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Arthroscopic Shoulder Surgery Postoperative Instructions

Diet

  • Begin with clear liquids and light foods (jello, soup, etc.)

  • Progress to your normal diet if you are not nauseated.

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Wound Care

  • Pink drainage/fluid from the arthroscopy portals (incisions) is common after surgery.  Fluid is used during surgery to distend the shoulder joint, and this fluid slowly leaks back out during the first 24-36 hours.  Do not become alarmed - reinforce the bandage as needed.  If the portals continue to drain after three days, please contact my office.

  • You may remove the operative dressing 3 days after your surgery.  Remove everything but the white tape strips directly on the skin.  These are “steri-strips” and should remain on.

  • After removing the dressing, apply Band-Aids over the wounds.  This is to keep dirt and debris out of the wound.  Change the Band-Aids daily until the wounds are completely dry.  When the wounds are dry, you do not need to use the Band-Aids any more.

  • Do not use bacitracin or any other ointments on the wounds.  Keep the wounds dry!

  • You may shower beginning 4 days after your surgery.  Cover the wounds with a watertight plastic wrap and secure it to your skin with tape.  Glad “Cling Wrap” or “Press’n Seal” works well.  Keep the incision(s) dry!

  • If the incisions are clean and dry 7 days after your surgery, you may shower with the wounds exposed to the water.  Gently pat the surgical area dry.

  • You may remove the sling to shower, but keep your operative arm across your belly.  You will likely need help removing your sling as you should not fire the muscles in your shoulder.  To clean under the arm, lean forward and let your arm hang.  You can also lean forward to help you get your sling back on without actively moving your shoulder.

  • Do not soak the shoulder in water.  You should not take a bath, go swimming, or go in the ocean until cleared by your surgeon.  These activities are usually allowed 2 weeks after suture removal.

 

 

Medications

  • If you received a nerve block prior to surgery, this is typically effective for pain control for about 20 hours.

  • You will be given a prescription for a narcotic (opioid) medication to help with pain relief (refer to the opioid policy).

    • Primary medication:  Oxycodone 5mg (more information here) 

      • Take 1-2 tablets every 4-6 hours as needed for pain

      • Max of 12 pills per day

      • Plan on using it for 2-5 days only

      • Take the minimum amount necessary

      • You can take acetaminophen (Tylenol) while taking oxycodone

      • Do not stop medication abruptly.  Wean over last couple of days.

    • Common side effects:  nausea, drowsiness, and constipation - to decrease the side effects take medication with food

    • If constipation occurs, consider taking an over-the-counter laxative

  • Ibuprofen 400-600mg (i.e. Advil) and naproxen (i.e. Naprosyn) may be taken in between the narcotic pain medication to help smooth out the post-operative 'peaks and valleys,' reduce overall pain medication required and increase time intervals between narcotic pain medication usage.

  • Take a baby (81mg) enteric coated aspirin starting the day after surgery.  Take one pill a day and continue for 2 weeks.  This is to help prevent blood clots since you will not be moving as much after surgery. 

  • Do not take the baby Aspirin if you currently are already taking Aspirin or another blood thinner (Coumadin, Plavix, etc.) or are allergic to aspirin.

 

 

Activity

  • No lifting or elevation of the arm until cleared by Dr. Hartshorn.

  • Your hand will get swollen.  This is the result of gravity pulling the swelling/fluid from around your shoulder down into your hand.  Grip exercises and finger motion are also encouraged daily to decrease the amount of hand swelling.  If there is a ball attached to your sling, you can use it to perform the grip exercises.

  • Motion of the elbow/wrist/hand is okay and encouraged daily.

  • Details regarding physical therapy will be discussed at your first post-operative visit.  You will be assigned to one fo the two rehabilitation protocols:

  • If pain is tolerable, you may return to sedentary work only or school 3-4 days after surgery.

 

 

Sling Use

  • Wear your sling at all times except in the shower or when removed for physical therapy.

  • You must sleep in your sling.  Inadvertent movements at night could put your repair at risk.

  • The sling will usually remain on for 4-6 weeks.  The exact length of time depends on your specific surgery and will be discussed with you after the surgery is completed.

  • While you are either sitting or standing, it is okay to unbuckle the sling portion to allow your elbow to straighten.  This does not use your shoulder muscles. Doing this prevents the elbow from getting stiff in the sling.

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DJO Ultrasling Quadrant

Brace Information

Ice Therapy

  • Begin immediately after surgery. 

  • Apply an ice pack or cold therapy unit for 20 minutes every 2 hours until your first post-operative visit.

  • The cold temperature will help control swelling and reduce pain.

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Driving

  • Absolutely no driving while taking any narcotic pain medications (Vicodin, Percocet, Oxycodone, etc.).  These medications impair your ability to safely drive a vehicle.

  • No driving until instructed otherwise by Dr. Hartshorn.  Effective use of both arms is required to operate a vehicle safely.

  • Do not open a car door (or any type of door) with the operative arm.

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Follow-Up

  • Please call the office to make or confirm your postoperative appointment.

  • The first appointment is usually 5-14 days after the surgery but may vary depending on the nature of the procedure.

  • Subsequent appointments are usually at 6 weeks, 3 months, 6 months, and 1 year after surgery.

  • If you received a folder with arthroscopic pictures from your surgery, please bring the folder with you to your first post-operative visit.  We will review the images with you and outline your physical therapy protocol at that time as well.

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Please Notify Our Office Immediately If:

  • Excessive bleeding from the incision site

  • Drainage from the incision more than 5 days from the surgery.

  • Poor pain control with your medications.

  • Numbness or tingling of the hand not related to bruising.  If you had a nerve block, then numbness and tingling is expected for the first 48 hours.

  • Fever > 101.5° after postoperative day #3.  It is common to have an elevated temperature the first couple of days after surgery.

  • Increased redness along incision or concern for infection.

  • Calf pain or leg swelling.

  • Shortness of breath.

  • Any other concerns or questions.

 

 

**EMERGENCIES**

  • If you have an emergency after office hours or on the weekend, call 781-429-7700, and you will be connected to our paging service. They will contact Dr. Hartshorn directly.

  • If Dr. Hartshorn cannot be reached, or if you have an emergency that requires immediate attention, proceed to the nearest emergency room.

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