normal to feel achy afterwards; you are exercising muscles you may not be used to using.
After Surgery: Continue to do the first six exercises and start to work on exercises seven and eight. Your physical therapist will be adding more exercises as you progress.
Please note: Be sure to do exercises in bed or a recliner chair (do not do them on the floor).
Exercise #1
Ankle Pumps: This can be done lying on your back with your knees straight or elevated. This also, can be done in your recliner chair. Movement: Slowly make up and down motions with your feet or point and flex your foot. Tip: Continue doing ankle pumps until you are walking as much as you were before surgery. Start doing them again if you are on a long care trip.
Exercise #2
Quad Sets: This can be done lying down or partially sitting up with your surgical leg straight. This can be done with a towel roll under your knee or with nothing under your knee.
Movement: Keep your legs out straight and toes pointed up. Tighten the muscles in the front of your thigh and press your knee down. Hold for a count of 5, and then relax. Tip: Keep the back of your thigh and buttock relaxed.
Exercise #3
Glute Sets: Begin lying on your back with your hands resting comfortably. Movement: Tighten your buttocks by squeezing together, hold for a count of 5, and then relax. Tip: Make sure not to arch your low back during the exercise or hold your breath as you tighten your muscles.
Exercise #4
Heel Slides: Begin lying on your back with your legs straight.
Movement: Slide one heel toward your buttocks, bending your knee as far as is comfortable, and then slide it back to the starting position and repeat. Tip: Make sure to keep your back flat against the bed during the exercise. Keep your knee away from the mid-line.
Exercise #5
Short Arc Quads: This can be done lying with your head in an upright position. Movement: Place a rolled towel (about 8” diameter) under the leg. Straighten knee and leg. Hold straight for 5 count. Tip: Work for full extension (straightening) of the knee.
Exercise #6
Straight Leg Raises: This can be done on your back lying. Movement: with the unaffected knee bent, and foot flat. Tighten the quad on the affected leg and lift the leg 12 inches from the surface. Keep knee straight and toes pointed towards your head.
Exercise #7
Long Arc Quads: This can be done sitting upright in your chair. Movement: slowly straighten operated leg and try to hold it for 5 sec. Bend knee, taking foot under the chair. Tip: Completely straighten knee. Do NOT bend forward at the hip.
Exercise #8
Seated Hamstring and Gastric Stretch Without or With Strap Sit on couch or bed with exercised leg extended and the other leg dangling off the side. Movement: Keeping the exercised knee straight, looking straight ahead, gently lean forward until a slight stretch is felt in the back of your thigh. As you become more flexible, use a strap to pull up on the foot. Hold for 20-30 seconds.
Range of Motion of the Knee
After knee replacement surgery, you will work with physical therapy to obtain maximum range of motion.
Knee Flexion
Knee flexion is the ability to bend the knee. Your goal is to bend your knee to 120 degrees within 6 weeks of surgery.
Knee Extension
Knee extension is the ability to straighten the knee. The goal is to be able to fully straighten your knee to zero degrees within six weeks of surgery. After six weeks, your knee stabilizes and you are typically only able to bend or straighten your knee to whatever motion you have at that time.
Preparing Your Home
Undergoing surgery can be a very stressful event for anyone. Preparing your home prior to surgery will make the transition from hospital to home easier.
Do simple things, such as the following:
Place frequently used items within reach on the counter top or in cabinets that don’t require reaching or bending.
Make sure stair railings are not loose.
Put clean linens on your bed.
Prepare and freeze meals that can be easily heated.
Remove throw rugs.
Make sure you have clear paths that you can navigate a walker through.
Make sure you have adequate light in the bedroom, bathroom and hallways. Install night-lights as needed.
Packing for Your Stay
Prior to your stay you will want to pack your belongings. Some items that you may need to bring include:
Rubber soled/non-skid shoes or closed back slippers
Dentures, hearing aids with extra batteries, eye glasses and eye glasses case
Loose fitting comfortable clothing for therapy (shorts/sweatpants)
Personal toiletries and grooming items (toothbrush, toothpaste, deodorant etc.)
CPAP machine with tubing and mask
Please DO NOT bring valuables
If you choose to bring a cell phone, remember your charger
Pre-Admission
Prior to your surgery you will be contacted by a pre-admission nurse to review your past medical and surgical history, your home medications, and provide you with pre-operative instructions. If additional testing and lab work is needed before your surgery, a pre-admission visit will also be scheduled by the pre-admission testing department at UF Health Central Florida. The pre-admission nurse will provide you with the time you should arrive at the hospital the day of your procedure. If you do not need to come in for a preadmission visit be sure to pick up your Hibiclens solution at least two days prior to your surgery.
The Night Before Surgery
DO NOT
DO NOT eat, drink, or chew anything after midnight. Ice chips, gum, or mints are not allowed. The only exception is a sip of water with any medications you are instructed to take prior to your surgery.
DO NOT bring any valuables
DO NOT shave your legs or groin
DO NOT use lotions or powders
DO
Two days before surgery, wash your hair and rinse it well. Then shower with Hibiclens as directed.
Wear freshly washed pajamas
Sleep on newly laundered linens
Eliminate the use of tobacco products and alcohol at least 48 hours prior to your procedure. It is recommended you stop smoking 3 weeks before your procedure and not resume for 3 weeks after your procedure.
Have your personal belongings packed and ready to go
Have a list of all medications that you are currently taking, including the dosage
The Day of Surgery
Arrival
You will be asked to arrive to the hospital approximately two hours before your surgery. You will check in at the Ambulatory Services Desk located in the front atrium of UF Health Central Florida.
Be sure to bring your insurance cards, a picture ID, Living Will, Advanced Directive and/or Health care Surrogate if applicable and a list of all medications including over the counter, herbal supplements, and vitamins, including dosages and the times they are taken.
Prepare for Surgery
Your pre-operative nurse will review and verify admission and personal health information, making sure that everything is in order for you to proceed with surgery.
In preparation for surgery, a hospital gown will be provided for you. You will remove all other clothing.
Intravenous (IV) fluids will be started prior to surgery. Monitors will be applied to assess heart rate, blood pressure and blood oxygen levels. Blood work may be drawn. You will be visited by your anesthesiologist before surgery to discuss various anesthesia options. The anesthesiologist will then decide on the best option for you. While in surgery, you will be monitored carefully by your anesthesiologist.
Recovery
When surgery is complete you will go to the Post Anesthesia Care Unit (PACU) where nurses will continually monitor your vital signs as you wake up. You will remain in the PACU are until you are fully awake and no longer require close monitoring, usually one to two hours.
You will then be transferred to the Joint Replacement Center if you will be staying over night or back to the ambulatory services unit if you will be discharging home. Your family will be able to visit you once you have been transferred. The team will work with you to manage pain, provide ongoing education, improve mobility and plan your discharge home. TO help achieve the best recovery, be prepared to get out of bed with assistance immediately following your surgery.
Pain Management
Experiencing some pain is normal when recovering from surgery. The goal of the orthopedic team is to control your pain so that you can participate in your physical therapy evaluation the day of surgery. It is important that we work together to always keep your pain well controlled.
Because everyone feels pain differently, you will be asked to rate your pain on a scale of zero to 10. Zero being no pain and 10 being the worst pain. The pain scale is used to help you and your nurse determine if your level of pain is getting better or worse. We ask that you monitor your pain and let us know when you feel you need more pain medications. Pain medication is ordered on an as needed basis. (See pain scale on next page.)
A pain goal will be set prior to surgery. This is the level of pain that you believe is acceptable, allowing you to be comfortable, but realizing that following surgery you will not be pain free. The goal is to maintain a pain control level that allows you to rest as well as take part in daily activities and physical therapy.
Understanding and Communicating Pain Levels After Surgery
Understanding pain control options can be complicated and confusing. This picture pain scale will help you describe your pain using the numbers 0-10. This is the universal pain scale. The time to talk with your nurse about pain is when your pain level is between 3-4. This allows time to intervene to manage pain before it becomes severe. See illustration below.
Important: You must let your nurse know early if you are having pain so they can intervene early to provide you best pain relief.
What to Expect After Surgery
Incentive Spirometer
You will be given an incentive spirometer to work on deep breathing and coughing to prevent pneumonia. We ask that you complete that 10 times every hour that you are awake. To use the incentive spirometer, place the mouthpiece in your mouth, take a slow, steady deep breath in through your mouth and hold as long as you can. Let that breath out slowly. The indicator (piston) will rise as you breathe in; try to raise it as high as you can. There is another smaller chamber with a disc. Your goal is to make sure the disc stays in the middle of the chamber while you breath in.
Preventing Blood Clots
After your surgery you will wear both anti-embolism stockings (TED hose) and sequential compression devices (SCD). These assist with blood circulation and the prevention of blood clots. It is important for you to begin ankle pump exercises. TED hose are elastic white stockings that should be worn everyday until you return to your follow up visit with your orthopedic surgeon. Notify your surgeon if you notice increased pain and swelling in either leg.
Blood Thinner Medication
You will be given a blood thinner to help avoid blood clots in your legs. The length of your treatment will be determined by your surgeon. The medication may be in pill or short form (a tiny needle that goes into the abdomen). Take this medication for as long as directed by your physician. This can be anywhere from two weeks to three months after your joint replacement.
Contact your doctor right away if you notice easy bruising, nosebleeds, or blood in your urine/stool.
Deep Breathing
Take a deep breath in through your nose and hold it 5-10 seconds. Let that breath out slowly like you are blowing out a candle.
Out of Bed Activity
Each morning following the day of your surgery, we will assist you out of bed, with bathing/dressing, and into a recliner. When in the recliner, your surgical leg should be elevated as much as possible to decrease swelling. We encourage to dress in comfortable clothing.
Therapy in the Hospital
The focus of therapy in the hospital is preparing you for your return home. You will be seen by a physical therapist the day of your surgery, and participate in group physical therapy twice a day, each day, until you are discharged. You will also be seen by an occupational therapist.
You will be educated on a home exercise program and are asked to work on your exercises when not in therapy.
Preventing and Recognizing Potential Complications
Blood Clots in the Lungs (Pulmonary Embolism)
A pulmonary embolism can occur when a blood clot in the leg breaks away from the vein in the leg and travel to the lungs.
How to prevent a pulmonary embolism:
Prevent blood clots in the legs
Recognize symptoms of a blood clot in the leg and call your physician promptly
Pulmonary embolism is a medical emergency. If any of the following signs or symptoms occur call 911:
• Shortness of breath
• Sudden chest pain
• Difficult or rabid breathing
• Coughing up blood
• Unexplained anxiety, especially with breathing
Blood Clots in Legs (DVT)
Surgery may cause the blood to slow and thicken in the veins of your legs, creating a blood clot in the leg called a deep vein thrombosis (DVT).
How to prevent blood clots:
Wear your compression stockings (TED hose) at home
Elevate your affected leg above heart level for short periods throughout the day.
Take you blood thinners as directed.
Perform your exercises and walk.
Perform ankle pumps.
Contact your surgeon right away if any of the following signs and symptoms occur:
• Pain or excessive tenderness in your leg or calf
• Redness of your calf
• Increased swelling in your foot, ankle, calf, or thigh that doesn’t go down when raised above the level of your heart
Infection
Hand-washing (or alcohol-based hand cleaner) is the most important step for preventing infection. Keep your incision dry. Eating a healthy diet and drinking plenty of fluids can also help prevent infection.
Your surgeon may recommend that you take antibiotics to prevent infection before you under go future dental procedures or other invasive medical procedures. Be sure to discuss this during your first post-op visit unless already done.
Contact your surgeon right away if any of the following signs or symptoms:
• Increased redness, heat, or swelling around the incision
• Increased or foul-smelling drainage from incision
• Increased pain in the joint
• Persistent fever greater than 101° F or chills
Contact your primary care doctor if you think you may have an infection elsewhere. This includes: bladder, sinus, tooth, etc.
Discharge from the Hospital
Congratulations! You are going home. Although there is still work to do, you have achieved a lot. When you get home, take a deep breath and relax. Remember, the benefits of your new knee are great, but they will take some time and effort to be realized.
Planning
Understanding your plan for discharge is an important task in the recovery process. Your care manager and the orthopedic team will work together with you to develop a plan that best meets your individual needs.
Goals for Discharge
Your physical goals before discharge from the hospital are:
Get in and out of bed without assistance safely
Get in and out of a chair without assistance safely
Knowing precautions related to your surgery
Demonstrate understanding of your home exercise program
Walk a functional distance using a walker
Perform stair climbing as applicable
Equipment you will use
Front wheeled rolling walker (2 wheels) to help you walk
An elevated toilet or bedside commode can be helpful for the bathroom. A bedside commode can often fit over the toilet and also be used to sit on in the shower.
Incision Care/Dressing Changes
If you are receiving home health services, they will change your dressing as directed by the surgeon. There will be some initial swelling, especially after performing your daily exercises. If you notice redness, warmth, odor, increased drainage, or opening of the incision, call your surgeon’s office immediately. Usually, staples are removed eight to 14 days after surgery by a health care professional and Prineo is removed in approximately 14 days after surgery at your follow up visit with your surgeon.
Diet
Good nutrition is important to promote your recovery and the healing of your surgical incision. Choose a diet with a range of fruit, vegetables, grains, dairy, and meat. Iron-rich foods include lean meat, shellfish, wholegrain foods, and green vegetables. Be sure to include foods high in fiber and drink plenty of water to prevent constipation. If constipation occurs, you can use a laxative or stool softener as needed. Occasionally, patients experience loss of appetite following surgery. This is normal. Your appetite will return over time with increased activity.
Coping with Stress
Undergoing surgery can be very stressful for anyone. Find support through friends and family to help you through your healing and rehabilitation process. Set realistic goals and keep a positive outlook. Make note of small achievements. Deep breathing and other relaxation techniques can also help to lessen your stress. Don’t forget to ask for help when you need it.
Pain Medication and Management
Few people are pain free when they leave the hospital. Expect to take pain medication for the first couple of weeks. You will be given a pain medication prescription for home. It is important to take you pain medication as prescribed by your surgeon and with food to avoid an upset stomach. You should take your pain medication about 30 minutes before your planned therapy/exercise session. Remember, don’t wait until discomfort has set in before taking your medication and do not drink alcohol or drive while taking pain medication.
As you have less discomfort, start to decrease how many pain pills you are taking and how often you are taking them. Eventually, you will no longer need pain medication. It is common to feel most discomfort when lying in bed at night or when sitting for several hours. It is recommended that you try and change your position every 45 minutes during the day to avoid stiffness, and you may need to take a pain pill before bed to help you sleep through the night. Numbness around the incision may be temporary or permanent.
Contact your surgeon if your discomfort does not respond to the above methods.
The Importance of Lifetime Follow-up Visits
Post-surgical physical therapy and exercise are vital to the success of your recovery from total knee replacement surgery. It is also important to keep in contact with your physician.
When should you follow up with your surgeon?
Every year, unless instructed differently by your surgeon
Anytime you have mild pain for longer than a week
Anytime you have moderate or severe pain
It is important to have follow up x-rays. The x-rays will be compared to previous x-rays to make sure there aren’t changes that need to be addressed by your surgeon.
It is in your best interest to read this information carefully. Your understanding of this material and how it relates to your plan of care is vital to a successful recovery.
Recommended Nutrition
Your body needs to be well-nourished to heal bones, muscles and skin that are affected by surgery. The nutrients from food provide us with the strength, energy and ability to heal. People who are well-nourished overall are less likely to develop an infection and may heal faster. Work on incorporating the following important nutrients into your diet before and after surgery.
Aim for 2 to 3 servings from each of these food groups daily (see chart page 17)
Meat and Alternatives
Milk and Alternatives
1 serving equals: 1 serving equals:
2 to 3 oz meat, poultry or fish 1 cup milk or soy beverage
½ cup beans
½ cup tofu
2 tablespoons peanut butter
1 cup yogurt
NUTRITION
PROTEIN
Protein contains all the essential amino acids to aid in wound healing and keeps your immune system strong. Protein is not just for muscle building. It is a key nutrient in bone building.
IRON
Iron is an important mineral for your body to make hemoglobin. Hemoglobin is a part of the blood that carries oxygen. It is important to increase your iron intake before and after surgery. Eating foods high in Vitamin C with iron-rich food can help your body absorb iron.
CALCIUM AND VITAMIN D
Calcium and Vitamin D are nutrients associated with healthy bones. All milk is fortified with Vitamin D to help absorb calcium. Yogurt is also a good source of calcium, but is not always fortified with Vitamin D, so check the nutrition label.
FIBER
Make sure to consume fiber-rich foods prior to and after surgery to avoid constipation (unless directed differently by your physician). It is important to increase your fiber intake slowly to avoid gas and bloating. Adequate fluid intake is also very important if you are increasing your fiber intake to avoid adverse effects. Prunes or prune juice (along with drinking plenty of water) have a natural laxative effect that can alleviate constipation while on pain medications.
WATER
Protein-rich food: Eggs, red and white meat, turkey, chicken, fish, cheese, low/nonfat milk, beans, nuts/seeds, soy protein
Iron-rich food: Red meat, egg yolks, dark green leafy vegetables, iron-rich cereals, beans, lentils, dried fruit, liver, watermelon, baked potato, dark meat turkey
Calcium- & Vitamin D-rich food: Low-fat dairy, like milk and yogurt
Fiber-rich food: Whole grains, bran, fruits, vegetables, beans, lentils
Drink at least 8 glasses of water or other calorie-free beverages per day to help with the prevention of constipation. Adequate hydration will also help to promote healing.
VITAMIN C
Vitamin C is needed to make a protein called collagen and is needed for repairing tendons, ligaments and healing surgical wounds.
ZINC
Zinc is also important for wound healing. Zinc is a mineral found mostly in animal foods. It is better to get zinc from foods than supplements.
Vitamin C-rich food: Citrus fruits, strawberries, kiwi, baked potatoes, broccoli, bell peppers
Zinc-rich food: Meat, fish, poultry, dairy, wholegrain foods, breads, cereals, nuts
