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Postoperative Care

After surgery your shoulder will be placed in a sling as directed by your doctor.  The sling is used to limit motion of your shoulder so that the rotator cuff tendon can incorporate and heal.  In some cases where the repair must be carefully protected, your arm may be placed in a sling with a pillow that is attached around your waist.  It is very important to wear your sling as directed by your doctor after surgery.  The sling is typically used for 4 to 6 weeks after surgery.  You may remove your arm from the sling to bend and straighten your elbow and to move your fingers several times a day.  You should not do any reaching, lifting, pushing, or pulling with your shoulder during the first six weeks after surgery.  You may remove the sling to bathe, dress, and perform elbow range of motion several times a day.

 

Risks and Complications

The list below includes some of the common possible side effects from this surgery.  Fortunately complications are very rare in your doctor’s practice.  Please note that this list includes some, but not all, of the possible side effects or complications.  Complications may include complications from anesthesia, infection (very rare with arthroscopic procedures) , nerve injury (extremely rare), blood vessel injury (extremely rare), bleeding (extremely rare), shoulder stiffness, failure of repair (failure of the tendon to completely heal to bone), failure of the anchors or sutures, failure to improve your symptoms as much as you had hoped, a blood clot can form in your arms or legs and very rarely travel to your lungs, complex regional pain syndrome (a painful condition involving the arm).

Postoperative Care

1.         Sling instructions.  Your sling must be worn for approximately six weeks after surgery.  It is for your comfort.  Wear your sling while sleeping or riding in a motor vehicle.  You may remove your sling while resting or sitting with your arm at your side, however, when you are up and about we recommend wearing this as a reminder to avoid any reaching, lifting, pushing, or pulling.  You should make it a point to remove your arm from the sling three to four times a day to bend and straighten your elbow and move your wrist and hand.  Otherwise you may walk around and sit up as much as you like.

2.         Diet.  We recommend that you eat a light diet the evening of surgery and the next day but you may resume eating a regular diet as soon as you tolerate it.

3.         Pain control.  When you are discharged from the hospital you will be given a prescription for pain medicine.  You may take this medicine as prescribed.  You will be given the option to purchase a cold pack machine.  This machine has a sleeve which is attached to an ice cooler.  You place ice and some water in the cooler and plug this in to a regular outlet.  This circulates cold water through the shoulder sleeve providing relief of pain and swelling after surgery.  You should keep ice on the shoulder frequently for the first 48-72 hours after surgery. We recommend icing 2-3 times per day for the first week especially before sleep.  We do recommend that you put a t-shirt or a thin towel between you and the sleeve so that it doesn’t injure your skin.

4.         Wound care.  You may remove your dressing and shower 48 hours after surgery if you do not have a pain catheter. If you have a pain catheter, this should be removed by a family member 72 hours after surgery along with the shoulder dressing.  You may then shower.   You may not get in a tub or pool and immerse the incisions underwater for six weeks but you may get in the shower and let the water run over them.  Pat the incisions dry afterwards, and place band-aids over the incisions.  There is no need to place any ointment over the incisions.  If you notice drainage, swelling or increased pain 5 days after surgery please call the office.  Redness around the incision is very common and should not be a concern unless it is associated with drainage 5 days after surgery, redness spreading away from the incision or fevers.

5.         Sleep.  It is often very difficult to sleep in the week or two following rotator cuff surgery.  The surgery itself may interfere with your sleep-wake cycle.   In addition, many patients have increased shoulder pain lying flat on their back.  We recommend that you try sleeping in a recliner or in a reclined position in bed.  You may place a pillow between your body and your arm and also behind your elbow in order to move your arm away from your body slightly.  You should wear your sling when you sleep.

6.         Driving.  Operating a motor vehicle may be difficult due to you inability to use your operative arm.  If you should have an accident or get pulled over while wearing a sling, the authorities may consider that driving while impaired.  The decision to drive is based on your comfort level with driving essentially one-handed.  If you need to drive, and a rotator cuff repair has been performed, you should wait at least until you have seen your doctor at the first postoperative visit.  No one should operate a motor vehicle while taking narcotic medications.

7.      Physical therapy.  The decision to prescribe physical therapy and when to start these activities is made on a case by case basis.  This will be discussed with you on your first postoperative visit.  You may be instructed by your surgeon /recovery room nurse to begin gentle range of motion exercises on the day of surgery.  These will be self directed exercises that you start on your own.

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