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6. Total Shoulder Arthroplasty
7. Postoperative Care

Postoperative Care

1. Sling instructions: After surgery your shoulder will be placed in a sling. The sling should be worn as directed by your doctor. You should wear your sling if you are up and about, or in large crowds, and while you are sleeping. You can remove the sling to bathe, dress, and if indicated, perform your range of motion exercises several times per day. Watch the video below to see how you should properly wear your sling. 
   
   
   
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.  Increasing fluids and dietary fiber (fruits, vegetables, and whole grains) in the weeks after surgery will assist with any constipation issues you may have from the pain medication.
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 discharged with your 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 urge 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: If you were discharged with a clear dressing covering your incision you should leave it in place until your follow up visit with your surgeon. This type of dressing can get wet, you may shower after your pain catheter is removed. If you were discharged with a white gauze dressing you may remove your dressing 5 days after surgery. After the dressing is removed you may then shower. You may not get in a hot tub or pool and immerse the incision underwater for six weeks but you may get in the shower and let the water run over them. Pat the incisions dry afterwards. There is no need to place any ointment over the incisions, it is better to keep them dry. Sometimes significant bruising is seen in the front of the shoulder or along the biceps muscle. This is normal and is related to mild internal bleeding after surgery. If you notice drainage from the incision, 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 shoulder 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. This is often much more comfortable.  You may place a pillow behind your elbow in order to move your arm away from your body slightly. This often helps with the pain. 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 you should wait at least until you have seen your doctor at the first postoperative visit. Once you are out of your sling you may drive once you feel safe operating a vehicle. No one should operate a motor vehicle while taking narcotic medications. Please limit car driving until you are off narcotics.
7. Physical therapy: In most cases you will begin your physical therapy the morning after surgery. You will be instructed on these exercises by your surgeon and/or an occupational therapist. These exercises will be done 2-3 times per day while in the hospital and at home. The video below also demonstrates your required exercises, as well as, the proper way to wear your sling. 
   
   
   
   Depending on the type of surgery, you may receive instructions for assisted range of motion shoulder exercises with pulleys, continuous passive motion (CPM) or laying down arm raises. Some post-operative instructions don't include moving your shoulder for up to 3 weeks. Following your surgeon's instructions is very important for the success of your recovery.
   

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