Almost all arthroscopic shoulder surgery is done on an outpatient basis. Your hospital or surgery center will contact you about the specific details for your surgery, but usually you will be asked to arrive at the hospital an hour or two prior to your surgery.
Do not eat or drink anything after midnight the night before your surgery. Stop taking anti-inflammatories, including aspirin, ibuprofen (Motrin® or Advil®) and Naprosyn® (Aleve®) 10 days before your operation. Tylenol® is fine to take, as recommended on the bottle for pain, as needed.
After arrival, you will be evaluated by a member of the anesthesia team. Arthroscopy can be performed under general anesthesia sometimes with an additional regional anesthesia. Regional anesthesia, often referred to as a block, numbs your shoulder and arm, and general anesthesia puts you to sleep. The anesthesiologist will help you determine which would be the best for you.
Dr. Gambacorta will make a few small incisions around your shoulder. A sterile solution will be used to fill the shoulder joint and rinse away any cloudy fluid, providing a clear view of your shoulder.
Dr. Gambacorta will then insert the arthroscope to properly diagnose your problem, using the TV image to guide the arthroscope. If surgical treatment is needed, the surgeon can use a variety of small surgical instruments (e.g., scissors, clamps, motorized shavers) through another small incision to remove or repair the torn cartilage, bursal tissue or extra bone spurs. Dr. Gambacorta can also repair torn tendons of the rotator cuff. This part of the procedure usually lasts 1-2hours.
At the conclusion of your surgery, Dr. Gambacorta will close your incisions with sutures and cover them with a bandage. You will be moved to the recovery room. Usually, you will be ready to go home in one or two hours. You should have someone with you to drive you home.
Your Recovery At Home
Recovery from shoulder arthroscopy is much faster than recovery from traditional open shoulder surgery. Still, it is important to follow Dr. Gambacorta’s instructions carefully after you return home. You should ask someone to check on you that evening.
The initial swelling in your shoulder goes down over the first few days. Sitting and sleeping in an elevated position may be more comfortable for short period of time after surgery. Apply ice as recommended by Dr. Gambacorta to relieve swelling and pain.
You will leave the hospital with a dressing covering your shoulder. You may remove the dressing 2 days after surgery unless otherwise directed. You may shower, but should avoid directing water at the incisions. Do not soak in a bath, swimming pool or hot tub. After your shower thoroughly pat dry the incision site and apply a band aids. Keep your incisions clean and dry. If a brace was applied after surgery instructions concerning range of motion restrictions and care will be discussed after surgery. Dr. Gambacorta will see you in the office 10-14 days after surgery to check your progress, review the surgical findings, and begin your postoperative treatment program.
Exercises For Your Shoulder
You should exercise your shoulder and arm regularly for several weeks following surgery to regain motion and strengthen the muscles under the guidance of a physical therapist. Dr. Gambacorta will give you a prescription for physical therapy at your first follow-up appointment with specific exercises and limitations. Until that visit, exercises for your shoulder and arm should consist of gentle pendulum circles with your shoulder and flexion and extension exercises out of the brace for your elbow and wrist at least 3 times a day.
Dr. Gambacorta will prescribe pain medication to help relieve discomfort following your surgery. You will need the medication most for the first two days after surgery, and after that, you should be able to begin to taper off the medication.
Potential postoperative problems with shoulder arthroscopy include infection, blood clots, injury to nerve or blood vessel and an accumulation of blood in the shoulder. These occur infrequently and are typically treatable. There is also a risk of subsequent retear of the cartilage or tendon – strengthening of the shoulder after surgery and avoidance of high risk activities are important in reducing this risk.
Call Dr. Gambacorta, or the orthopaedic surgeon on call, immediately if you experience any of the following:
- Persistent warmth or redness around the knee
- Persistent or increased pain
- Significant swelling in your knee
- Increasing pain in your calf muscle
- Shortness of breath or chest pain
Reasonable Expectations After Surgery
Although arthroscopy can be used to treat many problems, you may have some activity limitations even after recovery. The outcome of your surgery will often be determined by the degree of injury or damage found in your shoulder. Physical exercise and rehabilitation will play an important role in your final outcome. A formal physical therapy program also may add something to your final result.
A return to intense physical activity should only be done under the direction of your surgeon. It is reasonable to expect that by three to six months you should be able to engage in most of your former physical activities. This will be dependent on how fast your body can heal.
If you are a student, you will likely be able to return to school about one week after your surgery. If your job involves heavy work, such as a construction laborer, you may require more time to return to your job than if you have a sedentary job.
This information is intended for education of the reader about medical conditions and current treatments. It is not a substitute for examination, diagnosis, and care provided by your physician or a licensed healthcare provider. If you believe that you, your child, or someone you know has the condition described herein, please see your healthcare provider. Do not attempt to treat yourself or anyone else without proper medical attention.