Post Operative Instructions
Arthroscopic Rotator Cuff Repair
You have an undergone a rotator cuff repair using a small camera placed within your joint. During this procedure, your rotator cuff has been reattached to its normal insertion site on the humerus.
You have been placed in a "sling shot" sling for comfort and protection. Remain in this sling (including during sleeping) until seen in the office, where you will be shown how it may be easily removed and reapplied. Unless told otherwise, you will be using the sling for a period of 4-6 weeks.
A bulky compressive dressing has been applied to your shoulder to absorb some of the fluid (which can leak out for the first 48 hrs after arthroscopy). You may either keep your dressing dry and in place until your post-op visit, or remove it if you are comfortable 48 hours later. If you keep it in place, keep it dry by using a plastic bag (such as a clean garbage bag) over the dressing as a cover. Secure it with tape to prevent getting it wet. If you remove the dressings, you should apply Band-Aids over each of the small arthroscopic incisions when you shower.
Some degree of swelling of your arm, hand and fingers is normal. Swelling can be controlled by use of ice or cold therapy directly over the surgical site. Place a bag of ice or package of frozen vegetables the surgical site; 20 minutes on, and 20 minutes off. The swelling in your hands and fingers can be improved by squeezing the soft ball attached to the sling!
Because bleeding from the surgical site cannot escape, it typically travels under the skin to the most "dependent" part of the extremity. An evolving bruising of the arm or hand, which can increase over the first few weeks, is normal, and will ultimately resolve.
A low grade fever (less than 101°) is fairly common within the first 3-5 days following surgery. If the fever is higher or lasts longer, this could reflect infection and warrants contacting our office.
For the first week try to minimize how much you're up and about. Because your rotator cuff was repaired, you must avoid lifting your arm away from your side, usually for a six week period (the time it takes for the cuff to heal on average). Any activities in which your elbow is at the side are ok, including simple activities such as eating, cutting your food, writing, or typing. A good "rule of thumb" is that any activity in which your elbow is away from your waist is probably not a good activity (except when performed passively by your therapist). No lifting or carrying anything heavier than a coffee cup for the first 12 weeks. You should not drive until you have good control of the wheel, which typically takes a good 6 wks (the first four are in the sling).
Patients often find that they are more comfortable sleeping in an upright position following shoulder surgery. Whether this requires just another pillow or two, a "husband" (name of triangular pillow that one can obtain from the Healthy Back Store, for example) or even resting in a "Lazy Boy" type recliner, you may find sleeping in this position more comfortable for the first few weeks. However, such position is not necessary to protect the repair. It is simply a matter of your comfort.
Oxycontin, a long acting narcotic pain killer and Percocet® (oxycodone), a short acting narcotic pain killer, have been prescribed for pain. Take the oxycontin every 12 hours if you are experiencing severe pain, take the Percocet during those 12 hours if you have "breakthrough pain." (Please note: You may be able to take only the Percocet and won't need the Oxycontin). All narcotic pain medications can cause side effects, the most common of which is nausea. We have prescribed Phenergan to help with the nausea – take it as you need every 6 hours. If you have known side effects to any of these medications please let us know and we will call in a substitute. Tylenol can be used in place of a narcotic, but NOT in addition to the narcotic. Use Tylenol when pain is less severe.
Pain Medication Tips:
- Do not drive while taking pain medications.
- Do not drink alcoholic beverages while taking pain medications.
- Pain medication should be taken with food as this will help prevent any stomach upset.
- Often pain medications will cause constipation. Eat high fiber foods and increase your fluid intake if possible.
- To alleviate constipation, purchase a stool softener at any pharmacy and follow the recommended directions on the bottle.
You should be scheduled for a post-op appointment 10 – 14 days following surgery, at which time we will review your post-operative program and answer any of your questions. Your post-operative appointment is scheduled on: __________________________________________________________.
If you need to verify or change your post-op appointment, please call 703-277-BONE (2663).
Physical therapy is usually started 1 week from the date of your surgery. We will help you in identifying an appropriate therapist if you need assistance.
IN CASE OF EMERGENCY
You may reach me 24 hours/day through either office (703) 810-5215 Option 3 (Arlington) or (703) 810-5213 Option 3 (Tysons). You should contact me for any of the following symptoms:
- Fever greater then 101.5 degrees F
- Numbness, loss of color or coolness in hand
- Severe pain unresponsive to narcotic medication
- Excessive bleeding or vomiting
- Difficulty breathing or shortness of breath – Call 911