Rotator Cuff Repair Post Surgery Information

Review:

• You should be off all medications and supplements that may thin your blood. These should be stopped 10-14 days prior to surgery.
• This includes Aspirin, Advil, Motrin, Aleve, Naprosyn, Voltaren, Mobic -All herbal supplements -All vitamin E supplements or multivitamins that contain vitamin E
• You should be taking 1000mg of Vitamin C every day for 2 weeks prior to surgery and more a minimum of 2 weeks after surgery.
• You should be conscious of the condition of your skin in and around the operative site. If you have scabs and/or pustules, let us know right away. These may predispose you toward infection if left untreated. They may also necessitate cancelling your surgery.
• You should inform us all of your allergies, medications, and medical problems.
• You will be given a surgical packet with information and forms for you to fill out ahead of time and bring with you to the surgery center the day of surgery. Please make sure all of the papers make it back into the packet.
• You will be given a prescription for Doxycycline (an antibiotic). This should be taken twice a day the day before your surgery. You will take it once the morning of your surgery. The day following your surgery, resume taking it twice a day until the prescription is gone.
• Your surgery time and arrival time will be confirmed.

Day of surgery:

• Nothing to eat or drink after midnight the night before your surgery
• The surgery center will let you know which of your prescription medications you should take in the morning with a small sip of water. Nothing else!
• Bring surgical packet with completed forms to the surgery center
• Someone must drive you to and from the surgery center
• You will meet with the anesthesiologist who will discuss anesthesia (typically general) and nerve block with you. The majority of shoulder patients will receive a nerve block to assist with pain control. You will wake up comfortable with minimal pain after a nerve block.
• Surgery typically takes 2 hours and then you will be in the recovery area before being released.
• You will be in a sling when you wake up. You must wear the sling at all times unless instructed otherwise. This includes while sleeping.
• You will sleep best in a semi-upright position. If you have a recliner, this works best. If not, prop yourself up in bed with pillows to maintain a 45 degree incline.
• Specific post-op instructions and pain medication prescriptions will be given to you before your departure home.

Once Home:

• Plan to take it easy the first few days after surgery
• Start with a bland diet before resuming normal eating habits
• Activity as tolerated unless told otherwise
• You may bathe but must keep dressing dry and remain in the sling while doing so
• Ice
• Watch narrated video from surgery. It is not gross and will really help you to understand what is wrong and right with your shoulder.
• May resume prescription medications
• You must avoid any anti-inflammatory medications/NSAIDS for at least 6 weeks, preferably longer as they can interfere with healing. You will be instructed as to when it is safe to resume these.
• Use of tobacco will significantly interfere with cuff healing. You must stop all tobacco products 2 weeks prior to surgery.
• When you first get home, take an Oxycontin after you have had a small snack such as toast, cookies, etc. Having something in your stomach prior to taking the medicine can prevent nausea and vomiting. You may take Oxycontin every 12 hours.
• Once you feel the block wearing off (ie sensation returning) take 2 Percocet with a snack and then repeat every 4 hours. Set the alarm to medicate during the night. Most people are comfortable with this regimen. If your pain cannot be controlled, you may increase to Oxycontin 20mg every 12 hours.
• Constipation can be an issue while taking narcotics. Make sure to remain hydrated. Dried fruit and prune juice can help the stools soften and promote early bowel movements. If you haven’t had a bowel movement in 2 days with this, take Miralax as directed.
• Take your pain medication. The first few days after surgery try to stay ahead of the pain. If you have trouble with your medications, please let us know. Less and less pain medication will be needed the further you get out from surgery. Patients are typically off their pain meds 4-6 weeks after surgery.

Follow-up Appointment: (Usually the week following surgery)

• Discuss surgery findings/video
• You may get incision sites wet in the shower but no pool, spa, bathtub, or ocean until sites are completely healed (typically 10-14 days). A prescription for a shower sling will be given to you as you must remain in a sling for bathing.
• The sling will be worn for the first 6 weeks after surgery. Larger tears/repairs may require longer use.
• You should not drive while you are taking pain medication and/or are in the sling.
• PRP will be offered to you. PRP (platelet rich plasma) uses your own blood that is “spun down” and injected into the operative site to help stimulate you body’s ability to heal. Unfortunately insurance companies do not pay for this.
• Please remember that you must follow the strict post-op protocol in order to give you the best change of an optimal outcome. Despite how well your shoulder may feel, these guidelines and restrictions are put into place to keep your repair protected.

Physical therapy: (in general)

• Will be begin around 3-4 weeks post op starting with gentle passive range of motion exercises under the direction of a physical therapist.
• At 6 weeks the sling will be discontinued and active range of motion will be allowed with physical therapy.
• No strengthening or resistance will be allowed until you are 3 months post op. This may be longer depending upon the size of your tear and repair.
• You should not be lifting anything heavier than a cup of coffee before 3 months.
• Return to full function and sports activity usually takes 4-6 months.