Arthroscopic shoulder surgery for the treatment of rotator cuff tears: why, when and how it is done.
Edited By: Christopher J. Wahl, M.D., Suzanne L. Slaney, PA-C, ATC, MMS
Last updated Tuesday, May 16, 2006
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Recovering from surgery
How much pain do patients usually have after arthroscopic rotator cuff repair and shoulder surgery for rotator cuff tears, arthroscopic, minimally-invasive and open management and what medications are used to manage it?
Recovery of comfort and function following shoulder
procedures continues over a few months.
Initially, the shoulder must be protected from overuse or stressing the
repair while the shoulder heals using a sling and a very strict rehabilitation
program. Ironically, many patients who
undergo arthroscopic procedures feel very comfortable long before the healing
has taken place, probably because the approach spares the patient from large
incisions and dissection through the muscle tissues.
Immediately postoperatively, the patient is given strong
medications (such as morphine or Demerol) to help with the discomfort of
swelling and the work of the surgery.
Most patients are discharged to home the day of surgery with a
prescription for oral pain medications (such as hydrocodone or Tylenol with
codeine) and an anti-inflammatory medication.
How are medications after arthroscopic rotator cuff repair and shoulder surgery for rotator cuff tears, arthroscopic, minimally-invasive and open management administered? How long will they be needed?
Immediately postoperatively, pain medications are given
through an intravenous (IV) line.
Patients who require a hospital stay are placed on patient controlled
anesthesia (PCA) to allow them to administer their own medication as it is
needed. Oral pain medications are rarely
required after the first two to three weeks following the procedure.
How does pain medication usually affect pain and comfort following arthroscopic rotator cuff repair and shoulder surgery for rotator cuff tears, arthroscopic, minimally-invasive and open management?
Pain medications are 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
appropriate postoperative management.
What are the most frequent and most serious side effects of taking pain medication after arthroscopic rotator cuff repair and shoulder surgery for rotator cuff tears, arthroscopic, minimally-invasive and open management?
Other pain medications (taken through the IV or orally) can
cause drowsiness, slowness of breathing, difficulties in emptying the bladder
or bowel, nausea, vomiting, itching, or allergic reactions. Patients who have been on pain medications
for a long time prior to surgery may find that the usual doses of pain medication
are less effective. For some patients,
balancing the benefits and side effects of medications is challenging. Patients should notify their surgeon if they
have had previous difficulties with pain medications or pain control.
After arthroscopic rotator cuff repair and shoulder surgery for rotator cuff tears, arthroscopic, minimally-invasive and open management, what happens in the hospital and when is the patient usually discharged?
Most patients will not require a hospital stay after an
arthroscopic rotator cuff repair procedure.
Generally, a person must spend an hour or two in the recovery room until
the anesthetic medication has worn off.
The instructions for the care of their shoulder, bathing, use of
medications, and potential problems are explained to the patient and their
family prior to discharge.
What is the recovery from arthroscopic rotator cuff repair and shoulder surgery for rotator cuff tears, arthroscopic, minimally-invasive and open management? What type of rehabilitation is started in the hospital?
When the patient is ready for discharge they should have
been explained:
- What home exercises are appropriate and how often to do
them
- How to take their medications
- When and how to remove the postoperative dressing
- How to use their postoperative sling
- How to care for their shoulder and incisions
- How to recognized potential problems, and what is normal
and abnormal
- Who to call if there is a question
Because fluid is used to expand the shoulder joint during
arthroscopic procedures, the shoulder is frequently swollen for a few days
following surgery. Also, the incisions
will “weep” fluid for a couple of days postoperatively, and the dressing can
become damp.
The patient is asked to refrain from using the shoulder
and arm for any overhead activities EVEN IF IT FEELS GOOD for 3 to 4 weeks
after the procedure and remove the sling only to perform a strict set of
limited exercises of the wrist, elbow and shoulder. These exercises will be explained prior to
discharge.
Some patients find that finding a comfortable position to
sleep can be difficult for the first few days.
Some tricks to help sleeping are to:
- Try sleeping in a semi-reclined position or
recliner chair
- When lying down, support the elbow from behind
with one or two pillows so it doesn’t fall back against the bed
- The patient should not sleep on their side or
stomach
For the first 3 or 4 weeks, a home program of rest and
limited self-therapy is usually recommended.
Then, as healing has progressed, the arm is removed from the sling and a
formal rehabilitation program is started with the physical therapist, on an
outpatient basis.
Surgery for Rotator cuff tears, arthroscopic, minimally-invasive and open management at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington
If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-543-1552 or 425-646-7777 to make an appointment. Our clinical center is located in Seattle Washington, USA
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