Open Rotator Cuff Repair

Operation:
Your operation was performed through a 2-3 inch incision on the top of your shoulder. Your rotator cuff tendon, AC joint, and surrounding structures were inspected under direct visualization, and the diagnosis confirmed. Bone spurs and degenerative tissue were removed, and your torn rotator cuff tendon was sewn back to its normal position on your humerus bone. Additionally, the end of your collar bone may have been removed if your AC joint was found to be degenerative.

Pain:
Upon discharge, you will be given a prescription for pain medication that can be filled at either the hospital or a local pharmacy. The pain medication can be taken every 3 to 4 hours as needed. The medicine will help decrease the level of pain, but it is not meant to completely eliminate the pain. Some pain is expected. If you develop itching, skin rash, nausea or vomiting, please discontinue the medicine and call the office. Additionally, narcotics can cause constipation if used for an extended period of time. If this occurs, you should decrease the use of the prescribed medicine, and increase fluid, roughage and fruit intake in your diet. Please do not use aspirin unless you have OK’d it with your surgeon.

The use of ice decreases both swelling and pain. You may apply ice over your shoulder dressing for two to five days after surgery unless otherwise instructed. If you were given an ice water shoulder wrap, please follow the instructions provided.

Your surgeon may have inserted a pain pump into your shoulder. It consists of a small catheter, or tube, located within the surgical site, and connected to a fluid-filled container of local anesthetic (usually marcaine). The pump will automatically deliver medication directly into the surgical site for approximately two days. The catheter will be removed at your first post-op visit in 2-3 days, or we will provide specific instructions for you to do it at home.

Pain Pump:
You may have been sent home with a continuous infusion apparatus for pain management. The pump works automatically. Please do not pull or push on the pump or its tubing. One of the doctors at Valley Bone & Joint Clinic will remove this apparatus in approximately 48 hours to 72 hours.

Dressings:
Your incisions have been closed with suture and skin tape, covered with gauze pads and held in place with tape or a compressive wrap. Additionally, your pain pump catheter is held secure under a separate transparent bandage. It is not uncommon to notice bloody drainage on your dressing during the first 24-36 hours after surgery. If the drainage soaks through the bandage, simply reinforce it with additional bandages as needed. Please remove the original dressing in 3 days, and replace with sterile gauze and tape. The small incisions can be covered with Bandaids. Please do not remove the skin tape as they will fall off on their own.

Wounds:
The small incisions may be sore and you may develop bruising in the area of surgery as well as down your arm and your chest over the next several days. This will go away, and no special care is needed.

Bathing:
Although it is safe to shower or bathe in 2-3 days, please keep your shoulder incisions dry until after your sutures are removed 10-14 days following surgery (try saran wrap or waterproof tape). Please do not remove the skin tape, and change bandaids as necessary. Do not soak your shoulder under water, and avoid hot tubs and pools for two weeks.

Activity:
You should rest, relax and make arrangements to have someone stay with you for at least 24 hours after discharge. Do not drive any vehicle or operate mechanical equipment for 24 hours following your surgery. Even though you feel normal, your reaction time may be affected by the medication you have received. Returning to work or school depends greatly on working conditions and school requirements.

Immediately following surgery, your arm was placed in a sling, or shoulder immobilizer. It is strongly recommended that your arm remain immobilized in the sling just as it was when you left the surgery center. You may carefully remove the sling/immobilizer several times a day to perform gentle shoulder and elbow exercises, as instructed. You should not attempt to reach out in front of you, to reach overhead, to push or pull yourself up with your operative arm, or to lift objects. However, you are encouraged to move and exercise your hand and fingers. This will decrease the swelling in your arm and ease your rehabilitation.

Diet:
Drink clear liquids (apple juice, ginger ale, broth, 7-Up, etc.). Progress to your regular diet as you feel able. Do not drink alcoholic beverages for at least 24 hours following your surgery. If nauseated, wait 30 minutes and then begin drinking water or 7-Up in small amounts. If clear liquids are tolerated, you may progress to solid food. If nausea continues beyond 24 hours, contact the office.

Precautions:
If you develop a fever (temperature over 101°), unexpected or severe pain, redness, or swelling, please contact the office for consultation or examination. A low-grade fever is common after surgery. If your temperature is elevated, drink plenty of fluids and try regular Tylenol.

Follow-up: A post-operative visit with your surgeon or nurse will be made approximately 3-14 days following surgery to check your wounds and discuss your case. Physical therapy will usually begin three to five days after surgery. Probably the most important thing to remember about your shoulder surgery is that the post-operative rehabilitation is as important as the surgery itself. For this reason, your surgeon and therapists will monitor your rehab program closely, and if you have any questions or concerns, please feel free to discuss the situation with either of them.

Emergency Calls: If you have a problem of an emergency nature and are unable to reach your doctor, go to the Altru Hospital Emergency Room (phone: 701-780-5280); or your nearest hospital or emergency facility.


Contact Your Physician (Or His Alternate) If You Have Any Problems:

  • Fever greater than 101 degrees orally or if at all questionable.
  • Chills
  • Excessive bleeding
  • Separation of the incision
  • Excessive swelling or tenderness
  • Unusual drainage: pus-like drainage (white, yellow, or greenish in color); any excessive drainage
    from the area; foul odor from the incision or dressing.
  • Change in color around the area; excessive redness may indicate infection
  • Change in temperature around the area: unusual warmth
  • Increased pain in operative area