Patient Education

SHOULDER ARTHROSCOPY WITH MINI-OPEN ROTATOR CUFF REPAIR
OR
ARTHROSCOPIC ROTATOR CUFF REPAIR
Discharge Instructions

Operation:
The majority of your operation was performed by arthroscopic methods. The interior of your shoulder joint was visualized using a small telescope, and the diagnosis was confirmed. Bone spurs and damaged tissue were removed, and your torn tendon was sewn back to its normal position on your humerus bone. If your repair was performed entirely arthroscopically, the tendon was reattached to bone using anchors and suture through one or two small portal incisions.

Pain:
Upon discharge, you will be given a prescription for pain medication that can be filled at either the hospital or a local pharmacy. The pain medication can be taken every 3 to 4 hours as needed. The medicine will help decrease the level of pain, but it is not meant to completely eliminate the pain. Some pain is expected. If you develop itching, skin rash, nausea or vomiting, please discontinue the medicine and call the office. Additionally, narcotics can cause constipation if used for an extended period of time. If this occurs, you should decrease the use of the prescribed medicine, and increase fluid, roughage and fruit intake in your diet. Please do not use aspirin unless you have OK’d it with your surgeon.

The use of ice decreases both swelling and pain. You may apply ice over the shoulder dressing for two to five days after surgery unless otherwise instructed. If you were given a Cryocuff, please wear it for at least 4 or 5 days. You may then replace it with the shoulder sling that was sent home with you.
Your surgeon may have inserted a pain pump into your shoulder. It consists of a small catheter, or tube, located within the surgical site, and connected to a fluid-filled container of local anesthetic (usually Marcaine). The pump will automatically deliver medication directly into the surgical site for approximately two days. The catheter will be removed at the office in 2-3 days, or we will provide specific instructions for you to do it at home.

Dressings:
Your operation involved distending the shoulder joint with water, and therefore you may notice pink fluid soaking your dressing for the first several hours after surgery. This is not unusual and should stop soon after you get home. Your incisions have been closed with suture or skin tape, covered with gauze pads and held in place with tape or a compressive wrap. Additionally, if inserted, your pain pump catheter is held secure under a separate transparent bandage. If there is drainage through the bandage within the first 2 days, reinforce it with additional bandages as needed. Please remove the original dressing in 2-3 days and replace with sterile gauze and tape. The small incisions can be covered with Bandaids. Please do not remove the skin tape as they will fall off on their own.

Wounds:
The small incisions may be sore and you may develop bruising in the area of the surgery as well as down your arm and your chest over the next several days. This will go away, and no special care is needed.

Bathing:
Although it is safe to shower or bathe in 2-3 days, please keep your shoulder incisions dry until after your sutures are removed 10-14 days following surgery (try saran wrap or waterproof tape). Please do not remove the skin tape, and change Bandaids as necessary. Do not soak your shoulder under water, and avoid hot tubs and pools for two weeks.

Activity:
You should rest, relax and make arrangements to have someone stay with you for at least 24 hours after discharge. Do not drive any vehicle or operate mechanical equipment for 24 hours following your surgery. Even though you
feel normal, your reaction time may be affected by the medication you have received.

Your arm was placed in a sling, or Cryocuff, in the operating room. It is recommended that you use the sling nearly full-time for 4-6 weeks following surgery, unless otherwise instructed. You may remove the sling and use your arm at the side for light normal activities and table-top activities, such as washing your face, cutting your food, reading a book and writing or keyboarding. You should not attempt to reach out in front of you, to reach overhead, to push or pull yourself up with our operative arm, or to lift objects. However, you are encouraged to use your arm for light normal activities at the side. This will decrease the swelling in your arm and make your rehabilitation easier. Returning to work or school depends greatly on working conditions and school requirements.

Diet:
Drink clear liquids (apple juice, ginger ale, broth, 7-Up, etc.). Progress to your regular diet as you feel able. Do not drink alcoholic beverages for at least 24 hours following your surgery. If nauseated, wait 30 minutes and then begin drinking water or 7-Up in small amounts. If clear liquids are tolerated, you may progress to solid food. If nausea continues beyond 24 hours, contact the office.

Precautions:
If you develop a fever (temperature over 101°), unexpected or severe pain, redness, or swelling, please contact the office for consultation or examination. A low-grade fever is common after surgery. If your temperature is elevated, drink plenty of fluids and try regular Tylenol.

Follow-up:
A post-operative visit with your surgeon or nurse will be made approximately 3-14 days following surgery to check your wounds and discuss your case. Physical therapy will usually begin three to five days after surgery. Probably the most important thing to remember about your shoulder surgery is that the post-operative rehabilitation is as important as the surgery itself. For this reason, your surgeon and therapists will monitor your rehab program closely, and if you have any questions or concerns, please feel free to discuss the situation with either of them.

Emergency Calls:
If you have a problem of an emergency nature and are unable to reach your doctor, call or come to Altru Hospital Emergency Room (phone: 701-780-5280); or your nearest hospital or emergency facility.

Special Instructions:

• Fever greater than 101 degrees orally or if at all questionable.
• Chills
• Excessive bleeding
• Separation of the incision
• Excessive swelling or tenderness
• Unusual drainage: pus-like drainage (white, yellow, or greenish in color); any excessive drainage
  from the area; foul odor from the incision or dressing.
• Change in color around the area; excessive redness may indicate infection
• Change in temperature around the area: unusual warmth
• Increased pain in operative area