Your Arthroscopic Shoulder Surgery, A Helpful Guide

Your Arthroscopic Shoulder Surgery, A Helpful Guide

Your Arthroscopic Shoulder Surgery,
A Helpful Guide
Albert G. Volk, MD, FAAOS
One Orthopaedic Place
St. Augustine, Florida 32086
904.825.0540 Ext. 221
Fax 904.825.0517
[email protected]
ABOUT THE SURGEON
DR. VOLK attended college at The Johns Hopkins University and received his Medical Degree from Indiana University School of Medicine. He completed his internship and residency
program with the University of Southern California Orthopedic Department in Los Angeles,
California. While at USC he had the opportunity to learn from and operate with shoulder surgeon Dr. Frank Jobe at the esteemed Kerlan-Jobe Clinic in Centinela Hospital in Los Angeles,
California. Following his residency, Dr. Volk completed a sports medicine shoulder and knee
arthroscopy fellowship at the Matthews Orthopedic Clinic, Orlando Regional Medical Center
in Orlando, Florida. There Dr. Volk received an additional one year of intensive training in
shoulder and knee arthroscopy. He treated professional athletes including professional football, baseball, and basketball
players for various sports injuries. Following his one year fellowship, Dr. Volk entered into private practice in St. Augustine where he currently resides and practices. He has extensive experience in treating conditions of the shoulder, mostly
through arthroscopic procedures. He currently is the Chief Medical Advisor for the Professional Women’s Tennis Association and continues to evaluate and treat professional players with sports related injuries. He has two board certifications
with the American Board of Orthopaedic Surgeons, one in Orthopaedic Surgery and the other in Sports Medicine.
WELCOME
Thank you for choosing to have your arthroscopic shoulder surgery with Albert G. Volk, MD at Orthopaedic Associates of St. Augustine. Our Team of experienced and
compassionate professionals is dedicated to helping you
achieve an improved level of activity and a higher quality
of life.
Each year over 250,000 people in the United States undergo shoulder surgery. Candidates for the surgery include those individuals with acute shoulder pain or injury
that has severely diminished their ability to perform normal daily activities without pain. Shoulder surgery can
make a big difference in your ability to return to work,
sports, or other activities that you enjoy.
Most arthroscopic shoulder surgery patients recover
quickly. New minimally invasive arthroscopic techniques
and improved instrumentation have allowed us to quick-
en the recovery process. Most surgeries are performed
on an outpatient surgery basis through three or four tiny
ˆ˜VˆÃˆœ˜ÃÊV>i`Ê>À̅ÀœÃVœ«ˆVÊ«œÀÌʅœiðÊÊ/…ˆÃÊÈ}˜ˆwV>˜ÌÞÊ
lessens postoperative pain and facilitates postoperative
rehabilitation with minimal scarring.
At Orthopaedic Associates, Dr. Volk has designed a postœ«iÀ>̈ÛiÊ Ài…>LˆˆÌ>̈œ˜Ê «Àœ}À>“Ê ̅>ÌÊ ˆÃÊ Ã«iVˆwV>ÞÊ Ì>ˆlored to the type of shoulder surgery that you have un`iÀ}œ˜i°Ê Ê 7…i˜Ê ̅iÀiÊ ˆÃÊ >Ê Ài«>ˆÀÊ œvÊ >Ê ÀœÌ>̜ÀÊ VÕvvÊ œÀÊ >Ê
labrum, this usually entails wearing a postoperative sling
for a period of four to six weeks. The amount of time
that you will need to recover is highly dependent on the
procedure you had and on your preoperative physical
conditioning.
The better your physical condition prior to surgery, the
quicker and more successful your recovery will be.
MISSION STATEMENT
/…iÊ}œ>ÊœvÊ̅iÊ«…ÞÈVˆ>˜ÃÊ>˜`ÊÃÌ>vvÊ>ÌÊ"À̅œ«>i`ˆVÊÃÜVˆ>ÌiÃʜvÊ-ÌÊÕ}ÕÃ̈˜iʈÃÊ>Ü>ÞÃÊ̅iÊÃ>“i\Ê̜ʓ>݈“ˆâiÊ
your total movement and performance so you can return to the quality of life you deserve as soon as possible.
THE INTENDED PURPOSE OF THIS GUIDE
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continuity of care, and pre-planned postoperative activities and rehabilitation are important to creating the best
results. This guidebook will give you and your caregivers everything you need to know for a rapid return to a
healthy and active lifestyle.
UÊ /…ˆÃÊ}Ո`iʈÃʓi>˜ÌÊ̜Êi`ÕV>Ìi]Êi˜VœÕÀ>}i]Ê>˜`Êi“«œÜiÀ\ÊÊޜÕÊ̅iÊ«>̈i˜Ì]Ê̅iÊv>“ˆÞʜÀÊV>Ài}ˆÛiÀ°ÊÌÃÊ«ÕÀ«œÃiʈÃÊ
̜ÊÀiˆiÛiÊvi>ÀÊ>˜`ÊÃÌÀiÃÃÊ̅ÀœÕ}…ÊœÀ}>˜ˆâ>̈œ˜°ÊÌÊ܈ÊÃiÀÛiÊ>ÃÊ>ÊÃÌi«‡LއÃÌi«Ê}Ո`iÊ̜ÊޜÕÀÊ«Ài«>À>̈œ˜ÊvœÀÊÃÕÀ}iÀÞ°Ê
Furthermore, it will outline what will be expected of you before and after the surgery.
DECISION FOR SURGERY
You and Dr. Volk have decided that the best treatment for your shoulder problem
is shoulder arthroscopy.
Depending on the exact procedure and extent of the surgery will dictate:
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UÊ œÜʓ>˜ÞÊÜiiŽÃÊޜÕÊ܈Ê˜ii`Ê̜Ê>ÌÌi˜`ʜÀ̅œ«>i`ˆVÊÀi…>LˆˆÌ>̈œ˜°
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"À̅œ«>i`ˆVÊ,i…>LˆˆÌ>̈œ˜ÊŜՏ`ÊLi}ˆ˜Êœ˜iÊ̜ÊvœÕÀÊ`>ÞÃÊ>vÌiÀÊÃÕÀ}iÀÞ°Ê/…iÊwÀÃÌÊ
session is to change your operative dressing and to come up with a plan for your
treatment. If your orthopaedic rehabilitation is to be done at a location outside of
our facility or through a home health care agency, your physical therapist should call
œÕÀʜvwViÊ̜ʅ>ÛiÊ̅iʜ«iÀ>̈ÛiÊÀi«œÀÌÊv>Ýi`Ê̜Ê̅i“°Ê/…ˆÃÊ܈Êˆ˜vœÀ“ÊޜÕÀÊ«…ÞÈV>Ê
therapist regarding which procedure was performed and what kind of rehabilitation
to initiate.
2
Your Arthroscopic Shoulder Surgery
WHAT IS A SHOULDER ARTHROSCOPY
Arthro means joint and scope means to view inside that joint. An arthroscope is a small
˜>ÀÀœÜÊÌÕLiÊ̅>ÌʈÃʈ˜ÃiÀÌi`ʈ˜ÌœÊ̅iÊŜՏ`iÀʍœˆ˜ÌÊ̅ÀœÕ}…Ê>Ê«i˜Vˆ‡Ãˆâi`ʅœiÊ̅ÀœÕ}…Ê
܅ˆV…Ê>ÊwLiÀʜ«ÌˆVÊV>“iÀ>]ʏˆ}…ÌÊÜÕÀVi]Ê>˜`ÊÜ>ÌiÀÊyœÜÊ>ÀiÊ«>ÃÃi`°ÊÊ/…iÊV>“iÀ>ʈÃÊVœ˜˜iVÌi`Ê̜Ê>ÊLˆ}ÊÃVÀii˜]ʅˆ}…‡`iw˜ˆÌˆœ˜ÊÌiiۈȜ˜Ê“œ˜ˆÌœÀ°ÊÊÀ°Ê6œŽÊ܈ÊLiÊ>LiÊ̜ÊۈiÜÊ
the inside of your shoulder joint and identify frayed, torn, or degenerative tissue.
Impingement
1
One or more small incisions are made in the joint for insertion of special instruments
used to:
Torn Labrum
2
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remains.
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ëÕÀÃÊ>˜`ʈ˜y>“i`ʜÀÊ̅ˆVŽi˜i`ÊLÕÀÃ>ʜÀÊÃV>ÀÊ̈ÃÃÕi°
UÊ,i“œÛiÊ>À̅ÀˆÌˆÃÊvÀœ“Ê̅iÊ
Ê­>VÀœ“ˆœV>ۈVՏ>À®Êœˆ˜ÌqqՓvœÀ`Ê«ÀœVi`ÕÀi°
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UÊ,i«>ˆÀÊ>Ê̜À˜ÊÀœÌ>̜ÀÊVÕvv°
New and improved shoulder arthroscopic inventions have led to quicker recovery times, less pain, and faster
rehabilitation.
REASONS FOR SHOULDER ARTHROSCOPY
Torn Rotator Cuff
3
The reasons for shoulder arthroscopy might include:
UÊRotator cuff tear - This is the tendon structure of the shoulder that is responsible
vœÀʏˆv̈˜}ÊޜÕÀÊ>À“ÊœÛiÀÊޜÕÀʅi>`°Ê­ˆ}ÕÀiÊή
UÊAdhesive capsulitisʇÊvÀœâi˜ÊŜՏ`iÀ°
UÊBicipital tendonitis - frayed or inflamed biceps tendon.
UÊCalcific tendonitis - calcium deposits in the rotator cuff tendon.
UÊHistory of dislocations or subluxation of the shoulder - shoulder instability.
U Labral tears - This is a structure in the shoulder that helps to keep the shoulder in
place. The labrum can become frayed, torn, or detached and may need debridement
œÀÊÀi«>ˆÀ°Ê­ˆ}ÕÀiÊÓ®
U Acromioclavicular joint arthritis - The joint between the collar bone and the acro“ˆœ˜ÊLiVœ“iÃʈ˜v>“i`ʜÀÊ>À̅ÀˆÌˆV°Ê­ˆ}ÕÀiÊ{®
Arthritis and Loose Bodies
4
U Synovitis and bursitis - The lining of the joint covering of the tendon becomes
ˆ˜v>“i`ʜÀÊ̅ˆVŽi˜i`°Ê­ˆ}ÕÀiÊ£®
U Loose bodies - A piece of cartilage can break off the covering of the joint and float
vÀiiʈ˜Ê̅iʍœˆ˜ÌÊV>ÕȘ}ÊV>ÌV…ˆ˜}Ê>˜`Ê«>ˆ˜°Ê­ˆ}ÕÀiÊ{®
U Impingement - Usually caused by weakness or narrowing of the space between
̅iʅՓiÀ>Ê…i>`Ê>˜`Ê̅iÊ>VÀœ“ˆœ˜°ÊÊ*>ˆ˜ÊˆÃÊV>ÕÃi`Ê܅i˜Ê̅iÊ>À“ʈÃÊÀ>ˆÃi`ʜÛiÀÊ
̅iʅi>`°Ê­ˆ}ÕÀiÊ£®
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A Helpful Guide
3
HOW TO PREPARE FOR ARTHROSCOPIC SHOULDER SURGERY
UÊ*Ài«>À>̈œ˜ÊvœÀÊÃÕÀ}iÀÞÊLi}ˆ˜ÃÊ>ÃÊܜ˜Ê>ÃÊޜÕÀÊ`œV̜ÀÊÀiVœ“mends surgery.
UÊ Ü>ÞÃÊ V>ÀÀÞÊ >Ê ˆÃÌÊ œvÊ ÞœÕÀÊ VÕÀÀi˜ÌÊ “i`ˆV>̈œ˜ÃÊ ÜˆÌ…Ê ÞœÕ°Ê ÌÊ
is very important that we, as your healthcare providers, know
what medications you are taking. Your list should include the
name of the medication, the dosage of the medication, how
many times a day you take the medication, and at what time
you take the medication.
UÊ*Àiœ«iÀ>̈ÛiÊVi>À>˜ViʇÊ9œÕÊŜՏ`ʘœÌˆvÞÊޜÕÀÊv>“ˆÞÊ`œV̜ÀÊ
of your decision to have surgery. You may need to have an EKG
to check the condition of your heart, schedule lab work, or possibly a chest x-ray.
UÊ
ÕÀÀi˜Ìʓi`ˆV>̈œ˜ÃʇÊvÊޜÕÊ>ÀiÊVÕÀÀi˜ÌÞÊÌ>Žˆ˜}ÊLœœ`Ê̅ˆ˜˜iÀÃÊÃÕV…Ê>ÃÊ>ëˆÀˆ˜]Ê
œÕ“>`ˆ˜]Ê*>ۈÝ]ÊۈÌ>“ˆ˜Ê]Ê>˜Ìˆ‡ˆ˜y>““>̜ÀÞÊ`ÀÕ}ÃÊÃÕV…Ê>ÃÊ`ۈÊœÀʏiÛi]ÊޜÕÊ܈Ê˜ii`Ê̜Ê`ˆÃcuss with your family doctor when it is safe to stop taking these medications. In most cases, these medications should
LiÊÃ̜««i`ÊwÛiÊ̜ÊÃiÛi˜Ê`>ÞÃÊ«ÀˆœÀÊ̜ÊÃÕÀ}iÀÞ°ÊÊiÌÊޜÕÀÊv>“ˆÞÊ`œV̜ÀÊ`iVˆ`iÊiÝ>V̏ÞÊ܅i˜Ê>˜`ʅœÜÊ̜ÊÃ̜«Ê̅i“°
THE WEEK OF SURGERY
U 9œÕÊ ÜˆÊ LiÊ ÃV…i`Տi`Ê >Ê «Àiœ«iÀ>̈ÛiÊ ÛˆÃˆÌÊ >ÌÊ "À̅œ«>i`ˆVÊ ÃÜVˆ>ÌiÃÊ LivœÀiÊ
ޜÕÀÊÃÕÀ}iÀÞ°ÊÊvÊޜÕʅ>ÛiʘœÌÊ>Ài>`ÞÊ}ˆÛi˜ÊœÕÀʜvwViÊ>ʏˆÃÌʜvÊ>ÊœvÊޜÕÀÊVÕÀÀi˜ÌÊ
medications, please bring that with you for this visit. Your medical clearance, if
needed, should be completed at this time. A note from your family doctor or
heart doctor, any lab work, and a recent copy of your EKG should be brought
܈̅ÊޜÕʜÀÊv>Ýi`Ê̜ÊÕÃÊ«ÀˆœÀÊ̜ÊޜÕÀʜvwViÊۈḚ̀ÊÊ
U vÊޜÕÊ`œÊ˜œÌÊ}œÊ̜ÊޜÕÀÊ«Àiœ«iÀ>̈ÛiÊVi>À>˜ViÊ>««œˆ˜Ì“i˜ÌʜÀÊv>ˆÊޜÕÀÊVi>Àance test, the surgery will be postponed until proper clearance has been obÌ>ˆ˜i`°ÊÊ7iÊ܈Ê˜œÌÊ«ÀœVii`Ê>}>ˆ˜ÃÌÊ̅iÊ>`ۈViʜvÊ>˜œÌ…iÀÊ`œV̜À°ÊÊ
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care doctor when to take your heart medication, blood pressure medication, or
diabetes medication . If applicable, you will also have received instructions when
̜ÊÃ̜«ÊޜÕÀÊ
œÕ“>`ˆ˜]Ê*>ۈÝ]Ê>˜Ìˆ‡ˆ˜y>““>̜ÀˆiÃ]ʜÀÊ>ëˆÀˆ˜°ÊÊ
U ÌʈÃʘiViÃÃ>ÀÞÊ̅>ÌÊޜÕʘœÌˆvÞÊÕÃʈvÊޜÕÊ>ÀiÊ>iÀ}ˆVÊ̜Ê>˜Þʓi`ˆV>̈œ˜Ã°ÊÊ >ÕÃi>ʈÃÊ
not a true allergy. A true allergy can cause a rash, shortness of breath, swelling
of your tongue, or convulsions.
U ÌʈÃÊ>ÃœÊˆ“«œÀÌ>˜ÌÊ̜ʘœÌˆvÞÊÕÃʈvÊޜÕʅ>Ûiʅ>`Ê>˜ÞʅˆÃ̜ÀÞʜvÊ>˜iÃ̅iÈ>ÊVœ“«ˆcations from previous surgeries.
UÊ *i>ÃiʘœÌˆvÞÊÕÃʈvÊޜÕʅ>Ûiʅ>`Ê>ÊLœœ`ÊVœÌʈ˜ÊޜÕÀʏi}ÃʜÀʏ՘}Ê>˜`ʅ>`Ê̜ÊÌ>ŽiÊ>ÊLœœ`Ê̅ˆ˜˜iÀÊvœÀÊ̅ˆÃÊVœ˜`ˆÌˆœ˜°
UÊ Àˆ˜ŽÊ«i˜ÌÞʜvÊÜ>ÌiÀÊ>˜`ʍՈViÃÊ̅iÊÜiiŽÊLivœÀiÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ
UÊ ,i“i“LiÀÊ̜Ê`œÊ>ÊœvÊޜÕÀʏ>ÃÌʓˆ˜ÕÌiÊÀ՘˜ˆ˜}Ê>ÀœÕ˜`Ê̜ܘÊLivœÀiÊÃÕÀ}iÀÞ°ÊÊ9œÕÊ܈Ê˜œÌÊLiÊ>LiÊ̜Ê`ÀˆÛiÊÃ>viÞÊvœÀÊ
several weeks after surgery. You will not be able to lift anything after surgery until told by your doctor or physical
therapist. Do all of your grocery shopping and important errands the week before surgery.
4
Your Arthroscopic Shoulder Surgery
YOUR PREOPERATIVE VISIT WITH US
U 9œÕÊ܈ÊLiÊV…iVŽi`ÊvœÀÊΈ˜ÊVœ˜`ˆÌˆœ˜Ãʘi>ÀÊޜÕÀÊŜՏ`iÀ]ÊVœ`Ã]ÊVœÕ}…Ã]ÊÊ
and fevers.
U 9œÕÊ܈ÊLiÊ}ˆÛi˜Ê̈“iÊvœÀÊ>˜Þʏ>ÃÌʓˆ˜ÕÌiʵÕiÃ̈œ˜ÃʜÀÊV>ÀˆwV>̈œ˜Ã°
U *>ˆ˜Ê>˜`Ê>˜ÌˆLˆœÌˆVÊ«ÀiÃVÀˆ«Ìˆœ˜ÃÊ܈ÊLiÊ}ˆÛi˜Ê>ÌÊ̅ˆÃÊ̈“i°Ê9œÕÊ܈ÊÜ>˜ÌÊ̜ÊwÊ
these prescriptions prior to surgery. You do not want to be waiting for your
pain medications when you are in pain. Please be sure to get all of your
postoperative medications prior to your surgery.
U 9œÕÊ܈ÊÌ>ŽÊ̜Ê̅iÊ«Àiœ«iÀ>̈ÛiʘÕÀÃiÊÀi}>À`ˆ˜}Ê>˜iÃ̅iÈ>°Ê-…iÊ܈Ê}ˆÛiÊ
you the approximate time your surgery will be and when to arrive for prepaÀ>̈œ˜°Ê*i>ÃiʘœÌi]Ê`ÕiÊ̜ʏ>ÃÌʓˆ˜ÕÌiÊÃV…i`ՏiÊV…>˜}iÃÊޜÕÀÊÃÕÀ}iÀÞʓ>ÞÊ
be earlier or later than anticipated.
U ÌÊ̅ˆÃÊ̈“i]ÊޜÕÊ܈Ê>ÃœÊLiÊ}ˆÛi˜Ê>˜Ê>««œˆ˜Ì“i˜ÌÊ̈“iÊ>˜`Ê`>ÌiÊvœÀÊޜÕÀÊ
orthopaedic rehabilitation and postoperative visit with Dr. Volk.
WHAT KIND OF ANESTHESIA WILL I HAVE
U 9œÕÊ܈Ê…>ÛiÊ>ÊVœ“Lˆ˜>̈œ˜ÊœvÊ>ÊÀi}ˆœ˜>ÊŜՏ`iÀÊLœVŽÊ>˜`Ê}i˜iÀ>Ê>˜iÃ̅iÈ>°ÊœÃÌÊÃÕÀ}iœ˜Ã]Ê>˜iÃ̅iȜœ}ˆÃÌÃ]Ê
and patients prefer this. A regional block is called the interscalene block. It will cause everything from your neck to
ޜÕÀÊw˜}iÀ̈«ÃÊ̜ÊLiVœ“iʘՓL°
U /i“«œÀ>ÀÞʘՓL˜iÃÃÊvÀœ“ÊÃÕÀ}iÀÞʈÃÊ}œœ`Ê>˜`ʓi>˜ÃÊޜÕÊ܈Ê…>ÛiʏiÃÃÊ«>ˆ˜ÊœÀʘœÊ«>ˆ˜Ê՘̈Ê̅iÊLœVŽÊÜi>ÀÃʜvv°Ê/…iÊ
wÀÃÌÊviÜʅœÕÀÃÊ>vÌiÀÊÃÕÀ}iÀÞÊ>ÀiÊÕÃÕ>ÞÊ̅iʓœÃÌÊ«>ˆ˜vՏ°ÊÞÊÕȘ}Ê̅iÊLœVŽÊÜiÊV>˜Ê}iÌÊ̅ÀœÕ}…Ê̅>ÌÊ̈“iÊ܈̅ʏˆÌ̏iÊ
or no pain.
THE INTERSCALENE BLOCK
The anesthesiologist will clean your neck area with surgical preparation soap. Next they will insert a small thin needle
into the side of your neck. A small amount of electricity is used to locate the proper nerve to your shoulder. Once the
appropriate nerve is found, the anesthesiologist will inject a local anesthetic into this area. Other medications may be
>``i`Ê̜ʈ˜VÀi>ÃiÊ̅iʏi˜}̅ʜvÊ̈“iÊ̅>ÌÊ̅iÊLœVŽÊ܈Ê>ÃÌ°ÊÊ7…i˜Ê̅iÊLœVŽÊˆÃÊVœ“«iÌi`]ÊޜÕÊ܈ÊLiÊÌÀ>˜ÃviÀÀi`Ê̜Ê
the operating room and put into a light sleep for surgery.
A Helpful Guide
5
PREPARE YOUR HOUSE BEFORE SURGERY
UÊ ÀÀ>˜}iÊvœÀÊܓiœ˜iÊ̜Ê`ÀˆÛiÊޜÕÊ̜Ê>˜`ÊvÀœ“ÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ9œÕʓ>ÞʘœÌÊLiÊ>LiÊ̜Ê`ÀˆÛiÊÃ>viÞÊvœÀÊÃiÛiÀ>ÊÜiiŽÃÊ
after surgery because you will be on pain medication that might affect your judgment. Also, your arm will be in a
ŜՏ`iÀʈ““œLˆˆâiÀÊ>˜`ÊޜÕʓ>ÞʘœÌʅ>ÛiÊi˜œÕ}…ÊÃÌÀi˜}̅Ê̜Ê`ÀˆÛiÊ܈̅ʜ˜iʅ>˜`°
UÊ ,i“œÛiÊ>Ê̅ÀœÜÊÀÕ}ÃÊ̅>ÌÊVœÕ`ÊV>ÕÃiÊޜÕÊ̜ÊÌÀˆ«°
UÊ ii«Ê…>Ü>ÞÃ]ÊLi`Àœœ“Ã]Ê>˜`ÊL>̅Àœœ“ÃÊvÀiiʜvÊVÕÌÌiÀ°
UÊ ii«Ê>Ê«œÀÌ>LiÊ«…œ˜iʘi>ÀÊޜհ
UÊ ii«Ê>ʏˆÃÌʜvÊi“iÀ}i˜VÞʘՓLiÀÃÊVœÃiÊLÞ°
UÊ 7iÊÃÌÀœ˜}ÞÊÀiVœ““i˜`ÊÏii«ˆ˜}ʈ˜Ê>ʓœÀiÊÕ«Àˆ}…ÌÊ«œÃˆÌˆœ˜Ê̜ÊLiÊVœ“vœÀÌ>LiÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊÊ-œ“iÊ«iœ«iÊ«ÀiviÀÊ̜Ê
sleep in a recliner, purchase a pillow wedge or use extra pillows to sleep in more of an upright position.
UÊ "LÌ>ˆ˜Ê>ÊviÜʏ>À}iÊLÕÌ̜˜Ê`œÜ˜ÊňÀÌðÊ9œÕÊ܈Ê˜œÌÊLiÊ>LiÊ̜ÊÀ>ˆÃiÊޜÕÀÊ>À“ÊœÛiÀÊޜÕÀʅi>`ÊvœÀÊÃiÛiÀ>ÊÜiiŽÃ°
UÊ *ÕÀV…>ÃiʓˆVÀœÜ>Û>LiÊ`ˆ˜˜iÀÃʜÀÊwÝÊޜÕÀÊv>ۜÀˆÌiʓi>ÃÊ>˜`ÊvÀiiâiÊ̅i“ÊvœÀÊvÕÌÕÀiÊÕÃi°Ê
UÊ *Ài«>Àiʅi>Ì…ÞÊØ>VŽÃÊ̅>ÌÊV>˜ÊLiÊwÝi`Ê܈̅ʜ˜iʅ>˜`ÊÃÕV…Ê>ÃÊ>««iÃ]Ê«i>ÀÃ]Ê}À>«iÃ]ÊiÌV°
THE DAY OF YOUR SURGERY
UÊ /…iÊ`>Þʅ>ÃÊw˜>ÞÊ>ÀÀˆÛi`ÊvœÀÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ/…iÊÃÌ>vvʈÃʅˆ}…ÞÊÌÀ>ˆ˜i`ÊvœÀÊ
your procedure and for your comfort and safety. Remember, do not eat
or drink anything after midnight.
UÊ 9œÕʓ>ÞÊÌ>ŽiÊޜÕÀʅi>ÀÌʜÀÊLœœ`Ê«ÀiÃÃÕÀiʓi`ˆV>̈œ˜ÃÊ܈̅Ê̅iÊÓ>iÃÌÊ
>“œÕ˜ÌʜvÊÜ>ÌiÀʘiViÃÃ>ÀÞÊ̜ÊÃÜ>œÜÊޜÕÀÊ«ˆÃ°ÊÊ*i>ÃiÊ`œÊ̅ˆÃÊ>ÌÊ̅iÊ
earliest part of the day prior to your surgery.
UÊ />ŽiÊ>ÊŜÜiÀÊLivœÀiÊVœ“ˆ˜}Ê̜Ê̅iÊÃÕÀ}iÀÞ°
UÊ œÊ˜œÌÊÜi>ÀÊ>˜Þʓ>Ži‡Õ«Ê>˜`ÊÀi“œÛiÊ>Ê˜>ˆÊ«œˆÃ…°
UÊ *i>ÃiÊLÀˆ˜}ʏœœÃiÊwÌ̈˜}ÊVœÌ…ˆ˜}]ÊiëiVˆ>ÞÊLÕÌ̜˜Ê`œÜ˜ÊňÀÌð
UÊ vÊޜÕÀÊÃÕÀ}iÀÞʈÃʏ>ÌiÀʈ˜Ê̅iÊ`>Þ]ÊÃÌ>Þʅœ“iʜÀʘi>ÀÊ>Ê«…œ˜iʈ˜ÊV>ÃiÊ̅iÀiÊ
is a cancellation and we can call you in earlier.
UÊ i>ÛiÊ>ÊœvÊޜÕÀʍiÜiÀÞ]ÊÜ>ÌV…iÃ]ÊLœ`ÞÊ«ˆiÀVˆ˜}Ã]ÊÜ>iÌ]Ê>˜`Ê«ÕÀÃiÃÊ>ÌÊ
home.
UÊ ,i“œÛiÊ>Ê«ˆiÀVˆ˜}ðÊiÌ>ÊLœ`ÞÊ«ˆiÀVˆ˜}ÃÊV>˜ÊV>ÕÃiÊLÕÀ˜ÃʈvʏivÌʈ˜°
UÊ *i>ÃiÊ>ÀÀˆÛiʜ˜ÊœÀÊLivœÀiÊ̅iʈ˜ÃÌÀÕVÌi`Ê̈“i°
UÊ ,i“œÛiÊ>Ê`i˜ÌÕÀiÃʜÀÊ«>À̈>Ã°ÊÊ
UÊ œÊ˜œÌÊÜi>ÀÊޜÕÀÊVœ˜Ì>VÌʏi˜ÃiÃʜ˜Ê̅iÊ`>ÞʜvÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ*i>ÃiÊLÀˆ˜}ÊޜÕÀÊ}>ÃÃið
UÊ 9œÕÊ܈ÊLiÊ>Îi`Ê̜Ê}iÌʈ˜ÌœÊ>Ê}œÜ˜ÊvœÀÊÃÕÀ}iÀÞ°
UÊ 9œÕÀÊ6Ê܈ÊLiÊÃÌ>ÀÌi`Ê>˜`Ê܈ÊLiÊÕÃi`Ê̜ÊÌÀ>˜Ã«œÀÌÊyՈ`Ê̜ÊޜÕÀÊÛiˆ˜Ã°ÊÊ/…iÃiÊyՈ`ÃÊ܈ÊLiÊÕÃi`ÊvœÀÊÀi>Ý>̈œ˜]Ê̜ʫÕÌÊ
you to sleep, to wake you up, to give you pain medications, and to give you antibiotics.
UÊ vÌiÀÊ̅iÊ6ʅ>ÃÊLii˜ÊÃÌ>ÀÌi`Ê̅iÊ>˜iÃ̅iȜœ}ˆÃÌÊ܈Ê>`“ˆ˜ˆÃÌiÀÊޜÕÀÊŜՏ`iÀÊLœVŽ°ÊÊ9œÕÀÊLœVŽÊŜՏ`ÊܜÀŽÊvœÀÊ£ÓÊ
̜ÊÓäʅœÕÀðÊÊ­-iiÊÃiV̈œ˜Êœ˜Êˆ˜ÌiÀÃV>i˜iÊLœVŽ®Ê
6
Your Arthroscopic Shoulder Surgery
PAIN CONTROL AFTER SURGERY
UÊ 9œÕÀÊŜՏ`iÀÊLœVŽÊŜՏ`ʎii«ÊޜÕÊVœ“vœÀÌ>LiÊvœÀÊ£ÓÊ̜ÊÓäʅœÕÀÃÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊÊ9œÕʓ>ÞʘœÌˆViÊ>ÊviÜÊ̅ˆ˜}ÃÊ>vÌiÀÊ
surgery such as:
o
The inability to move your shoulder and hand.
o
Swelling may feel different.
o
Your hand and shoulder will be numb.
o
Your eyelid may droop.
o
Your voice may be hoarse.
UÊ /…iÃiÊÃޓ«Ìœ“ÃÊ>ÀiʘœÀ“>Ê>˜`ÊŜՏ`ÊÜi>À œvvʈ˜Ê̅iʘiÝÌÊ£ÓÊ̜ÊÓäʅœÕÀðÊ9œÕʓ>ÞÊviiÊˆŽiÊޜÕÊV>˜˜œÌÊÌ>ŽiÊ>Ê`ii«Ê
LÀi>̅]Ê̅ˆÃʈÃÊ>ÊVœ““œ˜ÊœVVÕÀÀi˜Vi°ÊœÜiÛiÀ]ʈvÊޜÕʅ>ÛiÊŜÀ̘iÃÃʜvÊLÀi>̅Ê̅>Ìʏi>`ÃÊ̜ÊÈ}˜ˆwV>˜Ìʏ>LœÀi`ʜÀÊ`ˆvwVՏÌÞʈ˜ÊLÀi>̅ˆ˜}]Ê̅i˜ÊޜÕÊŜՏ`ÊV>Ê̅iÊ«…ÞÈVˆ>˜Êœ˜ÊV>°ÊÊvÊ̅iÊLÀi>̅ˆ˜}ʈÃÊiÝÌÀi“iÞÊ`ˆvwVՏÌ]ÊޜÕÊŜՏ`ÊV>Ê
™££ÊœÀÊ«ÀœVii`Ê̜Ê̅iʘi>ÀiÃÌÊi“iÀ}i˜VÞÊÀœœ“°ÊÊ
UÊ 7iÊÀiVœ““i˜`Ê̅>ÌÊޜÕÊÀiÃÌÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊÊvÊޜÕÀÊLœVŽÊÃÌ>ÀÌÃÊ̜ÊÜi>ÀʜvvÊ>ÌÊÓÊ>°“°]Ê̅i˜ÊޜÕʅ>ÛiÊ>Ài>`Þʅ>`Êiˆ}…ÌÊ
hours of sleep.
UÊ 7…i˜Ê̅iÊLœVŽÊÃÌ>ÀÌÃÊ̜ÊÜi>ÀʜvvÊ>˜`ÊޜÕÊ>ÀiÊLi}ˆ˜˜ˆ˜}Ê̜ÊviiÊ>ʏˆÌ̏iÊ՘Vœ“vœÀÌ>Li]ÊޜÕʓ>ÞÊLi}ˆ˜Ê̜ÊÌ>ŽiÊޜÕÀÊ
pain medication that has been prescribed for your surgery. Do not wait for your block to completely wear off because
̅iÊ«>ˆ˜ÊVœ˜ÌÀœÊV>˜ÊLiʓœÀiÊ`ˆvwVՏ̰
AFTER SURGERY
UÊ 9œÕÊ܈ÊÜ>ŽiÊիʈ˜Ê̅iÊÀiVœÛiÀÞÊÀœœ“Ê܈̅ÊޜÕÀÊ`ÀiÃȘ}Ê>˜`ÊŜՏ`iÀʈ““œLˆˆâiÀʈ˜Ê«>Vi°ÊÊ*i>Ãiʏi>ÛiÊ̅iÊ`ÀiÃȘ}Ê>˜`ÊŜՏ`iÀʈ““œLˆˆâiÀʜ˜Ê՘̈ÊޜÕÀÊ
wÀÃÌʜÀ̅œ«>i`ˆVÊÀi…>LˆˆÌ>̈œ˜Ê“iï˜}Ê­ÕÃÕ>Þʈ˜Êœ˜iÊ̜Ê̅ÀiiÊ`>Þî°ÊÊ
UÊ 9œÕÀÊwÀÃÌʜvwViÊ>««œˆ˜Ì“i˜ÌÊ܈ÊLiÊ>««ÀœÝˆ“>ÌiÞÊ£ÓÊ`>ÞÃÊvœœÜˆ˜}ÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ
At that time we will take out your sutures, explain your surgery and show you the
operative pictures. Your exact procedure and restrictions will be given to you.
ORTHOPAEDIC REHABILITATION
UÊ 9œÕÀÊwÀÃÌʜÀ̅œ«>i`ˆVÊÀi…>LˆˆÌ>̈œ˜ÊÃiÃȜ˜Ê܈ÊLiʜ˜iÊ̜Ê̅ÀiiÊ`>ÞÃÊ>vÌiÀÊޜÕÀÊ
surgery.
UÊ ivœÀiÊÃÕÀ}iÀÞʓ>ŽiÊÃÕÀiÊ̅>ÌÊޜÕÀʈ˜ÃÕÀ>˜ViÊVœ“«>˜ÞʜÀÊ7œÀŽiÀýÊ
œ“«i˜Ã>tion carrier approves the payment for your rehabilitation at the facility where you will be having it.
UÊ 9œÕÀÊiÝ>VÌÊiÝiÀVˆÃiÃÊ>˜`ÊÀiÃÌÀˆV̈œ˜ÃÊ܈ÊLiÊ>VVœÀ`ˆ˜}Ê̜Ê̅iÊëiVˆwVÊÃÕÀ}iÀÞÊ̅>ÌÊޜÕʅ>`Ê«iÀvœÀ“i`°
WHAT TYPE OF ORTHOPAEDIC REHABILITATION WILL I NEED?
Shoulder Arthroscopy Without Repair
If you have had any of the following surgeries without any type of
repair:
UÊiLÀˆ`i“i˜ÌʜvÊ>Ê«>À̈>ÊÀœÌ>̜ÀÊVÕvvÊÌi>ÀʇÊV>VˆwVÊÌi˜`œ˜ˆÌˆÃ]ʏ>LÀՓÊ
or biceps tendon.
UÊՓvœÀ`ÊÊ«ÀœVi`ÕÀiʇÊÀiÃiV̈œ˜ÊœvÊ̅iÊ`ˆÃÌ>ÊV>ۈVi°
UÊ-ÕL>VÀœ“ˆ>Ê`iVœ“«ÀiÃȜ˜Ê‡Ê}ˆÛˆ˜}ÊޜÕʓœÀiÊë>ViÊLiÌÜii˜Ê̅iÊ
top of the humeral head and the undersurface of the acromion.
UÊ-ޘœÛiV̜“ÞʜÀÊLÕÀÃiV̜“ÞʇÊÀi“œÛˆ˜}ʈ˜y>“i`Ê̈ÃÃÕiÊvÀœ“ʈ˜Ãˆ`iÊ
the shoulder.
A Helpful Guide
7
1
First six
weeks
œÀÊ>˜ÞÊ̅iÃiÊ«ÀœVi`ÕÀiÃ]ÊޜÕÊ܈ÊÕÃiÊޜÕÀÊŜՏ`iÀʈ““œLˆˆâiÀÊvœÀÊVœ“vœÀÌÊ
and can discontinue it whenever you feel comfortable. This is typically anywhere from seven to ten days after the surgery.
Early pendulum exercises and passive range of motion will be performed
`ÕÀˆ˜}Ê̅iÊwÀÃÌÊÜiiŽ°ÊÊ/…ˆÃÊ܈ÊiÛi˜ÌÕ>ÞÊ«Àœ}ÀiÃÃÊ̜Ê>V̈ÛiÊÀ>˜}iʜvʓœÌˆœ˜Ê
and active strengthening exercises when comfortable, which usually takes
two to three weeks from the date of your surgery.
Arthroscopic Rotator Cuff Repair
If an arthroscopic rotator cuff repair was performed then your postoperative
activity and restrictions will be as follows:
2
Week 7 - 12
U /…iÊ wÀÃÌÊ ÃˆÝÊ ÜiiŽÃÊ ÞœÕÊ ÜˆÊ LiÊ ÀiµÕˆÀi`Ê ÌœÊ Üi>ÀÊ >Ê Ãˆ˜}Ê >˜`Ê `œÊ «>ÃÈÛiÊ
external rotation stretches as tolerated, with your elbow at your side to
>V…ˆiÛiÊ>Ìʏi>ÃÌÊ{xcʜvÊiÝÌiÀ˜>ÊÀœÌ>̈œ˜°ÊÊ­-iiʈ}ÕÀiÊ£®
U 9œÕÊ܈ÊLiÊÀiµÕˆÀi`Ê̜ÊÜi>ÀÊ̅iÊψ˜}Ê`>ÞÊ>˜`ʘˆ}…Ì]ʈ˜VÕ`ˆ˜}ÊÏii«ˆ˜}ÊvœÀÊ
̅iÊwÀÃÌÊ̅ÀiiÊÜiiŽÃ°Ê
U /…iÊÃiVœ˜`Ê̅ÀiiÊÜiiŽÃÊÜiÊ܈ÊÀiµÕˆÀiÊ̅>ÌÊޜÕÊÜi>ÀÊ̅iÊψ˜}Ê`ÕÀˆ˜}Ê̅iÊ
`>ÞÊ̈“iÊ>˜`ʓœÃÌÊ`iw˜ˆÌiÞʈvÊޜÕÊ>ÀiÊÜ>Žˆ˜}Ê>ÀœÕ˜`Ê̅iʅœÕÃiʜÀʈvÊޜÕÊ
go outside of your house. If you are sitting inactive, you may take off the
sling keeping your elbow at your side. You may discontinue the pillow por̈œ˜ÊœvÊ̅iÊψ˜}Ê>vÌiÀÊÎÊÜiiŽÃ°
U 7iiŽÃÊÇÊ̅ÀœÕ}…Ê£ÓÊޜÕʓ>ÞÊLi}ˆ˜Ê«>ÃÈÛiÊiiÛ>̈œ˜ÊœvÊޜÕÀÊŜՏ`iÀÊ>ÃÊ
̜iÀ>Ìi`°ÊÊ/…iÊ̅iÀ>«ˆÃÌÊ܈Ê>ÃÈÃÌÊޜÕÊ܈̅ÊÛ>ÀˆœÕÃÊiÝiÀVˆÃiðʭ-iiʈ}ÕÀiÊ
Ó®
3
Week 13 &
Thereafter
U 7iiŽÊ£ÎÊ>˜`Ê̅iÀi>vÌiÀÊޜÕÊ܈ÊLi}ˆ˜Ê>ÊÃÌÀi˜}̅i˜ˆ˜}Ê«Àœ}À>“ʈ˜ÊœÀ̅œpaedic rehabilitation using a /…iÀ>‡>˜`Á and weights. ­-iiʈ}ÕÀiÃÊÎÊEÊ{®
UʘÊV>ÃiʜvÊ>ÊÀiۈȜ˜ÊÀœÌ>̜ÀÊVÕvvÊÀi«>ˆÀʜÀʓ>ÃÈÛiÊÀœÌ>̜ÀÊVÕvvÊÀi«>ˆÀÊ­}Ài>ÌiÀÊ̅>˜ÊxÊV“ʈ˜Ê`ˆ>“iÌiÀ®]ÊÜiÊÌÞ«ˆV>ÞÊ`œÊ˜œÌÊ>œÜÊޜÕÊ̜Ê`ˆÃVœ˜Ìˆ˜ÕiÊ̅iÊ
sling until eight weeks after your surgery and do not begin strengthening
՘̈Ê£ÇÊÜiiŽÃÊ­vœÕÀʓœ˜Ì…îÊ>vÌiÀÊ̅iÊÃÕÀ}iÀÞ°ÊÊ
Uʜ˜Ì…ÊÈÝÊ>˜`Ê̅iÀi>vÌiÀÊޜÕʓ>ÞÊÀiÃՓiÊvՏÊ՘ÀiÃÌÀˆVÌi`Ê>V̈ۈÌÞʈvÊ̅ˆÃʈÃÊ
a primary repair and is less than 5 cm in diameter. If it is a revision repair or
…>ÃÊ>Ê`ˆ>“iÌiÀʜvÊ}Ài>ÌiÀÊ̅>˜ÊxÊV“]ÊÜiÊ܈Ê…>ÛiÊޜÕÊÜ>ˆÌÊ՘̈Ê£Óʓœ˜Ì…ÃÊ
postoperative to resume full unrestricted activity, which could include golf
or overhead sports.
4
Week 13 &
Thereafter
Arthroscopic Biceps Tenodesis
If this is performed without a repair of the rotator cuff, then the same protoVœÊvœÀÊ̅iÊ-*ʏiȜ˜ÊÀi«>ˆÀʈÃÊvœœÜi`Ê­ÃiiÊ-*ʏiȜ˜ÊÀi«>ˆÀÊ«ÀœÌœVœ®°Ê
If this is performed with a rotator cuff repair, then the same protocol is used
vœÀÊ>ÊÀœÌ>̜ÀÊVÕvvÊÀi«>ˆÀÊ­ÃiiÊÀœÌ>̜ÀÊVÕvvÊÀi«>ˆÀÊ«ÀœÌœVœ®°
Arthroscopic Repair of Subscapularis Tendon
vÊÜiÊÀi«>ˆÀÊ̅ˆÃÊëiVˆwVÊ«>ÀÌʜvÊޜÕÀÊÀœÌ>̜ÀÊVÕvvʈ˜Ê̅iÊvÀœ˜ÌʜvÊޜÕÀÊŜՏ`iÀÊ
called the subscapularis muscle, certain exceptions to the rotator cuff protoVœÊ܈Ê>««Þ°Ê/…ˆÃʈ˜VÕ`iÃÊiÝÌiÀ˜>ÊÀœÌ>̈œ˜ÊÀiÃÌÀˆVÌi`Ê̜ÊäcÊvœÀÊ̅iÊwÀÃÌÊÈÝÊ
weeks and then increased as tolerated.
8
Your Arthroscopic Shoulder Surgery
Arthroscopic Anterior Instability Repair
If we perform surgery to correct a dislocating shoulder, the following restrictions and activities apply:
U 7iiŽÊœ˜iÊ̅ÀœÕ}…ÊvœÕÀÊޜÕÊ>ÀiÊ̜ÊÜi>ÀÊ>Êψ˜}ÊvՏÊ̈“iÊ>˜`Ê܈ÊLiÊi˜VœÕÀ>}i`Ê̜ÊiÝÌiÀ˜>ÞÊÀœÌ>ÌiÊ̅iÊ>À“Êœ˜ÞÊäcÊ
­Ì…iÊÃÌÀ>ˆ}…ÌÊ>…i>`Ê«œÃˆÌˆœ˜®°
U vÌiÀÊvœÕÀÊÜiiŽÃÊ̅iÊψ˜}ʈÃÊ`ˆÃVœ˜Ìˆ˜Õi`Ê>˜`ÊޜÕÊ܈ÊLiÊ>œÜi`ʜÛiÀ…i>`ÊÃÌÀiÌV…ˆ˜}Ê>V̈ۈÌÞÊÕȘ}Ê>ÊÀœ«iÊ>˜`ʫՏiÞÊ
in orthopaedic rehabilitation.
U vÌiÀÊÈÝÊÜiiŽÃÊޜÕÊ܈ÊLi}ˆ˜Ê«>ÃÈÛiÊiÝÌiÀ˜>ÊÀœÌ>̈œ˜ÊÃÌÀiÌV…iÃÊ܈̅Ê>Ê}œ>Êœvʅ>ۈ˜}ʜ˜i‡…>vÊ̅iÊ>“œÕ˜ÌʜvÊiÝÌiÀ˜>Ê
ÀœÌ>̈œ˜Ê̅>ÌʈÃÊ«ÀiÃi˜Ìʜ˜Ê̅iʜ««œÃˆÌiÊÈ`iÊ­˜œÀ“>ÊÈ`i®ÊLÞÊ£ÓÊÜiiŽÃÊ«œÃ̜«iÀ>̈Ûi°
U /…iÀ>‡>˜`ÁÊÃÌÀi˜}̅i˜ˆ˜}ʈÃÊLi}՘Ê>ÌÊÈÝÊ̜Êiˆ}…ÌÊÜiiŽÃ°
U vÌiÀÊ̅Àiiʓœ˜Ì…ÃÊޜÕÊV>˜ÊLi}ˆ˜ÊܜÀŽˆ˜}ʜÕÌÊ܈̅ÊÜiˆ}…ÌÃʈ˜Ê>Ê}ޓ°
U vÌiÀÊÈÝʓœ˜Ì…ÃÊޜÕÊ܈ÊLiÊÀii>Ãi`Ê̜ÊvՏÊ>V̈ۈÌÞʈ˜VÕ`ˆ˜}ÊVœ˜Ì>VÌÊëœÀÌð
Arthroscopic Superior Labrum Anterior-Posterior (SLAP) Repair
vÊޜÕʅ>`Ê>ÊÀi«>ˆÀʜvÊ>Ê-*ʏiȜ˜]Ê̅iÊvœœÜˆ˜}Ê>V̈ۈ̈iÃÊ>˜`ÊÀiÃÌÀˆV̈œ˜ÃÊ܈Ê>««Þ\
U œÀÊ̅iÊwÀÃÌÊvœÕÀÊÜiiŽÃ]ÊޜÕÊ܈ÊLiÊÀiµÕˆÀi`Ê̜ÊÜi>ÀÊ̅iÊψ˜}Ê>ÌÊ>Ê̈“ið
U ÕÀˆ˜}Ê̅œÃiÊvœÕÀÊÜiiŽÃ]ÊޜÕÊ܈ÊLiÊÕÀ}i`Ê̜ʫiÀvœÀ“ÊiÝÌiÀ˜>ÊÀœÌ>̈œ˜ÊÃÌÀiÌV…iÃÊ>ÃÊv>ÀÊ>ÃÊ«œÃÈLiÆÊ܈̅ÊޜÕÀÊ}œ>Ê
being to try and match the external rotation of the side that was not operated on by the end of four weeks.
U vÌiÀÊvœÕÀÊÜiiŽÃÊ̅iÊψ˜}Ê܈ÊLiÊ`ˆÃVœ˜Ìˆ˜Õi`°ÊÊÌÊ̅ˆÃÊ«œˆ˜Ì]ÊޜÕÊV>˜ÊLi}ˆ˜ÊœÛiÀ…i>`ÊÃÌÀiÌV…ˆ˜}Ê>˜`ÊVœ˜Ìˆ˜ÕiÊ܈̅Ê
passive external rotation stretches.
U vÌiÀÊÈÝÊÜiiŽÃÊ«œÃ̜«iÀ>̈ÛiÞÊ/…iÀ>‡>˜`ÁÊÃÌÀi˜}̅i˜ˆ˜}ʈÃÊLi}՘°ÊÊ
U vÊޜÕÊiÝ«iÀˆi˜ViÊ«>ˆ˜Ê܈̅ÊÀiÈÃÌi`ÊvœÀÜ>À`Êyi݈œ˜ÊœvÊ̅iÊ>À“Ê>ÌÊÈÝÊÜiiŽÃÊ«œÃ̜«iÀ>̈ÛiÞ]ÊÜiÊ܈Ê`i>ÞÊLˆVi«ÃÊVÕÀÃÊ
until eight weeks postoperatively.
U ÌÊ̅Àiiʓœ˜Ì…ÃÊ«œÃ̜«iÀ>̈ÛiÞÊޜÕÊV>˜ÊLi}ˆ˜ÊܜÀŽˆ˜}ʜÕÌÊ܈̅ÊÃÌÀi˜}̅i˜ˆ˜}ʈ˜Ê̅iÊ}ޓ°ÊÊ>ÃiL>Ê«>ÞiÀÃÊV>˜ÊLi}ˆ˜Ê
̜ʏœLÊ>ÊL>ÃiL>Ê>˜`ʈ˜ˆÌˆ>ÌiÊܓiÊϜÜÊ̅ÀœÜˆ˜}ʓœÌˆœ˜Ã°ÊÊ7iÊ܈ÊÕÃÕ>ÞÊ}iÌÊޜÕʜ˜Ê>˜Êˆ˜ÌiÀÛ>Ê̅ÀœÜˆ˜}Ê«Àœ}À>“Ê
beginning four months postoperatively.
U ÌÊ ÃiÛi˜Ê “œ˜Ì…ÃÊ «œÃ̜«iÀ>̈ÛiÞÊ ÞœÕÊ V>˜Ê Li}ˆ˜Ê ÌœÊ ÀiÌÕÀ˜Ê ÌœÊ vՏÊ >˜`Ê Õ˜ÀiÃÌÀˆVÌi`Ê >V̈ۈÌÞ]Ê ˆ˜VÕ`ˆ˜}Ê >Ê œÛiÀ…i>`Ê
sports.
SOME POSTOPERATIVE EXCEPTIONS
Calcific Tendonitis
*>̈i˜ÌÃÊ܅œÊ…>ÛiÊ>À̅ÀœÃVœ«ˆVÊÃÕÀ}iÀÞÊ̜ÊÀi“œÛiÊV>VˆÕ“Ê`i«œÃˆÌÃʈ˜Ê̅iÊÀœÌ>̜ÀÊVÕvvÊÌi˜`Ê̜ÊLiVœ“iʓœÀiʈ˜y>“i`Ê
and stiff after surgery. Therefore we start immediate postoperative stretching, including passive elevation with a rope
and pulley and passive external and internal rotation.
SLAP Lesion Repair in Association with Small Rotator Cuff Tear
7iʅ>ÛiÊvœÕ˜`Ê̅>Ìʈ˜Ê}i˜iÀ>]Ê«iœ«iÊ܅œÊ…>ÛiÊ̅iÃiÊÌܜʫÀœVi`ÕÀiÃÊÌi˜`Ê̜Ê`iÛiœ«Ê“œÀiÊ«œÃ̜«iÀ>̈ÛiÊÃ̈vv˜iÃÃÊ
and therefore we now start immediate passive forward elevation as well as passive internal and external rotation.
A Helpful Guide
9
POSSIBLE COMPLICATIONS
U Ì…œÕ}…Ê̅iÊ«œÃÈLˆˆÌÞʜvÊVœ“«ˆV>̈œ˜ÃʈÃʏœÜ]ʈvÊ̅iÞʜVVÕÀÊ̅iÞÊV>˜ÊLiÊÛiÀÞÊÃiÀˆœÕðÊÊ*i>ÃiÊVœ˜Ì>VÌÊÕÃÊ>ÌÊ>˜ÞÊ̈“iÊ
>ÌÊ­™ä{®ÊnÓ5‡äx{ä°Ê,i“i“LiÀ]ʜÕÀÊAfter Hours Injury ClinicʈÃʜ«i˜Ê՘̈Ê£ä\ääÊ«°“°Êœ˜ÊÜiiŽ˜ˆ}…ÌÃÊ>˜`ʜ˜Ê->ÌÕÀ`>ÞÃÊ
vÀœ“Ê™\ääÊ>°“°Ê՘̈ÊÇ\ääÊ«°“°Ê7iÊ>ÀiÊVœÃi`ʜ˜Ê-՘`>Þ°Ê
U œ“«ˆV>̈œ˜Ãʓ>Þʈ˜VÕ`i\ÊiÝViÃÈÛiÊLii`ˆ˜}]ʘiÀÛiʈ˜ÕÀÞ]ʈ˜viV̈œ˜]ÊÃÜiˆ˜}ʈ˜Ê̅iʘiVŽÊœÀÊv>Vi]Ê«iÀÈÃÌi˜Ìʅ>˜`Ê
numbness, bruising of the arm, stiffness and recurrent tears of repaired structures.
U vÊޜÕÊviiÊ̅>ÌÊޜÕÊ>Àiʅ>ۈ˜}Ê>ʓi`ˆV>Êi“iÀ}i˜VÞʜÀÊ>ÀiÊ՘>LiÊ̜ÊVœ˜Ì>VÌÊÕÃÊ>ÌÊ>˜ÞÊ̈“iÊ«i>ÃiÊV>Ê™££°
REASONS TO CALL THE DOCTOR
UÊ ˆvwVՏÌÞÊLÀi>̅ˆ˜}°
UÊ iÛiœ«Ê>ÊÌi“«iÀ>ÌÕÀiÊ}Ài>ÌiÀÊ̅>˜Ê£ä£°xc°
UÊ ÝViÃÈÛiÊLii`ˆ˜}ÊvÀœ“Ê̅iÊܜ՘`°ÊÌʈÃʘœÀ“>ÊvœÀÊ̅iÊܜ՘`Ê̜ʅ>ÛiÊ>ÊVi>ÀʜÀÊ«ˆ˜ŽÊ`ˆÃV…>À}iÊvœÀÊ>ÊviÜÊ`>ÞÃÊ>vÌiÀÊ
surgery. If there is a large amount of dark red drainage, apply pressure and contact the doctor.
UÊ vÊޜÕÀʅ>˜`ʜÀÊ>À“ÊÀi“>ˆ˜ÃʘՓLʏœ˜}iÀÊ̅>˜ÊÓ{ʅœÕÀð
UÊ vÊޜÕÀʅ>˜`ÊÌÕÀ˜ÃÊLÕiʜÀÊ«ÕÀ«iÊ>˜`ʈÌÊviiÃʓÕV…ÊVœ`iÀÊ̅>˜ÊޜÕÀʜ̅iÀʅ>˜`°
UÊ ˜ÞÊÃiÛiÀiÊÀi`˜iÃÃʜÀÊ`À>ˆ˜>}iÊ>ÌÊ̅iʈ˜VˆÃˆœ˜ÊœÀÊ̅iʈ˜VˆÃˆœ˜Ê`œiÃʘœÌÊÃi>ÊÕ«Ê>vÌiÀÊ̅iÊÃÕÌÕÀiÃʅ>ÛiÊLii˜ÊÀi“œÛi`°
UÊ vÊ̅iÀiʈÃÊ>Ê܅ˆÌiʜÀÊÞiœÜˆÃ…Ê`À>ˆ˜>}iÊVœ“ˆ˜}ÊvÀœ“Ê>˜ÞʜvÊ̅iʈ˜VˆÃˆœ˜Ã°
SUMMARY
This preoperative brochure is meant to:
UÊ`ÕV>Ìi°
UʘVœÕÀ>}i°
Uʓ«œÜiÀʜÕÀÊ«>̈i˜ÌÃÊ̜ÊÃ>viÞÊÀi>V…Ê̅iˆÀÊ}œ>ÃÊ>ÃʵՈVŽÞÊ>ÃÊ«œÃÈLi°
GOALS
UÊ/œÊLiÊ>ÃÊ«>ˆ˜ÊvÀiiÊ>˜`ÊÃÌÀœ˜}Ê>ÃÊ«œÃÈLiÊÜÊ̅>ÌÊޜÕÊV>˜ÊÀiÌÕÀ˜Ê̜\
o Your sport.
o Your activities of daily living.
o The quality of life you deserve.
THANK YOU
/…>˜ŽÊޜÕÊvœÀÊi˜ÌÀÕÃ̈˜}ÊÕÃÊ܈̅ÊޜÕÀÊV>Ài°ÊÊ7iÊ܈Ê`œÊiÛiÀÞ̅ˆ˜}Ê«œÃÈLiÊ̜ʓ>ˆ˜Ì>ˆ˜ÊޜÕÀÊÌÀÕÃÌÊ>˜`ÊVœ˜w`i˜Vi°Ê
vÊޜÕʅ>ÛiÊ>˜ÞʵÕiÃ̈œ˜ÃÊ«i>ÃiÊV>ÊÕÃÊ­™ä{®ÊnÓx‡äx{ä°
10
Y
Your A
Arthroscopic
th
i Sh
Shoulder
ld S
Surgery
FREQUENTLY ASKED QUESTIONS
HOW SUCCESSFUL IS THE SURGERY?
If a repair is performed, expect:
˜Ê }i˜iÀ>]Ê >À̅ÀœÃVœ«ˆVÊ ÃÕÀ}iÀÞÊ œvÊ Ì…iÊ Ã…œÕ`iÀÊ ˆÃÊ nxÊ
-95% successful, depending on the complexity of the operation and adherence to the postoperative rehabilitation
«ÀœÌœVœ°Ê*œœÀʜÕÌVœ“iÃʅ>ÛiÊLii˜Ê>ÃÜVˆ>Ìi`Ê܈̅\Ê
UÊ-ˆÌ̈˜}Ê`iÎʍœLÊqÊÓÊ̜ÊÎÊÜiiŽÃ
UÊ"˜ÊޜÕÊviiÌʍœLÊqÊÎÊ̜ÊÈÊÜiiŽÃ
Uʈ}…Ê`i“>˜`ʍœLÊqÊÓÊ̜Ê{ʓœ˜Ì…ÃÊ
WHEN CAN I DRIVE?
U *œœÀÊ̈ÃÃÕiʵÕ>ˆÌÞ°
U >À}iʜÀʓ>ÃÈÛiÊÌi>ÀðÊ
U *œœÀÊVœ“«ˆ>˜ViÊ܈̅ʫœÃ̜«iÀ>̈ÛiÊÀi…>LˆˆÌ>̈œ˜Ê>˜`Ê
restriction.
U *>̈i˜ÌÊ>}iÊ­œ`iÀÊ̅>˜ÊÈxÊÞi>Àî°Ê
WHAT ARE THE COMPLICATIONS AND FREQUENCY?
Fortunately, complications from shoulder surgery are infrequent, and those from arthroscopic surgery are even
iÃÃÊ Vœ““œ˜°Ê /…iÃiÊ ˆ˜VÕ`iÊ ­ÜˆÌ…Ê vÀiµÕi˜VÞÊ œvÊ œVVÕÀÀi˜Vi®\Ê
£°Ê iÀÛiÊ ˆ˜ÕÀÞÊ ­£Ê «iÀVi˜Ì®\Ê /…ˆÃÊ À>ÀiÞÊ œVVÕÀÃÊ vœÀÊ Ài«>ˆÀÊ
of massive rotator cuff tears, where soft-tissue releases
are necessary and there is a potential for stretching the
nerves.
ӰʘviV̈œ˜Ê­iÃÃÊ̅>˜Ê£Ê«iÀVi˜Ì®\Ê1ÃiʜvÊ>˜ÌˆLˆœÌˆVÃÊ`ÕÀˆ˜}Ê
the procedure and sterile surgical technique limit the risk
of infection.
ΰÊ-̈vv˜iÃÃÊ­iÃÃÊ̅>˜Ê£Ê«iÀVi˜Ì®\Ê>ÀÞÊÀi…>LˆˆÌ>̈œ˜Ê«Àœtocols decrease the likelihood of permanent stiffness or
loss of motion following a rotator cuff repair. This also less
frequent with arthroscopic procedures.
{°Ê/i˜`œ˜ÊÀi‡Ìi>ÀÊ­ÈÊ«iÀVi˜Ì®\Ê-iÛiÀ>ÊÃÌÕ`ˆiÃʅ>ÛiÊ`œVÕmented tearing of the rotator cuff following all types of
repairs. It appears that tendon re-tear does not guarantee a poor result, return of pain, or poor function.
}>ˆ˜]Ê Ì…ˆÃÊ `i«i˜`ÃÊ œ˜Ê >Ê Ài«>ˆÀÊ ÛiÀÃÕÃÊ ˜œÊ Ài«>ˆÀ°Ê 7ˆÌ…Ê
˜œÊÀi«>ˆÀ]ÊޜÕÊ܈ÊLiÊ>LiÊ̜Ê`ÀˆÛiʈ˜Ê£‡ÓÊÜiiŽÃ°Ê7ˆÌ…Ê>Ê
Ài«>ˆÀ]ÊޜÕÊV>˜ÊiÝ«iVÌÊ̜ÊÀiÌÕÀ˜Ê̜Ê`ÀˆÛˆ˜}ÊvÀœ“ÊӇÈÊÜiiŽÃÊ
following your surgery. This will depend on the extent of
the repair and the frequency and distance you need to
`ÀˆÛi]Ê>ÃÊÜiÊ>ÃÊޜÕÀÊVœ˜w`i˜ViʏiÛi°
HOW LONG DO I HAVE TO WEAR THE SLING?
7ˆÌ…œÕÌÊ>˜ÞÊÌÞ«iʜvÊÀi«>ˆÀÊޜÕÊV>˜Ê`ˆÃVœ˜Ìˆ˜ÕiÊ̅iÊψ˜}Ê
as soon as you are comfortable without it. This can be
>˜Þ܅iÀiÊ vÀœ“Ê xÊ `>ÞÃÊ ÌœÊ ÓÊ ÜiiŽÃ°Ê Ê 7ˆÌ…Ê >Ê Ài«>ˆÀ]Ê ÜiÊ
}i˜iÀ>Þʅ>ÛiÊޜÕÊÜi>ÀÊ̅iÊψ˜}Ê>ÊœvÊ̅iÊ̈“iÊ­iÝVi«ÌÊ
ŜÜiÀˆ˜}®ÊvœÀÊ̅iÊwÀÃÌÊÎÊÜiiŽÃ°Ê/…i˜ÊvÀœ“ÊÜiiŽÊÎʇÈÊޜÕÊ
only need to wear the sling if you are up walking around
the house or you go outside of the house. Those with
massive rotator cuff repairs need to wear the sling up to
nÊÜiiŽÃÊ>vÌiÀÊÃÕÀ}iÀÞ°
DO I HAVE TO WEAR THE SLING AT NIGHT?
7ˆÌ…œÕÌÊ>˜ÞÊÀi«>ˆÀ]ÊޜÕÊ`œÊ˜œÌʘii`Ê̜ÊÜi>ÀÊ̅iÊψ˜}Ê>ÌÊ
˜ˆ}…Ì°Ê7ˆÌ…Ê>ÊÀi«>ˆÀ]ÊÜiÊÜ>˜ÌÊޜÕÊ̜ÊÜi>ÀÊ̅iÊψ˜}Ê܈̅Ê
̅iÊ«ˆœÜÊvœÀÊ̅iÊwÀÃÌÊÎÊÜiiŽÃÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊvÌiÀÊ̅>Ì]Ê
ˆÌ½ÃÊÕ«Ê̜ÊޜհÊ-œ“iÊ«iœ«iÊw˜`ʈÌʓœÀiÊVœ“vœÀÌ>LiÊ̜Ê
Üi>ÀÊ̅iÊψ˜}Ê>Ìʘˆ}…ÌÊLiޜ˜`Ê̅iÊÎÊÜiiŽÃ]ÊiëiVˆ>ÞʈvÊ
̅iÞÊ>ÀiÊÀiÃ̏iÃÃÊÏii«iÀðʏÜ]ÊvœÀÊ̅iÊwÀÃÌÊÃiÛiÀ>Ê˜ˆ}…ÌÃÊ
>vÌiÀÊ̅iÊÃÕÀ}iÀÞ]ÊܓiÊ«iœ«iÊw˜`ʈÌʓœÀiÊVœ“vœÀÌ>LiÊ
to sleep in an upright position or in a recliner chair.
WHERE CAN I GET MORE INFORMATION?
WHEN CAN I SHOWER?
i˜iÀ>ÞʓœÃÌÊ«iœ«iÊ>ÀiÊ>LiÊ̜ÊŜÜiÀÊӇÎÊ`>ÞÃÊ>vÌiÀÊ
̅iÊÃÕÀ}iÀÞ°Ê/…ˆÃʈÃÊÕÃÕ>ÞÊ>vÌiÀÊ̅iÊwÀÃÌÊ`ÀiÃȘ}ÊV…>˜}iÊ
>ÌÊ œÀ̅œ«>i`ˆVÊ Ài…>LˆˆÌ>̈œ˜°Ê 7iÊ >ÃŽÊ ÞœÕÊ ÌœÊ Žii«Ê ̅iÊ
incisions dry with waterproof adhesive bandages and or
plastic wrap and tape. Also, it is important that you do
˜œÌÊÃÕL“iÀ}iÊ̅iʈ˜VˆÃˆœ˜Ãʈ˜ÊÜ>ÌiÀÊ­ÌÕLʜÀÊ«œœ®Ê՘̈Ê>ÌÊ
i>ÃÌÊ {nÊ …œÕÀÃÊ >vÌiÀÊ Ì…iÊ ÃÕÌÕÀiÃÊ >ÀiÊ Ì>Ži˜Ê œÕÌÊ ­ÓÊ ÜiiŽÃÊ
>vÌiÀÊÃÕÀ}iÀÞ®°
*i>ÃiÊviiÊvÀiiÊ̜ÊV>Ê>˜`Ê>ÎʵÕiÃ̈œ˜ÃÊ>ÌÊ>˜ÞÊ̈“i°Ê9œÕÊ
V>˜Êw˜`ʓœÀiʈ˜vœÀ“>̈œ˜Êœ˜Êˆ˜iÊ>Ì\ÊÊÜÜÜ°œ>ÃÌ>Õ}°Vœ“
or www.orthoinfo.aaos.org.
WHEN CAN I GO BACK TO WORK?
This of course depends on what type of work you do and
what type of surgery you have. In general, for arthroscopic surgery without any type of repair:
UÊ-ˆÌ̈˜}Ê`iÎʍœLÊqÊ£Ê̜ÊÓÊÜiiŽÃ
UÊ"˜ÊޜÕÀÊviiÌʍœLÊqÊÓÊ̜Ê{ÊÜiiŽÃ
Uʈ}…Ê`i“>˜`ʍœLÊÀiµÕˆÀˆ˜}ʜÛiÀ…i>`Ê>V̈ۈÌÞÊqÊÈÊ̜ÊnÊ
weeks
(L-R) Albert Volk, MD; Patrick Thompson, PA-C, MPAS; Arlow Bailey, OPA-C
A Helpful
H l f l Guide
G id
11
IT TAKES
A JOINT
TO
PROVIDE
TASK FORCE
QUALITY
POST-OP CARE
Count
Welcome
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award-winning
staff to
Count onon
Welcome
Homecare’s
award-winning
staff to continue
the expert
continue
the
expert
care
you
require
to
recuperate
at
home. Our
programs
care you require to recuperate at home. Our programs help prevent
infections,
help
prevent
infection,
enhance
healing,
and
restore
maximum
mobility
– all in the
enhance healing, and restore maximum mobility – all in the comfort of your home.
comfort of your home.
Welcome Homecare’s Advantages:
U Compassionate nurses certified in advanced wound-care,
diabetic cardiac protocols and medication management
U Supervision by your orthopedic surgeon
U One-to-one care by licensed Physical Therapists
U Seamless integration between surgical team and
Welcome Homecare
U Advanced technologies used in healing, tracking
and communications
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JACKSONVILLE
.... 904-727-9624
LIC# HHA21285096 .................. FAX: 904-720-0059
ORANGE PARK .... 904-272-5044
LIC# HHA21789096 .................. FAX: 904-269-2485
ORANGE
PARK .... 904-272-5044
LIC#
..................
FAX: 904-269-2485
ST. HHA21789096
AUGUSTINE
.... 904-461-0461
LIC# HHA299991624 .................. FAX: 904-461-0468
ST. AUGUSTINE.... 904-461-0461
FERNANDINA
...... 904-277-8330
LIC#
HHA299991624 ..................
FAX: 904-461-0468
LIC# HHA21790096 .................. FAX: 904-277-7923
FERNANDINA ...... 904-277-8330
MACCLENNY
........ 904-259-3111
LIC#
HHA21790096 ..................
FAX: 904-277-7923
LIC# HHA217880961 .................. FAX: 904-259-5176
MACCLENNY ........ 904-259-3111
PALM COAST ........ 866-461-0461
LIC# HHA217880961 .................. FAX: 904-259-5176
LIC# HHA299991624 .................. FAX: 866-461-0468
PALM COAST ........ 866-461-0461
LIC# HHA21285096
LIC# HHA299991624
.................. FAX: 866-461-0468
We deliver better
than anyone
We offer you and your
patients a full range of
post-operative therapies
delivered directly to your
patients, wherever they are.
• Orthopedic Bracing
• Continuous Passive Motion
• Cold Therapy
• Compression Therapy
Systems
• TENS/NMES Electric
Stimulation
One number delivers it all!
1.800.RENT.CPM