Treating Shoulder Dislocation / Subluxation (Instability) and Associated Pain with Minimally Invasive Arthroscopy
Last updated Friday, January 04, 2008
Recovering from surgeryPain and pain management
Pain from this surgery is managed
by the anesthetic and by medications. With the arthroscopic approach, the
patients would leave the hospital that day with a prescription for Vicodin or a
similar narcotic, which could be expected to help them manage postoperative
pain.
With the open approach, the patient is likely to
experience more pain after surgery, and will have an intravenous drip pain
reliever overnight and ice treatment into the next day. Sometimes patient-controlled
analgesia is used to allow the patient to administer the medication. Within a
day or so, the patient usually can be transitioned to oral pain medications such
as hydrocodone or Tylenol with codeine.Use of medications In
most cases pain relievers are prescribed for patients to take one to two weeks
postoperatively.Effectiveness of medications Pain medications can be very powerful and effective. Their proper use lies in the balancing of their pain relieving effect and their other, less desirable
effects. Good pain control is an important part of the postoperative
management.Important side effects Pain
medications can cause drowsiness, slowness of breathing, difficulties in
emptying the bladder and bowel, nausea, vomiting and allergic reactions.
Patients who have taken substantial narcotic medications in the recent past may
find that usual doses of pain medication are less effective. For some patients,
balancing the benefit and the side effects of pain medication is challenging.
Patients should notify their surgeon if they have had previous difficulties
with pain medication or pain control.Hospital stay For those patients who undergo the open shoulder-surgery approach, the patient spends an hour or so in the recovery room postoperatively. A drainage tube is sometimes used to remove excess fluid from the surgical area. The drain is usually removed on the day after surgery. Bandages cover the incision(s). They are usually changed two days after surgery.
Very rarely patients have
complications from surgery, such as infection, that require a longer stay in
the hospital. Recovery and rehabilitation in the hospital After
surgery, some in-patients may see a physical therapist before being discharged
in order to minimize the likelihood of scar tissue. Typically patients will
start physical therapy in earnest after they are home.Hospital discharge At the time of discharge, the
patient should be relatively comfortable on oral medications, should have a dry
incision, should understand their exercises and should feel comfortable with
the plans for managing the shoulder.
For the first month or so after
this procedure, the shoulder on which surgery was performed may be less useful
than it was immediately beforehand.
The specific limitations can be
specified only by the surgeon who performed the procedure. The incision(s) must be kept clean and dry
for the first week after surgery. It is
important that the repaired structures not be challenged until they have had a
chance to heal. Usually the patient is asked to lift little more than a cup of
coffee for one month after surgery and wear a sling when up and about. Convalescent assistance After this shoulder surgery, patients
will be in a sling for the better part of one month, so usually will require
some assistance with self-care, activities of daily living, shopping and
driving during that span. The range of motion with the lower arm is
unrestricted. People may return to work the following week and resume tasks
such as typing (removing their arm from the sling if need be) but should not
put any load on the repaired shoulder.
Patients usually go home after this
surgery, especially if there are people at home who can provide the necessary
assistance. Surgery for Cartilage and ligament tears in the shoulder at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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