Total Shoulder Replacement

Post-Operative Instructions/Information after Total Shoulder Replacement

Clothing for Hospital Should Include Loose Fitting Upper Apparel

• A loose fitting sleeveless undershirt followed by a loose button down shirt.
• Please do not wear a traditional bra for two weeks, but one with a T-back or racer back straps are okay.

General Information

• A total shoulder surgery is done as an in-patient. It is usual that you are discharged the next day.

Pain Management

• A long acting local anesthetic is generally administered in the shoulder at the end of surgery to decrease pain. The local anesthetic will last for an average of 8-12 hours, with a range of 6-36 hours. Somewhere during this time period, you should expect your shoulder will begin to hurt more, indicating that the local anesthetic is wearing off. Additionally, sometimes a supplemental block is administered by the anesthesiologist. The anesthesiologist will discuss this option with you.
• It is advisable to begin taking some of the pain medication as soon as the block is felt to wear off. You should try to say ahead of the pain for the first 12 hours after the block wears off only. After that, pain medication should be taken only to treat pain as opposed to preventing it. It is not safe to set an alarm to take pain medication at a specific interval as this can result in overdosing of medication. The oxycodone is for more severe pain and the Vicodin is for less severe pain. The ibuprofen should be taken every day for the anti-inflammatory assistance until no more medication is required.
• The interval for taking pain medication, noted on the bottle every 3, 4 or 6 hours, is a minimal interval only. Pain medication does not need to be used any more often than your pain requires.
• Icing is beneficial, particularly for the first 4 days, and can be applied as often as 10-15 minutes out of the hour while awake. It should be applied a minimum of 4 times a day during the first 4 days. Care should be taken not to place the ice directly over the skin. The Ace wrap or dressing, or a towel should be placed between the ice and the skin.
• Please leave your arm in the Ultrasling except for bathing and changing clothes.
• The pad may be removed as long as your elbow remains at your side. You may unbutton the sling to move your elbow as long as your hand is kept facing your body.

Incisions :

• You will have an incision closed by Steri-Strips that should be kept dry until your first post op visit.

Rehabilitation

• You will need to start physical therapy two weeks after surgery. You will be given an prescription on your first post-operative visit. The number of visits required with the physical therapist will vary depending on how things progress post-operatively.

Signs of Trouble

• If at any point after surgery you develop a fever higher than 101.5 degrees Fahrenheit, or if you notice significant redness, swelling or foul smelling drainage from the incision, please contact Barbara, or the medical assistant covering for her, during our regular office hours. If the problem occurs after office hours, please call the answering service at 503-214-5200. If you experience significant calf pain or swelling, this would be another issue that would be best dealt with immediately.
• In the future you will need to take antibiotics for any dental work or any invasive procedures or injections as prophylactic treatment.
• You may shower after 48 hours as long as the wound is covered with saran wrap and securely tied to keep it dry.