Downloadable and Printable Post Op Instructions 

Post Operative Instructions after Arthroscopic Shoulder Labral Repair

Helpful Hints & Important Precautions for Patients

Diet

• You may resume clear liquids and light foods after surgery (jello, soup, etc.)
• Progress to your normal diet as tolerated as long as you are not nauseated.

Medications:

• Before surgery you will be offered a nerve block which helps greatly with pain control and decreases your need to take narcotic medications.  This typically lasts for 8-12 hours.  It is important to begin taking your pain pills before this medicine wears off.
• The first medication I use is Percocet (Oxycodone/Tylenol) which is a strong narcotic pain medication. It will begin to work within 15 minutes after taking it with a maximal effect in one to two hours. Normally, Percocet is taken 1 pill every 6 hours but if the pain is severe, it can be used 2 pills every 4 hours.
• Common side effects of this medication are nausea, constipation, itching, and drowsiness.
• The best way to prevent nausea is to take the medicine with a little food, start with just one pill, and be patient while the medicine begins to work. Usually, after the first few doses the nausea will go away. I also prescribe an anti-nausea medication called Zofran (Odansetron) to be taken if you have persistent nausea after surgery.
• I strongly recommend you take an over-the-counter stool softener starting the day of surgery such as Colace 100 mg 1 tablet a day and/or a laxative such as Sennokot DS 2 tablets a day to avoid constipation.
• Take Benadryl one half hour before your narcotic if you experience itching.
• You will also be given a prescription for Naprosyn which is a strong anti-inflammatory medication.  Take this twice a day with food in addition to the Percocet.  Both medications will work synergistically in pain relief.
• Transition from Percocet to Tylenol as your pain subsides, but pay attention to the dosage as Percocet has 325 mg of Tylenol in each pill.  Patients with normal liver function should not consume more than 4000 mg of Tylenol per day.
• All non-narcotic medications will be called in to your pharmacy prior to surgery.

Bandages & Sling:

• Your post-operative dressing has two layers you need to understand in order to properly care for your surgery site. Your incisions were closed with absorbable stitches and covered with steri-strips (butterfly bandages).
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      • The second layer is a large white fluffy dressing and ABD pads that are held loosely in place with tape.
      • Unless directed otherwise, remove this second layer of dressing 2 days after surgery.
      • Because the surgery is performed arthroscopically, occasionally there will be water with a small amount of blood on this dressing.  This is nothing to worry about, however if you see a lot of bleeding please call Dr. Sablan.

Washing & Sling:

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        • You should be careful to keep the wound clean and dry for the first 48 hours after surgery.
        • Beginning on the second day after surgery it is OK to shower.  Place plastic wrap over the steri-strips.
        • Do not take a bath until after the first post-operative visit.
        • It is OK to go into a swimming pool after the first post-operative visit, but no lakes or ocean until two weeks after surgery.
        • You will have a sling with a supporting pillow placed after surgery.  The only time you are allowed to remove it is during showering and during elbow and wrist range of motion exercises. 

Ice & Activity:

• One important goal following surgery is to minimize swelling around your surgery site. The best way to achieve this is with the frequent application of ice.  This is most important during the first 48 hours following surgery. The ice pack should be large (like a big zip-lock bag or bag of peas) and held firmly on the area of your surgery. Apply for 15 minutes every hour while awake if possible. Look for signs of frost-bite.
• Keep your elbow against the pillow and in front of the plane of the body to avoid stress on the repair
• Keep a pillow behind the elbow while lying down to prevent the elbow from sliding backwards.
• While sitting in a chair you may remove the sling three times a day to perform elbow and wrist ROM exercises.
• You may return to sedentary work only or school in 3-4 days after surgery if your pain is tolerable.
• You can use your hand to write and type, but no lifting or carrying with the operative arm.
• Avoid driving unless otherwise instructed by Dr. Sablan
• Avoid long distance traveling in cars or by airplane during the first week after surgery to avoid increasing your risk of developing blood clots.

Sleeping:

• Many patients have difficulty sleeping after shoulder surgery.  You may find that sleeping in a slightly upright position (ie reclining chair) will be your most comfortable position.  Make sure to have your pain under control before you sleep.

Physical Therapy

• The goal of physical therapy is to first assess how your body responded to the surgical procedure. They help you feel comfortable with your surgery and make sure you aren't afraid to start doing things. Your therapist will start gentle range of motion exercises on your first visit.
• You will start physical therapy after your first post-operative visit.

Follow up appointment:

• We try to give all of our patients a follow-up office visit at the same time we schedule your surgery.
• Typically I want to see my patients in the office 5 to 10 days after surgery.

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FOLLOW UP APPOINTMENT: ______________

What to watch out for:

∞ Pain that is increasing every hour in spite of the pain medication

∞ Drainage from the wound more than 2 days after surgery

∞ Increasing redness around the surgical site

∞ Pain or swelling around your surgery

∞ Fever greater than 101.5 degrees.

∞ Unable to keep food or water down for more than one day.