Home instructions for Shoulder Arthroscopy

 

 

You had the following procedure:

oAnterior capsular shift with labral repair(Bankart)         oDistal clavicle excision

oSLAP tear repair                                                                 oChondroplasty/microfracture

o Rotator Cuff Repair                                                           oLoose  or foreign body removal

oSubacromial Decompression                                             oBiceps tenodesis

o Manipulation under anesthesia with                              oSLAP tear or Rotator Cuff Tear     

     Arthroscopic capsular release                                              debridement                                              

                                                                                                  

 

General Instructions:

 

Following your surgery you will have a bandage on your shoulder and your arm will be protected in a sling.

 

Your arm may be numb or asleep for up to 24 hours after surgery due to the block provided by anesthesia. You should start taking pain medication before the pain sensation begins.

 

Pain or swelling in the operated area is normal. This pain can be lessened by the use of an ice pack, your sling, and by the use of your pain medication as needed. You should never take your pain medication early or take more medication than is prescribed. If you have pain that is not controlled by the ice, rest and taking your pain medications; please contact the surgery scheduler listed on your post operative appointment sheet.

 

You will wear your sling at all times during the first four weeks after surgery except while exercising your elbow, performing the exercises learned in therapy, or bathing.

 

After the first 24 hours post op. at that time it is important that you straighten out your elbow for approximately 5-10 minutes per hour while you are awake. This will prevent your elbow from becoming stiff and help you later in physical therapy. You will need to protect your operative are while straightening out your elbow. This may be accomplished as follows:

 

1. If you have a sling that Velcro’s above the forearm, first stand up. Second, release the Velcro at the top of the sling. While supporting the upper part of the operative arm with the opposite hand, allow gravity to help you straighten out your elbow. After 5-10 minutes, place your arm back in the sling and secure the Velcro.
2. If your sling has a pillow attached, follow the instructions as above, leaving the pillow in place at your side.
3. If your sling does not have a pillow or snaps, remove the sling entirely and follow the instructions in item one, replacing the sling after five to ten minutes.

 

 

After the first 48-72 hours following surgery, you may remove your dressing and take a shower using antibacterial soap to clean your wounds. If you have small white strips of tape across the incision (steri-strips) do not attempt to remove them they will fall off on their own in about 7-14 days. It is important that you do not tub bathe, swim, sit in a hot tub or otherwise immerse your shoulder in standing water until after your two week post operative appointment.

 

After you shower do not apply any ointments, lotions, creams, or powders on your wounds including antibacterial ointments. Simply put a clean dressing or Band-Aid over the wounds. If you are comfortable leaving the wounds open to air that is okay as well.

 

 

 

Side Effects of Pain Medications:

 

Constipation: this may be decreased by increasing your fluid intake, (especially water and other clear liquids without caffeine) fresh vegetables and fruits.

 

Nausea and Vomiting: this may be diminished by taking your medication with food or by taking Phenergan as prescribed by your physician.

 

Drowsiness: Make certain you do not operate any motor vehicles or sign any legal documents while taking your pain medication. Schedule yourself at least 8 hours of sleep each night to ensure you are getting enough rest and to help reduce your pain.

 

Dizziness: When rising from sitting or lying position, rise slowly while holding onto a stationary object such as a chair, the wall or a table.

 

Common Post Operative Questions and Answers after Arthroscopy

 

My shoulder, hand and elbow are swollen and I have a lot of bruising, is this normal?

 

Swelling is normal after surgery. Again, this may be lessened by ice and rest. You may be swollen and bruised throughout your upper arm, forearm, hand, shoulder, neck and chest. The bruising occurs as a result of the trauma of surgery. At the time of your surgery approximately 5,000 or more ccs of fluid was infused through your shoulder joint to keep the joint distended and allow the physician to see more clearly. This fluid is absorbed by your body’s tissue and can cause bruising due to increased pressure on the small vessels near your skin.

 

Is it normal to have a lot of drainage?

 

Yes, it is normal to have drainage that will sometimes even saturate the dressing on the first post operative day. The drainage should be clear, yellow-pink tinged watery fluid. Bright red or thick red drainage is not normal and should be reported to the nurse or the surgeon on call.

 

 

Should I be concerned if I run a temperature for the first 72 hours after surgery?

 

No, for two reasons: First and foremost a temperature is the body’s normal response to inflammation or infection. As your body temperature increases bacteria, which flourish at 98.6 degrees F, die at higher temperatures. Secondly, it is extremely uncommon to have a temperature due to infection in the first 3-4 days post surgery. Infection is more likely at 10-14 days post operatively.

Having said that, it is important to understand, the most common reason that patients will run a temperature post operatively is that they are not clearing their airway. Pain and pain medication alter the way we normally breathe. This contributes to the most common post operative complication, pneumonia.

 

 

Is there anything I can do to decrease my risk of getting pneumonia?

 

Yes. Do not just lie in bed. Get up, and walk around your house for at least 5-10 minutes of each hour. It is also important that you take at least 10 deep breaths each hour. Coughing also helps to open the airways, try forcing yourself to cough two times after your breathing exercises, coughing should come from deep in your chest or belly to be effective, not from your throat. Performing the breathing and coughing exercises encourages the small airways at the bottom of your lungs to open and prevents them from collapsing. Keeping your airway open will decrease your chance of getting pneumonia.

 

 

 

What if I am performing the breathing exercises, my temperature is greater than 101.5 F and it does not subside, even with Ibuprofen or Aspirin?

 

Call the nurse or your surgery scheduler.

 

What are the symptoms of infection that I should report?

 

After the first 72 hours, a temperature greater than 101.5 F that does not decrease with breathing exercises, Ibuprofen, or Aspirin, you should report as well as any of the following symptoms if they occur:

 

1. Increased warmth, accompanied by swelling, redness or streaking.
2. Draining that is thick, cloudy, yellow or green.
3. Foul odor at the wound site.
4. Pain that is not controlled by your pain medication.

 

Can I take Tylenol with my pain medications?

 

No. you should not take Tylenol or acetaminophen with your pain medications. Many of the prescription medications have some Tylenol in them and therefore you should not take extra Tylenol because it may damage your liver.

 

When can I drive?

 

Ideally, you should not drive until after your 2 week post operative appointment.

 

Who should I call if I have questions or concerns after surgery?

 

The surgery scheduler for your physician.

 

 

Exercises

• Do not move your shoulder (up/down or rotation) unless specifically instructed!

• Starting the day after surgery, you may remove your sling and straighten your arm out for a period of 5-10 minutes at a time, then place sling back on. You may do this 3-4 times a day.
• While your arm is in the sling, you can squeeze a rubber ball and bend your wrist up and down. This will help to avoid stiffness and help reduce swelling.

 

Bandages

• Your bandage may show blood stains within 1-12 hours after surgery. This is mostly fluid that was used to irrigate your shoulder so that we could see and work clearly, that has been tinged with blood. It is no cause for concern. Do not try to remove the dressing to look underneath them for 48 hours. If the dressings are soaked with blood within the first day or two after surgery (dark red, as opposed to pink fluid) call my office.
• Remove all your bandages 48 hours after surgery and cover all wounds with Band-Aids. You may shower (with wounds covered) after 72 hours (3 days), but do not swim, bathe, or otherwise submerge your incisions under water for 10 days. Reapply Band-Aids if wet.

 

 

Work

• Your comfort level should be your guide for return to work. Avoid overhead arm positions for 3 weeks, except for your exercises.
• Limit lifting, pushing, and pulling for one week, then as comfort allows.

 

Important

• Report any complications to my office immediately. This includes excessive bleeding, wound breakdown, redness around wounds, uncontrolled pain, or a fever over 101 F.
• Eat a balanced diet and get plenty of rest.

 

 

 

IF THERE ARE ANY QUESTIONS, please call the office for further instructions:

827-2480 from 8a.m. until 5 p.m. Monday through Friday.

After hours, or weekends for an emergency call: 220-4493.