Post Operative Instructions
Arthroscopic Subacromial Decompression
Using a small camera (the arthroscope), the subacromial space (bordered by the undersurface of the acromion or shoulder blade above and the rotator cuff muscle tendons below), has been decompressed. During this procedure, bone spur(s) and/or thickened soft tissue are pared down or removed to open up the space available for free excursion of the underlying cuff.
You have been placed in a sling for comfort. Remain in this sling until seen in the office, where you will be shown how it may be easily removed and reapplied. You will probably use the sling for a short period of a week or so, just until you are comfortable. You may use it at night if you roll on it in your sleep, or when you're out and about in public, to avoid inadvertent contact.
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. 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.
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.
You may use the shoulder based on the degree of your comfort. Avoid lifting anything heavy or wearing a heavy back-pack or purse. Avoid driving until you have good control of your shoulder and you are off narcotic pain medication. Take it easy for the first week or so.
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. It is simply a matter of your comfort.
Vicodin® (Hydrocodone) or Percocet ® (oxycodone) narcotic pain killers, have been prescribed for pain. Take one to two every six hours as needed for pain, which is typically needed for the first week or so after surgery. 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 schedule on: ______________________________________________.
If you need to verify or change your post-op appointment, please call 703-277-BONE (2663).
Physical therapy is usually started in the first week following 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